JAMA
January 6, 2015, Vol 313, No. 1
http://jama.jamanetwork.com/issue.aspx

Viewpoint | January 6, 2015
The President’s National Security Agenda – Curtailing Ebola, Safeguarding the Future
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Lawrence O. Gostin, JD1; Henry A. Waxman, JD2; William Foege, MD, MPH3
[+] Author Affiliations
JAMA. 2015;313(1):27-28. doi:10.1001/jama.2014.16572.
[Excerpt]
The Ebola epidemic is projected to affect tens of thousands in Sierra Leone, Liberia, and Guinea, with immense economic and social costs. Even in the United States, where only 1 patient with Ebola virus disease has died, the disease has spurred public fear, tested the readiness of the public health system, and led to measures such as enhanced border screening and state quarantines. The lesson of Ebola is clear: strong, resilient health systems are needed in Africa to curtail the outbreak at its source and in the United States to ameliorate risks and reassure the public.

The United States has led the global response to Ebola, devoting significant financial and human resources, deploying military troops, and sponsoring a groundbreaking United Nations Security Council resolution. Although there is some evidence that the spread of the disease is slowing in Liberia, the response of the United States is still not complete. Health systems in West Africa have been overwhelmed, and the US domestic public health system was not initially prepared, with inadequate training of and protection for health workers and inconsistent exercise of public health powers. This should not be a surprise given the severe budget cuts of recent years, including a 10% reduction in the Centers for Disease Control and Prevention’s 2013 budget1 and the loss of more than 50 000 state public health professionals.2

President Obama is trying to address these challenges. On November 5, 2014, he submitted a $6.2 billion emergency supplemental funding request to Congress to improve domestic and global health capacities in 3 critical areas: a surge of resources for containment and treatment in West Africa; enhanced prevention and detection of, and response to, Ebola entering the United States; and, perhaps most important, buttressing health systems to respond rapidly and flexibly to all hazards in the future.3 Epidemics will occur in the future. It is urgent that Congress support his request…