WEBVTT - How Funding Cuts Left the World Vulnerable to Ebola 0:00:01.000 --> 0:00:05.320 How funding cuts left the world vulnerable to Ebola, A 0:00:05.360 --> 0:00:08.440 strain with no known treatment or vaccine, is spreading fast, 0:00:08.920 --> 0:00:12.400 and the international system built to contain outbreaks is in crisis. 0:00:12.960 --> 0:00:17.599 By Jason Gale and Jessica Nix, read aloud by Mark Liedorf. 0:00:19.120 --> 0:00:22.280 As the burial workers in masks, gloves and blue surgical 0:00:22.320 --> 0:00:24.759 gowns pull a coffin from the back of a vehicle, 0:00:25.239 --> 0:00:29.560 the mourners press in closer, yelling and gesturing. The crowd 0:00:29.600 --> 0:00:32.279 buffets and shoves the men. Open it so we can 0:00:32.320 --> 0:00:34.639 see him, Open it, so we can see him. They 0:00:34.680 --> 0:00:39.760 shout your thieves onlookers cry you've killed someone. With the 0:00:39.800 --> 0:00:42.760 pressure escalating, the team sets the coffin on the ground 0:00:42.800 --> 0:00:46.440 and steps back, allowing the lid to be opened. An 0:00:46.479 --> 0:00:50.240 ebola patient's viral load often peaks around the time of death, 0:00:50.520 --> 0:00:54.320 when infectious bodily fluids can almost coat the body, making 0:00:54.400 --> 0:00:59.080 touching a corpse especially dangerous. So these chaotic moments captured 0:00:59.120 --> 0:01:01.680 in a shaky self video from the town of Kondo 0:01:01.840 --> 0:01:05.400 in the Eastern Democratic Republic of Congo, risk becoming yet 0:01:05.440 --> 0:01:09.960 another axis of transmission in the growing outbreak. The confrontation 0:01:10.160 --> 0:01:13.920 isn't an isolated event. Treatment tents and isolation wards have 0:01:14.000 --> 0:01:16.880 been set on fire, and tensions at one burial became 0:01:16.959 --> 0:01:20.000 so volatile that police fired warning shots into the air 0:01:20.080 --> 0:01:23.360 to disperse the crowd. In early June, it was reported 0:01:23.360 --> 0:01:26.680 that a team conducting another burial had been attacked, forcing 0:01:26.680 --> 0:01:30.920 workers to abandon the coffin. This violence, stemming from mistrust 0:01:30.920 --> 0:01:34.600 of authorities, is hampering efforts to contain a particularly dire 0:01:34.720 --> 0:01:38.840 outbreak of ebola, whose pathology it can overwhelm the body 0:01:38.880 --> 0:01:43.280 with fever, vomiting, diarrhea, internal bleeding, and organ failure has 0:01:43.319 --> 0:01:46.520 made it one of the world's most feared diseases. As 0:01:46.560 --> 0:01:49.520 of June second, more than four hundred and seventy suspected 0:01:49.600 --> 0:01:52.760 or confirmed cases and at least sixty one deaths had 0:01:52.760 --> 0:01:55.920 been reported across a swath of Congo and Uganda, stretching 0:01:55.920 --> 0:01:58.880 about as far as the distance from New York to Cleveland. 0:01:59.320 --> 0:02:02.440 This outbreak has the most momentum upon discovery of any 0:02:02.480 --> 0:02:06.720 Ebola outbreak in history, says Jeremy Konnandike, a former senior 0:02:06.760 --> 0:02:10.440 official with the US Agency for International Development who oversaw 0:02:10.480 --> 0:02:13.520 the American response to the twenty fourteen to sixteen West 0:02:13.560 --> 0:02:17.960 African Ibola epidemic. It's going to be exceptionally difficult to contain. 0:02:18.960 --> 0:02:22.400 The world spent a decade overhauling ebola preparedness after the 0:02:22.440 --> 0:02:26.079 West African epidemic, which was by far the deadliest on record. 0:02:26.680 --> 0:02:29.440 Even with a steady commitment to those reforms, though the 0:02:29.520 --> 0:02:32.239 current outbreak would have been hard to stop. Much of 0:02:32.280 --> 0:02:35.160 the world's planning focused on the more common zayere strain, 0:02:35.720 --> 0:02:39.160 leading to vaccines, antibody treatments, and rapid tests that have 0:02:39.200 --> 0:02:44.280 successfully disrupted several outbreaks, But the rare bundibujio strain behind 0:02:44.320 --> 0:02:47.920 the current epidemic has no approved vaccine or treatment, and 0:02:48.000 --> 0:02:50.960 widely used diagnostic tools initially failed. 0:02:50.639 --> 0:02:51.280 To detect it. 0:02:51.880 --> 0:02:54.480 The virus also surfaced in one of the hardest places 0:02:54.480 --> 0:02:57.640 in the world to stop an outbreak, a warscuarred region 0:02:57.680 --> 0:03:01.280 where years of conflict have displaced more than five million people, 0:03:01.680 --> 0:03:05.200 hollowed out health systems, and freight trust between communities and 0:03:05.240 --> 0:03:09.959 the government. Former US officials say the challenges were exacerbated 0:03:10.000 --> 0:03:12.720 by a foreign aid freeze announced by the Trump administration 0:03:13.160 --> 0:03:16.280 and the decimation of American backed health programs under Elon 0:03:16.400 --> 0:03:20.640 Musk's Department of government efficiency, which included the dismantling of 0:03:20.760 --> 0:03:24.480 USAID and the cancelation of almost eighty five percent of 0:03:24.520 --> 0:03:28.480 its programs. Prior to that, in Eastern Congo, the agency 0:03:28.480 --> 0:03:32.560 funded health groups, community surveillance, specimen transport, and monitoring of 0:03:32.600 --> 0:03:36.720 potential disease transmission from animals to humans. Other g seven 0:03:36.720 --> 0:03:40.480 countries also cut AID last year, including Germany, France, Japan, 0:03:40.560 --> 0:03:43.680 and the UK, but none did so nearly as deeply 0:03:43.720 --> 0:03:47.200 as the US, whose annual global development assistance dropped by 0:03:47.240 --> 0:03:50.680 fifty seven percent, according to figures from the Organization for 0:03:50.720 --> 0:03:55.720 Economic Cooperation and Development. One flagship US program that supported 0:03:55.760 --> 0:03:59.040 related capacity across Africa, the two hundred and forty five 0:03:59.080 --> 0:04:04.040 million dollars STRO Initiative, was repeatedly halted and restarted, throwing 0:04:04.080 --> 0:04:07.560 contracts and payment systems into turmoil and prompting a major 0:04:07.640 --> 0:04:10.720 partner to lay off staff. According to a former senior 0:04:10.800 --> 0:04:14.880 USAID official who oversaw outbreak preparedness before leaving last year, 0:04:15.680 --> 0:04:19.560 US assistance to Congo has also fallen sharply since last year, 0:04:19.839 --> 0:04:23.440 including steep reductions in humanitarian and health programs tied to 0:04:23.440 --> 0:04:29.000 outbreak preparedness and response CONANDIKE says USAID's former footprinting Congo 0:04:29.400 --> 0:04:31.960 gave American officials a much clearer picture of what was 0:04:32.000 --> 0:04:35.279 happening on the ground, especially in the conflict hit East, 0:04:35.560 --> 0:04:39.640 where humanitarian funding was concentrated. Much of that eyes and 0:04:39.720 --> 0:04:43.719 Ears capability disappeared after missions were closed and staff and 0:04:43.760 --> 0:04:44.559 funding were cut. 0:04:45.440 --> 0:04:46.160 When I was at. 0:04:46.160 --> 0:04:49.080 USAID, if my team had come to me and said 0:04:49.480 --> 0:04:52.600 some of our NGO partners are seeing clusters of unexplained 0:04:52.680 --> 0:04:56.200 viral hemorrhagic fever in eastern Congo, that would be a 0:04:56.200 --> 0:05:00.400 hair on fire type of moment. Conandike says, how many 0:05:00.440 --> 0:05:02.599 of those programs are gone and there's no one on 0:05:02.640 --> 0:05:04.479 the other end of the line in the US government. 0:05:05.520 --> 0:05:09.280 Internal tensions over the cuts spilled into public view early on. 0:05:10.080 --> 0:05:14.840 In congressional testimony last March, Nicholas Enrich, USAID's former Acting 0:05:14.880 --> 0:05:18.240 Assistant Administrator for Global Health, said that after an abola 0:05:18.240 --> 0:05:21.520 outbreak was reported in Uganda in January twenty twenty five, 0:05:21.920 --> 0:05:25.520 bureaucratic bottlenecks tied to the Trump administration's foreign aid freeze 0:05:25.640 --> 0:05:26.680 slowed the response. 0:05:27.320 --> 0:05:29.640 The outbreak was declared over that April. 0:05:30.520 --> 0:05:34.599 Enrich also testified that political appointees had instructed staff to 0:05:34.640 --> 0:05:38.280 give lower priority to ebola response work even after some 0:05:38.360 --> 0:05:42.920 programs resumed. The State Department disputed his account, telling Wired 0:05:43.000 --> 0:05:46.719 magazine that Secretary of State Marco Rubio personally reviewed and 0:05:46.760 --> 0:05:51.200 approved USAID decisions and that Enrich was spreading leaks and lies. 0:05:52.240 --> 0:05:55.279 Other parts of the global disease response system were scaled 0:05:55.320 --> 0:05:57.920 back after the US began withdrawing from the World Health 0:05:58.000 --> 0:06:01.760 Organization in early twenty twenty five. Those cuts included a 0:06:01.800 --> 0:06:06.800 thirty five million dollar award supporting WHO emergency surveillance, laboratory 0:06:06.839 --> 0:06:10.640 networks and outbreak coordination. Funding was also cut for a 0:06:10.760 --> 0:06:14.719 WHO managed global network of more than seven hundred laboratories 0:06:15.000 --> 0:06:19.479 that track pathogens including ibola, denge, and measles. The organization 0:06:19.520 --> 0:06:21.840 has struggled to deal with the collapse of support from 0:06:21.880 --> 0:06:25.200 what had long been its largest donor. With other governments 0:06:25.279 --> 0:06:28.200 not stepping in to fully replace the lost funding, the 0:06:28.320 --> 0:06:32.520 WHO has frozen hiring, laid off staff, and sharply reduced 0:06:32.560 --> 0:06:37.120 spending across emergency operations. Former US officials and on the 0:06:37.160 --> 0:06:40.120 ground partners say the result of these and other cuts 0:06:40.160 --> 0:06:43.880 has been a thinner, slower, and more fragmented international response 0:06:43.920 --> 0:06:48.840 system just as another major Ebola crisis unfolds, The Trump 0:06:48.880 --> 0:06:52.839 administration disputes claims that its policies have weakened outbreak detection, 0:06:53.320 --> 0:06:55.800 and Department of State officials have stressed that an epidemic 0:06:55.880 --> 0:06:58.640 emerging in a remote conflict zone would have been difficult 0:06:58.680 --> 0:07:02.520 to identify under any circmace stances. White House spokesman Cushed 0:07:02.520 --> 0:07:05.479 de Si said in a statement that within twenty four hours. 0:07:05.160 --> 0:07:07.120 Of being notified of the outbreak, the. 0:07:07.080 --> 0:07:12.240 Administration mobilized a swift and robust response, convening top medical experts, 0:07:12.280 --> 0:07:16.920 deploying aid and materiel, increasing screening and testing procedures, airlifting 0:07:16.960 --> 0:07:21.080 American citizens out of the DRC, and implementing travel restrictions. 0:07:21.800 --> 0:07:24.800 Desi added that the US continues to act faster and 0:07:24.880 --> 0:07:28.280 more comprehensively than any other country to contain the transmission 0:07:28.320 --> 0:07:32.280 of Ebola. Timothy Pigott, a spokesman for the State Department, 0:07:32.600 --> 0:07:35.640 says it is false to claim that the USAID reform 0:07:35.680 --> 0:07:39.560 has negatively impacted our ability to respond to Ibola. The 0:07:39.560 --> 0:07:42.120 State Department added in a statement that the realignment of 0:07:42.240 --> 0:07:46.320 USAID did not have any significant effect on funding levels 0:07:46.360 --> 0:07:48.920 for health and health security programs in the eastern part 0:07:48.920 --> 0:07:52.280 of Congo, and that the US has recently mobilized more 0:07:52.280 --> 0:07:54.840 than one hundred and ten million dollars in assistance to 0:07:54.880 --> 0:07:58.440 the country, where it continues to be the largest bilateral donor. 0:07:59.240 --> 0:08:02.560 The Department added that STRIDES and similar programs are now 0:08:02.600 --> 0:08:05.920 overseen by its Bureau of Global Health, Security and Diplomacy, 0:08:06.240 --> 0:08:10.480 a structure that provides more efficient and effective coordination. An 0:08:10.520 --> 0:08:14.280 internal WHO briefing note circulated in mid May and viewed 0:08:14.280 --> 0:08:18.040 by Bloomberg BusinessWeek, warned that aid cuts and conflict were 0:08:18.080 --> 0:08:22.120 pushing parts of Eastern Congo's health system toward collapse. More 0:08:22.160 --> 0:08:25.000 than half of health facilities in some areas had closed 0:08:25.040 --> 0:08:27.560 or been damaged, the note said, and as many as 0:08:27.600 --> 0:08:30.200 eighty five percent of those that remained were facing critical 0:08:30.280 --> 0:08:33.680 drug and staff shortages, with almost forty percent of health 0:08:33.679 --> 0:08:37.640 workers estimated to have left their posts. We're playing catch up, 0:08:37.760 --> 0:08:41.680 says Karen Donnelly, Senior Vice president for Crisis Response, Recovery 0:08:41.679 --> 0:08:45.040 and Development at the International Rescue Committee, which operates health 0:08:45.080 --> 0:08:49.040 sites in Congo. Every delay in tackling any contagious outbreak, 0:08:49.120 --> 0:08:51.319 and especially ebola, can be fatal. 0:08:52.080 --> 0:08:53.520 The IRC, whose. 0:08:53.280 --> 0:08:56.439 Budget relies broadly on the US and other donors, has 0:08:56.480 --> 0:08:59.640 scaled back sixty percent of its Congolese health sites. In 0:08:59.679 --> 0:09:02.960 boom Na, the outbreak's epicenter. Only two of its five 0:09:03.000 --> 0:09:06.560 primary care sites remain in the ten days after the 0:09:06.559 --> 0:09:10.760 outbreak was declared, pharmacies in Bunya ran out of hand sanitizer, 0:09:11.040 --> 0:09:14.760 and local health officials reported shortages of protective equipment. The 0:09:14.800 --> 0:09:18.120 city's laboratory was processing only a trickle of ebola tests 0:09:18.360 --> 0:09:21.280 and briefly suspended operations after running out of fuel for 0:09:21.320 --> 0:09:25.120 a generator. AID workers told The New York Times. As 0:09:25.160 --> 0:09:28.400 for burials, Red Cross teams have people trained to carry 0:09:28.400 --> 0:09:31.040 them out in a safe and dignified manner, but lack 0:09:31.120 --> 0:09:33.760 the money to pay for the work, says Joanne lu, 0:09:33.880 --> 0:09:36.760 a public health professor at McGill University who helped lead 0:09:36.800 --> 0:09:40.479 the response of Medicine Sants Frontier to the West African epidemic. 0:09:41.200 --> 0:09:44.359 The result of all this is a dangerous convergence of crises, 0:09:44.880 --> 0:09:47.400 Ibola spreading through one of the hardest places in the 0:09:47.440 --> 0:09:50.079 world to contain it at a moment when the international 0:09:50.120 --> 0:09:54.720 surveillance and response systems built after past epidemics are significantly weakened. 0:09:55.520 --> 0:09:58.080 I suspect The numbers we have are only a fraction 0:09:58.200 --> 0:10:00.840 of the actual toll, and the limit heated testing and 0:10:00.920 --> 0:10:04.040 contact tracing suggest it will be early to mid June 0:10:04.080 --> 0:10:06.599 before we have a realistic understanding of what's happening on 0:10:06.640 --> 0:10:10.720 the ground, says Craig Spencer, an emergency medicine physician who 0:10:10.720 --> 0:10:14.200 became New York City's first Ebola patient after treating cases 0:10:14.200 --> 0:10:17.720 in West Africa in twenty fourteen. What we're seeing now 0:10:17.880 --> 0:10:22.880 is really the worst case scenario. Ibola is among the 0:10:22.880 --> 0:10:27.080 world's deadliest infectious diseases, with mortality rates ranging from roughly 0:10:27.120 --> 0:10:30.080 twenty five percent to ninety percent, depending on the strain 0:10:30.200 --> 0:10:33.640 and access to care. The consensus among scientists is that 0:10:33.800 --> 0:10:36.440 bats are the natural reservoir for the virus, and that 0:10:36.480 --> 0:10:40.200 it occasionally jumps into humans through contact with them, for example, 0:10:40.200 --> 0:10:43.679 in saliva or droppings that contaminate fruit, or via other 0:10:43.800 --> 0:10:46.720 infected animals, including primates hunted. 0:10:46.400 --> 0:10:47.080 For bush meat. 0:10:47.800 --> 0:10:50.679 Since the virus was first identified in nineteen seventy six 0:10:51.000 --> 0:10:53.840 near the Ebola River in what is now Congo, there 0:10:53.840 --> 0:10:58.800 have been periodic outbreaks, usually in remote rural communities. Once 0:10:58.800 --> 0:11:02.960 in humans, it can read with terrifying efficiency, even tiny 0:11:03.000 --> 0:11:06.559 Amounts of infected fluid entering the body through cuts, scratches, 0:11:06.679 --> 0:11:09.160 or the eyes can be enough to trigger an infection 0:11:10.040 --> 0:11:13.920 as patients become desperately ill. Millions of virus particles can 0:11:13.960 --> 0:11:16.760 concentrate in a single drop of blood, and they can 0:11:16.800 --> 0:11:21.199 also permeate vomit, diarrhea, and sweat, thereby turning basic acts 0:11:21.240 --> 0:11:25.280 of caregiving or burial preparation into dangerous work, especially in 0:11:25.280 --> 0:11:29.160 places with little running water or sanitation. The twenty fourteen 0:11:29.200 --> 0:11:32.720 to sixteen outbreak infected more than twenty eight thousand people 0:11:33.080 --> 0:11:36.400 and killed more than eleven thousand across Guinea, Liberia, and 0:11:36.440 --> 0:11:41.680 Sierra Leone. Infected people also carried the virus to Lagos, London, Madrid, 0:11:41.920 --> 0:11:45.520 New York, and other major cities. The first signs of 0:11:45.559 --> 0:11:49.199 the latest outbreak surfaced as rumors residents in the remote 0:11:49.240 --> 0:11:52.720 mining town of Mongdwalu started posting in early May about 0:11:52.800 --> 0:11:57.000 unusual deaths spreading through the community. Soon, health workers in 0:11:57.080 --> 0:12:00.800 nearby clinics were seeing clusters of patients with fevers, vomiting, 0:12:00.840 --> 0:12:04.960 and profound weakness, symptoms that resemble those of malaria, typhoid, 0:12:05.000 --> 0:12:09.360 and gastro intestinal infections. Initial field tests for the Zayre 0:12:09.440 --> 0:12:12.920 strain came back negative. Blood samples then traveled more than 0:12:12.960 --> 0:12:16.840 one thousand miles through conflict zones to the National Institute 0:12:16.840 --> 0:12:21.240 of Biomedical Research in Kinshasa. The Institute's director General, Jean 0:12:21.320 --> 0:12:25.240 Jacques Muyembe Tamfum, who helped discover Ibola fifty years ago, 0:12:25.559 --> 0:12:29.760 told reporters the samples arrived in poor cold chain conditions 0:12:30.160 --> 0:12:35.079 with temperatures improperly controlled. Preliminary tests on viable samples showed 0:12:35.080 --> 0:12:37.920 the virus in about a dozen African health authorities set 0:12:37.960 --> 0:12:42.000 on May fifteenth. The Bundi Boujo strain was confirmed later 0:12:42.040 --> 0:12:45.679 that day. It now appears the disease had been circulating 0:12:45.760 --> 0:12:50.240 undetected for many weeks. Three Congolese Red Cross volunteers who'd 0:12:50.240 --> 0:12:53.839 handled bodies during a humanitarian mission in late March died 0:12:53.840 --> 0:12:57.439 from ibola last month, pushing back the timeline. 0:12:56.920 --> 0:12:57.640 Of the outbreak. 0:12:58.440 --> 0:13:02.200 Historically, multiple use US funded health partners in eastern Congo 0:13:02.520 --> 0:13:05.880 would likely have been in constant communication with American officials 0:13:06.200 --> 0:13:10.280 as soon as unexplained hemorrhagic fever cases began appearing. Connandike 0:13:10.360 --> 0:13:14.800 says now the formal architecture, but also the informal network 0:13:14.840 --> 0:13:17.559 of relationships, the people you call if you see an 0:13:17.559 --> 0:13:21.960 oh shit kind of problem, it's all gone. We'll be 0:13:22.040 --> 0:13:25.319 right back with how funding cuts left the world vulnerable 0:13:25.360 --> 0:13:32.000 to Ebola. Welcome back to How funding cuts left the 0:13:32.000 --> 0:13:36.960 world vulnerable to Ebola. Standing in front of reporters before 0:13:37.000 --> 0:13:40.320 boarding his plane on the windswept tarmac at Florida's Homestead 0:13:40.360 --> 0:13:43.920 Air Reserve Base on May twenty first, Marco Rubio was 0:13:44.040 --> 0:13:46.960 clear about the US government's top priority in the crisis. 0:13:47.520 --> 0:13:50.160 We care about Ebola. We don't want anyone dying or 0:13:50.200 --> 0:13:53.400 being affected by ebola, he said, But our number one 0:13:53.400 --> 0:13:55.920 priority will always be making sure it doesn't come to 0:13:55.960 --> 0:14:00.600 the United States. That's our number one obligation. One American 0:14:00.679 --> 0:14:04.000 known to have contracted ebola in Congo, a missionary doctor 0:14:04.040 --> 0:14:06.960 believed to have been infected while performing emergency surgery on 0:14:07.040 --> 0:14:10.720 a patient with severe abdominal pain, was evacuated to Germany 0:14:10.760 --> 0:14:14.800 for treatment. Travelers arriving from ebola affected countries are being 0:14:14.880 --> 0:14:19.040 routed through enhanced screening at four US airports, while Green 0:14:19.080 --> 0:14:22.280 card holders who recently traveled through Congo, South Sudan or 0:14:22.360 --> 0:14:25.760 Uganda can be temporarily barred from re entering the country. 0:14:26.320 --> 0:14:29.360 The US has also moved to establish a quarantine facility 0:14:29.360 --> 0:14:32.880 in Kenya for exposed Americans, though the High Court there 0:14:32.920 --> 0:14:36.440 has temporarily barred the site from opening. The State Department 0:14:36.480 --> 0:14:40.400 says its working with Kenyan authorities and is optimistic objections 0:14:40.440 --> 0:14:44.720 will be resolved. An existing network of thirteen containment sites 0:14:44.800 --> 0:14:47.560 was built in the US after the twenty fourteen outbreak, 0:14:47.800 --> 0:14:51.680 but it hasn't been tapped to coordinate response efforts. The 0:14:51.720 --> 0:14:56.040 State Department says it activated disaster response teams on May nineteenth, 0:14:56.360 --> 0:14:59.320 four days after the outbreak was announced by the WHO. 0:15:00.080 --> 0:15:02.280 The more than one hundred and sixty million dollars in 0:15:02.320 --> 0:15:06.080 Ibola related assistance the Department has announced includes funding for 0:15:06.120 --> 0:15:10.040 fifty treatment clinics in Congo and Uganda, though questions remained 0:15:10.040 --> 0:15:12.720 about how this measure will be implemented. The day after 0:15:12.840 --> 0:15:16.320 Rubio made the clinic announcement, the Ugandan Health Ministry said 0:15:16.320 --> 0:15:19.359 it hadn't heard from the US about establishing such facilities. 0:15:19.920 --> 0:15:22.520 The State Department says it will be coordinating with governments 0:15:22.520 --> 0:15:26.760 and frontline responders about the clinics. Former officials note that 0:15:27.080 --> 0:15:30.520 prior to the State Department taking over USAID missions and 0:15:30.560 --> 0:15:33.920 related field infrastructure were well positioned to coordinate with health 0:15:33.960 --> 0:15:38.080 ministries and other parties. Konnandike, who oversaw the construction of 0:15:38.120 --> 0:15:41.680 treatment units during the West African epidemic, says, the last 0:15:41.680 --> 0:15:43.800 thing we would have ever wanted to do is catch 0:15:43.880 --> 0:15:46.520 them off guard with an announcement. We hadn't discussed with 0:15:46.560 --> 0:15:50.080 them first and didn't have their buy in on Ibola. 0:15:50.120 --> 0:15:55.240 Facilities require specialized infection control systems, staff supply chains, and 0:15:55.320 --> 0:15:59.840 community engagement strategies to function swiftly and safely. Proper in 0:16:00.000 --> 0:16:04.480 infrastructure and communication allow responders to rapidly identify, isolate, and 0:16:04.560 --> 0:16:08.720 treat infected people, while contact tracers work to identify, monitor 0:16:08.760 --> 0:16:11.760 and quarantine everyone who is exposed to them until the 0:16:11.760 --> 0:16:15.160 incubation period between two and twenty one days for Ebola 0:16:15.440 --> 0:16:19.800 has passed. All this depends heavily on trust and cooperation. 0:16:20.520 --> 0:16:23.920 Community members must allow contact tracers into their homes and 0:16:24.000 --> 0:16:27.400 agree to isolate, to report symptoms early, and to modify 0:16:27.440 --> 0:16:32.360 burial practices. Right now, in Congo, misinformation is running rampant, 0:16:32.640 --> 0:16:35.720 and almost every day brings another alarming example of how 0:16:35.800 --> 0:16:39.800 trust has broken down, whether its patients fleeing treatment facilities 0:16:39.920 --> 0:16:42.600 or crowds attacking hospitals demanding. 0:16:42.200 --> 0:16:43.800 The release of bodies for burial. 0:16:44.560 --> 0:16:47.400 As many as one in three people in Ituri, the 0:16:47.480 --> 0:16:50.760 province with by far the most cases, believe the virus 0:16:50.800 --> 0:16:54.720 isn't real, according to Action Aid International, a charity group 0:16:54.720 --> 0:16:59.560 that's been conducting information sessions to address these misperceptions. Lou 0:17:00.000 --> 0:17:02.240 and the McGill professor, who worked in West Africa during 0:17:02.280 --> 0:17:06.840 the twenty fourteen apademic says international responders often underestimated how 0:17:07.040 --> 0:17:11.600 terrifying ebola treatment centers appeared to frightened communities. The outreach 0:17:11.640 --> 0:17:15.040 could come across like, Hey, guys, come to die in 0:17:15.040 --> 0:17:18.520 my Ebola center on your own, with people wearing spacesuits, 0:17:18.880 --> 0:17:20.639 and I have no treatment for you, and I have 0:17:20.720 --> 0:17:25.800 no vaccine. She says, there's nothing attractive about that. Grace 0:17:25.840 --> 0:17:29.840 Wairima and Dungu, Senior Manager for Africa Communications and Media 0:17:29.880 --> 0:17:33.320 at Mercy Corps, another of the frontline aid groups operating 0:17:33.359 --> 0:17:36.639 in Congo, says the withdrawal of funding by the US 0:17:36.640 --> 0:17:39.800 and other major donors has led communities to be newly 0:17:39.840 --> 0:17:43.840 suspicious of agencies that re emerged only after Ibola arrived. 0:17:44.480 --> 0:17:47.199 Her organization warned at the time of the pullback that 0:17:47.240 --> 0:17:50.760 the consequences could be far reaching. What we feared most 0:17:50.800 --> 0:17:54.399 has finally come now to be in Dungu says the 0:17:54.480 --> 0:17:57.520 cuts left so many health facilities and health workers out 0:17:57.560 --> 0:18:00.560 of work, and the health facilities without adequateses support and 0:18:00.600 --> 0:18:05.560 the surveillance capacity. Caitlin Brady, Congo, director for the Danish 0:18:05.600 --> 0:18:10.320 Refugee Council, says that although many European governments slashed funding two, 0:18:10.480 --> 0:18:14.520 we're so much weaker without the US. The breakdown of 0:18:14.520 --> 0:18:18.160 trust now harming Ibola response efforts in eastern Congo has 0:18:18.280 --> 0:18:22.400 roots and implications that extend far beyond Central Africa. During 0:18:22.440 --> 0:18:26.880 the COVID nineteen pandemic, public health agencies accumulated enormous powers 0:18:26.920 --> 0:18:32.560 over daily life lockdowns, school closures, vaccine mandates, border restrictions, 0:18:32.560 --> 0:18:36.439 and quarantine rules that reshaped politics across much of the world. 0:18:37.200 --> 0:18:41.560 Many officials argue those tools saved lives, they also triggered 0:18:41.560 --> 0:18:45.879 a backlash that fundamentally altered the political environment surrounding infectious 0:18:45.880 --> 0:18:49.920 disease and contributed to the push to cut aid. Few 0:18:49.920 --> 0:18:53.600 figures have embodied that backlash more than Robert F. Kennedy Junior, 0:18:54.040 --> 0:18:58.240 who built a national following attacking vaccine mandates, pharmaceutical companies, 0:18:58.440 --> 0:19:01.560 and what he described as collusion between public health authorities 0:19:01.560 --> 0:19:06.320 and government regulators. Now, as Health Secretary, Kennedy is overseeing 0:19:06.400 --> 0:19:11.440 responses to simultaneous outbreaks of measles, hantavirus, and ibola, trying 0:19:11.440 --> 0:19:14.160 to reassure supporters that the government will avoid the sweeping 0:19:14.160 --> 0:19:18.040 measures associated with the COVID pandemic, even as officials imposed 0:19:18.040 --> 0:19:22.320 targeted screening, quarantine, and travel restrictions in response to ebola. 0:19:22.800 --> 0:19:25.359 At the headquarters for the Centers for Disease Control and 0:19:25.400 --> 0:19:28.760 Prevention in Atlanta, more than one hundred employees have been 0:19:28.800 --> 0:19:31.960 moved from their day jobs onto the emergency response team. 0:19:32.119 --> 0:19:35.200 According to three people familiar with the agency's actions, who 0:19:35.240 --> 0:19:38.800 requested anonymity because they weren't authorized to speak on its behalf, 0:19:39.480 --> 0:19:41.760 the team is juggling both the hunt of virus and 0:19:41.840 --> 0:19:45.280 ibola outbreaks, starting early in the morning and working late 0:19:45.320 --> 0:19:49.800 into the night. The agency's emergency operations center, always staffed 0:19:49.880 --> 0:19:53.320 twenty four to seven, has grown increasingly crowded and loud. 0:19:53.800 --> 0:19:57.680 People are fielding calls from CDC country offices in Uganda 0:19:57.720 --> 0:20:01.440 and Congo, helping coordinate sampling and lab tests with roughly 0:20:01.480 --> 0:20:04.680 one hundred and thirty employees on the ground. They're also 0:20:04.760 --> 0:20:08.919 working with outside partners, coordinating travel and answering questions from 0:20:09.040 --> 0:20:12.840 congressional offices. The Department of Health and Human Services is 0:20:12.880 --> 0:20:15.920 briefing the White House daily on the Ebola response. Two 0:20:16.000 --> 0:20:19.520 of the people say the challenges have been compounded by 0:20:19.600 --> 0:20:24.120 leadership upheaval and staffing losses at the CDC. Former officials 0:20:24.200 --> 0:20:26.840 say at least a quarter of the agency's employees have 0:20:26.960 --> 0:20:31.000 left over the past year via layoffs, buyouts, or resignations, 0:20:31.040 --> 0:20:35.159 while several senior positions remain filled by acting officials. The 0:20:35.240 --> 0:20:39.200 departures have included both senior outbreak leaders and younger staff, 0:20:39.480 --> 0:20:43.040 says Daniel Jernigan, a thirty one year CDC veteran who 0:20:43.040 --> 0:20:46.639 directed the National Center for Emerging in Zoonotic Infectious Diseases 0:20:46.760 --> 0:20:49.720 from April twenty twenty three to August twenty twenty five. 0:20:50.560 --> 0:20:53.840 You have removed the generals and you've removed the troops 0:20:53.880 --> 0:20:54.760 at the beginning of that. 0:20:54.760 --> 0:20:56.320 Career pipeline, he says. 0:20:57.320 --> 0:21:01.359 Former CDC officials say outbreak messaging is increasingly being routed 0:21:01.400 --> 0:21:06.040 through political appointees with limited public health experience, The officials 0:21:06.040 --> 0:21:09.120 count more than twenty such appointees, a record as far 0:21:09.160 --> 0:21:12.520 as they know, with no career staff scientist remaining in 0:21:12.560 --> 0:21:16.840 the director's office. Deb Horri, chief medical Officer and Deputy 0:21:16.840 --> 0:21:19.760 director for program in Science from December twenty twenty two 0:21:19.840 --> 0:21:22.680 to August twenty twenty five, points to a May tenth 0:21:22.720 --> 0:21:27.400 social media post from HHS as an example of questionable communications. 0:21:28.000 --> 0:21:30.840 The post described an American evacuated from a hunt of 0:21:30.880 --> 0:21:35.520 virus stricken cruise ship as having tested mildly PCR positive 0:21:35.600 --> 0:21:39.480 for Andy's virus. What are you a little bit pregnant? 0:21:39.600 --> 0:21:43.440 Horri asks, that wouldn't come from our staff. She notes 0:21:43.480 --> 0:21:47.840 that recent CDC appointees have backgrounds far removed from infectious 0:21:47.840 --> 0:21:52.760 disease response, including in urology, aviation, law, and real estate. 0:21:53.680 --> 0:21:57.280 Asked about the CDC's response to the Abola outbreak, HHS 0:21:57.320 --> 0:22:01.000 spokesperson Andrew Nixon sent a statement that highlight the mobilization 0:22:01.080 --> 0:22:05.680 of personnel and resources, and also said when dangerous outbreaks emerge, 0:22:05.960 --> 0:22:08.679 ministries of health and public health agencies around the world 0:22:08.960 --> 0:22:13.399 continue to turn to CDC for trusted technical expertise, rapid 0:22:13.440 --> 0:22:17.960 operational support, and public health leadership. The United States remains 0:22:18.000 --> 0:22:22.480 deeply engaged in outbreak detection, containment, surveillance, clinical response, and 0:22:22.520 --> 0:22:26.680 global health security, supported by emergency funding from the US, 0:22:26.840 --> 0:22:30.760 the World Bank, African governments, and international donors. A sprawling 0:22:30.840 --> 0:22:34.920 patchwork of CDC and local health workers, WHO officials, Red 0:22:34.960 --> 0:22:39.600 Cross burial crews, and aid organizations is relying on surveillance, treatment, 0:22:39.800 --> 0:22:43.200 and outreach efforts that are less structured than what existed before. 0:22:43.840 --> 0:22:46.680 Red Cross volunteers met with six hundred and forty five 0:22:46.720 --> 0:22:49.439 families on their first day, going door to door to 0:22:49.520 --> 0:22:54.320 explain how ibola spreads and discourage unsafe burial practices. But 0:22:54.400 --> 0:22:56.960 less than a week after the outbreak was declared, health 0:22:57.000 --> 0:22:59.560 workers were already struggling to follow up with more than 0:22:59.600 --> 0:23:03.560 sixty ten ten hundred identified contacts across the epicenter, reaching 0:23:03.600 --> 0:23:06.840 barely one in five each day as the virus spread 0:23:06.920 --> 0:23:10.920 faster than responders could track it. Everyone knows the struggle 0:23:11.000 --> 0:23:14.840 is steeply uphill. The chains of transmission aren't even connected 0:23:14.880 --> 0:23:18.920 to each other, always a bad sign, Lou says, Now 0:23:18.960 --> 0:23:23.240 I have this same doom feeling. There's little hope for 0:23:23.280 --> 0:23:26.480 a vaccine in the near term, despite the scientific advances 0:23:26.480 --> 0:23:30.800 that emerged during the COVID pandemic. Instead, the Trump administration 0:23:30.880 --> 0:23:35.320 has dismantled or defunded several US programs focused on emerging pathogens, 0:23:35.760 --> 0:23:39.560 including one network designed to identify dangerous viruses before they 0:23:39.600 --> 0:23:43.560 infect humans and potentially to develop vaccines that was scrapped 0:23:43.640 --> 0:23:46.960 last June after being deemed unsafe for Americans and not 0:23:47.040 --> 0:23:50.080 a good use of taxpayer funding, according to a stop 0:23:50.119 --> 0:23:54.480 work order one center received. The administration has also closed 0:23:54.560 --> 0:23:58.320 key divisions at the National Institute of Allergy and Infectious Diseases, 0:23:58.680 --> 0:24:01.800 including one that helped COREP coordinate global outbreak research and 0:24:01.840 --> 0:24:06.880 response efforts. For some former health officials, ebola itself isn't 0:24:06.880 --> 0:24:10.919 the only story. It's also what it portends. We have 0:24:11.080 --> 0:24:15.000 lost so much ground, says Jean Marazzo, a physician who 0:24:15.040 --> 0:24:17.960 succeeded Anthony Fauci as head of the National Institute of 0:24:17.960 --> 0:24:21.879 Allergy and Infectious Diseases in twenty twenty three. Marazzo was 0:24:21.920 --> 0:24:25.720 placed on administrative leave last year and later dismissed after 0:24:25.760 --> 0:24:30.200 publicly criticizing changes to infectious disease policy and research priorities. 0:24:31.080 --> 0:24:33.880 A measle's epidemic that's infected more than forty two hundred 0:24:33.920 --> 0:24:37.679 Americans since January twenty twenty five. Was already a warning 0:24:37.720 --> 0:24:42.639 sign before hantavirus and ebola came along. Now, Marozzo says, 0:24:43.000 --> 0:24:46.040