Health

The United States’ Ebola Relief Money Could Have Been Better Spent

CREDIT: AP Photo/Jerome Delay

Construction workers build an Ebola isolation and treatment center in front of an unfinished and abandoned government building in Monrovia, Liberia

At the height of the Ebola outbreak, 14 out of 15 counties in Liberia had cases of the deadly disease, and medical professionals on the ground reported a shortage of beds in Ebola Treatment Units. Six months after the first reported case in the region, American officials sent nearly 3,000 troops in the West African nation and spent nearly $1.4 billion to help construct nearly a dozen new treatment centers.

Now, Liberian health officials and other international key players say those efforts may have been ill-timed. Reports by American officials show that, out of the 11 treatment units that American troops constructed, only two have been used. Those centers only saw 28 patients since opening last December — suggesting that the funds didn’t make much of a difference, and could have been better used to strengthen Liberia’s healthcare infrastructure and support the inexpensive measures taken on the ground to quell Ebola’s spread.

“My task was to convince the international organizations, ‘You don’t need any more Ebola treatment centers,’ ” Dr. Hans Rosling, a Swedish public health expert who advised Liberia’s health ministry, told the New York Times. “I warned them, ‘The only thing you’ll show is an empty Ebola treatment center,’ ” Rosling added. “‘Don’t do it.’ ”

However, American officials — perhaps reeling from criticism that the U.S. hadn’t responded quickly enough to the Ebola outbreak — ignored calls to shift resources toward capacity building just as the number of Ebola cases in Liberia began to drop. In addition to building 11 centers, the U.S. built another facility in conjunction with a private organization, set up Ebola testing labs, deployed teams to rural areas to battle Ebola in case of flare-ups, and airlifted critical supplies to inaccessible parts of the nation. The U.S. also financed awareness and education campaigns.

But the influx of funds and resources might have been a little too much, too late, according to the new report. A week after President Obama’s announcement, Ebola cases peaked at 635 per week. By the time the first U.S. treatment center opened in mid-November, the weekly rate of infection fell by more than half, according to data collected by the World Health Organization and United States Agency for International Development. On the week when the last of the 11 centers opened in January, health officials reported less than 100 confirmed cases of Ebola.

At the beginning of this year, the Washington Post reported that the U.S.-built centers in Liberia were sitting “nearly empty” as the outbreak began to fade.

Part of the decline in Ebola cases can be attributed to the efforts of residents on the ground who used the little they had to fight the virus in their communities. In one Monrovia-based neighborhood, for example, a 200-volunteer task force led a campaign to place chlorine and buckets in public places and donate two vehicles that volunteers could use to monitor the sick. People in another neighborhood bought rubber boots and megaphones to counter rumors that Ebola didn’t exist.

“Communities taking responsibility for their own future — not waiting for us, not waiting for the government, not waiting for the international partners, but starting to organize themselves,” Peter Graaff, the leader of the United Nations intervention in Liberia, told the New York Times in the wake of the report’s release.

In the months since the start of the Ebola outbreak, African leaders, some of whom have grown increasingly wary of the pitfalls of international aid, have spoken out about the need to maintain financial independence, particularly in case of another public health emergency.

During a two-day summit in Ethiopia’s capital of Addis Abba, The African Union, a coalition of African countries, reached an agreement to impose taxes that leaders said would help the group phase out its use of dollars from the World Powers. This announcement comes two years after Ethiopian officials outlined the East African’s country’s plans to make long-term investments in higher education, agriculture, and manufacturing that would improve its standing in the global economy.

Such moves in the last couple years originated out of a fear of foreign control of Africa nearly half a century after a sweep of independence across the continent. Today, more than 70 percent of the African Union’s operational budget comes from international donors, including the United States and the European Union — a situation that leaders like Zimbabwe President Robert Mugabe and Kenyan President Uhuru Kenyatta say keeps the continent in a state of perpetual colonialism.

“We should be able to take our decisions freely,” Francine Muyumba, head of the Pan-African Youth Union (PYU), told Vanguard Media Limited in February. “In case of emergencies like Ebola, we need to have the means to intervene quickly and without having to wait for foreign money. Money from donors always comes with strings attached.”

Some people also remain skeptical that outside donations are being used for their intended purposes in a country still plagued by corruption and fiscal mismanagement years after the end of a 14-year civil war. Amid reports of an impending $5 billion donation from the international community, Liberians are worried they’ll never personally see any of the benefits of that aid money.

But Liberian Deputy Information Minister Isaac Jackson said that times have changed, and Liberians can hold other Liberians accountable to completing the mission at hand.

“We’ve been able to put in place some of the best measures in accounting for the Ebola money,” Jackson told VOA News. “As we speak, the minister of finance and development planning, the Honorable Amara Konneh, has challenged all ministries and agencies that received Ebola money to carry out proper accountability, meaning they will have to account for Ebola money.”

One area where money could be well-served: An effort to attract and keep the best minds in Liberia, which experts say requires a 500 percent increase of the annual salaries of medical professionals. At the height of the Ebola outbreak, Liberia — a nation with a population of more than 4 million — had fewer than 170 qualified medical professionals, nearly 100 of whom died after contracting the disease. Other African countries face the same problem in many professional fields; one out of nine Africans who hold a degree from a university migrate to one of 34 Organization of Economic Cooperation Development member states — including the United States, Britain, France, and Spain.