Ebola Could Be Eradicated — But Only if the World Works Together

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Ebola Could Be Eradicated — But Only if the World Works Together
New treatments for Ebola and drug-resistant tuberculosis offer hope, but they won’t be successful on their own.
By The Editorial Board
New York Times, 16 Aug 2019
The global health community got a few pieces of hopeful news this week. On Monday the World Health Organization announced that two newly developed intravenous drug therapies appear capable of curing Ebola. The medications could help end a continuing epidemic in the Democratic Republic of Congo, where nearly 2,800 people have been infected over the past year and more than 1,800 have died. Combined with the recently developed Ebola vaccine, they could even help eradicate a disease that has killed more than 12,000 people over the past four decades.

Then, on Wednesday, the Food and Drug Administration effectively endorsed a three-drug treatment that appears to cure so-called extensively drug-resistant tuberculosis — the deadliest version of the world’s deadliest infectious disease. Tuberculosis infects about 10 million people globally every year, and roughly 30,000 to 50,000 people are believed to be infected with the extensively drug-resistant strain, which is usually fatal.

Together, these developments could mark a pivotal moment in the century-long quest for global health security. But that quest will only succeed with the help of sustained, cross-border collaboration. For instance, countries need health systems capable of detecting disease outbreaks and delivering and monitoring these new treatments — all of which require substantial funding. International policies must be in place to promote the use of the treatments, and affected communities need to trust the organizations charged with providing their care.

The latest effort to stamp out Ebola in Congo has faced some of these problems — there’s been a deep mistrust of global health workers, and the World Health Organization has received only half of the money that donors have promised to devote to the crisis. The fight against tuberculosis faces similar challenges, including a lack of global investment that has prevented medication and innovative diagnostics from reaching the people who need them most. Roughly a quarter of people believed to be infected with extensively drug-resistant tuberculosis are properly treated for the disease, a problem that will need to be resolved quickly for the new drugs to have an impact.

Each of these challenges has been exacerbated by an increase in xenophobia around the globe. As the journalist Maryn McKenna wrote in The New Republic earlier this year, “the assumption that every nation owes an investment in health to every other nation no longer holds.” Nowhere is this shift more pronounced than in the United States, which until recently was a leader in global health. During the last Ebola outbreak, which spread across West Africa from 2014 to 2016, the Centers for Disease Control and Prevention deployed the largest number of personnel in that agency’s history. By the time the crisis had resolved, the Obama administration had begun a global initiative to better protect the world from infectious disease threats. More than 60 countries ultimately participated.

In recent years, that leadership has all but evaporated. In the past two years, the Trump administration has dissolved the federal government’s biosecurity directorate, scaled back its infectious disease prevention efforts, restricted development aid for countries like Congo, made several attempts to rescind foreign aid, including for global health, and pulled C.D.C. workers from Congo’s outbreak zones without a clear plan to send them back.

The administration has also announced policies meant to scare legal immigrants off public assistance programs, including for health care, to which they are legally entitled. Such policies imperil everyone: The more people who don’t have access to vaccines or antibiotics, the greater the risk that an infectious disease will spread. That applies to diseases like Ebola that might arrive on American shores from other countries, but it also applies to diseases that are already here, like flu and measles. The only reliable way for a country to protect itself from these threats is for it to help other countries do the same.

The new medications for Ebola and tuberculosis are the product of years of investment and careful work. That investment could continue to pay off, but only if the United States and its partners around the world increase their global health efforts, instead of shrinking away from them.