Reid Wilson - Epidemic: Ebola and the global race to prevent the next killer outbreak = Epidemic: Ebola and the global scramble to prevent the next killer outbreak

EPIDEMIC

Ebola and the Global Scramble to Prevent the Next Killer Outbreak

REID WILSON

BROOKINGS INSTITUTION PRESS

Washington, D.C.

Copyright 2018

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Library of Congress Cataloging-in-Publication data are available.

ISBN 978-0-8157-3135-1 (cloth : alk. paper)

ISBN 978-0-8157-3136-8 (ebook)

9 8 7 6 5 4 3 2 1

Typeset in Electra

Composition by Westchester Publishing Services

For Veronica and Max
my two inspirations

Contents

Cast of Characters

In Washington

Barack ObamaPresident of the United States

Chris CoonsSenator from Delaware; member of the Senate Committee on Foreign Relations

Anthony FauciDirector of the National Institute of Allergy and Infectious Diseases

Ron KlainU.S. ebola response coordinator; former chief of staff to Vice President Biden

Jeremy KonyndykDirector, Office of U.S. Foreign Disaster Assistance, U.S. Agency for International Development

Amy PopeDeputy homeland security adviser, National Security Council

Samantha PowerAmbassador to the United Nations

Susan RiceNational security adviser

Rajiv ShahAdministrator, U.S. Agency for International Development

Gayle SmithSenior director for development and democracy, National Security Council

In West Africa

Ellen Johnson SirleafPresident of Liberia

Alpha CondePresident of Guinea

Ernest Bai KoromaPresident of Sierra Leone

Tolbert NyenswahAssistant minister of health, Liberia; head of Incident Management System

Tamba BoimaDirector, Community Health Services Division, Ministry of Health, Liberia

Mosaka FallahEpidemiologist and immunologist

Hans RoslingInternational health expert, Karolinska Institute

Sheik Umar KhanHead of Lassa Fever Program, Kenema Government Hospital

Robert GarryProfessor of Microbiology and Immunology, Tulane University

Piet deVriesCountry director for Liberia, Global Communities

Brett SedgewickDirector of development services, Global Communities

George WoryonwonGlobal Communities

David RobinsonSenior adviser for operations, World Vision International

Craig SpencerMdecins Sans Frontires (Doctors Without Borders)

Kent BrantlySamaritans Purse

Nancy WritebolServing in Mission

David BlackleyEpidemiologist, U.S. Centers for Disease Control and Prevention

Barry FieldsMicrobiologist, U.S. Centers for Disease Control and Prevention

Peter KilmarxEbola response team leader, U.S. Centers for Disease Control and Prevention, Sierra Leone; deputy team leader, U.S. Centers for Disease Control and Prevention, Guinea

Kim LindbladeEpidemiologist, U.S. Centers for Disease Control and Prevention

Joe WoodringSenior medical officer, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention

Dan MartinPublic health adviser, U.S. Centers for Disease Control and Prevention

Leisha NolenEpidemic Intelligence Service, U.S. Centers for Disease Control and Prevention

Deborah MalacU.S. ambassador to Liberia

Darryl WilliamsMajor general, commander, United States Army Africa

Gary VoleskyMajor general, commander, 101st Airborne Division

Ross LightseyLieutenant colonel, 101st Airborne Division

Tony CostelloMajor, 36th Engineer Brigade

Jeff KugelmanCaptain, U.S. Army Medical Research Institute for Infectious Diseases

Michael SchmoyerCaptain, U.S. Public Health Service

Fabian LeendertzEpidemiologist, Robert Koch Institute

In Atlanta

Tom FriedenDirector, U.S. Centers for Disease Control and Prevention

Charlie StokesPresident and chief executive officer, U.S. Centers for Disease Control and Prevention Foundation

At the U.S. Army Medical Research Institute for Infectious Diseases, Fort Detrick, Maryland

John DyeChief of Viral Immunology

Brian GentileColonel, director of administration

David NorwoodChief of Diagnostic Systems Division

Randy SchoeppVirologist

Travis WarrenPrincipal investigator, Division of Molecular and Translational Sciences

In Geneva

Margaret ChanDirector-general, World Health Organization

Christopher DyeDirector of strategy, Office of the Director-General, World Health Organization

Gregory HartlSpokesman, World Health Organization

In Miami

Julio FrenkPresident, University of Miami; member, World Health Organization Ebola Interim Assessment Panel

Preface

THE OUTBREAK OF EBOLA Virus Disease began in 2013 in a small town in rural Guinea. From there, it spread to Liberia, then Sierra Leone, then across borders into Nigeria, Mali, Europe, and the United States. In the end, more than 28,000 people were infected, and 11,325 lost their lives. Dozens of organizations fought the disease, from global organizations like the United Nations and governments like that of the United States to nongovernmental groups like Mdecins Sans Frontires, the Red Crescent/Red Cross, and Global Communities. Together, thousands of responders poured into West Africa to aid the thousands more Guineans, Liberians, and Sierra Leoneans who took it upon themselves to save their own countries.

All those who helped save lives deserve recognition, but it is not possible to tell their stories in one place. Instead, my aim is to relate the broader story of the global response to the outbreak, with a special focus on the United States governments work to combat Ebola, while shining a spotlight on the weak state of global health preparedness. While this volumes goal is to be as comprehensive as possible, I am aware, regretfully, that many heroes of that period will be left out.

Dozens of sources were interviewed for this work over hundreds of hours, beginning even before the outbreak formally ended. The vast majority of those sources spoke on the record. In the few instances where those sources asked for anonymity to discuss sensitive topics, I have sought to provide as much contextual information about their identities as those sources would allow.