Perhaps most important, the U.S. is prone to the same forgetfulness and shortsightedness that befall all nations, rich and poor—and the myopia has worsened considerably in recent years. Public-health programs are low on money; hospitals are stretched perilously thin; crucial funding is being slashed. And while we tend to think of science when we think of pandemic response, the worse the situation, the more the defense depends on political leadership.
When Ebola flared in 2014, the science-minded President Barack Obama calmly and quickly took the reins. The White House is now home to a president who is neither calm nor science-minded. We should not underestimate what that may mean if risk becomes reality.
[---]
Anthony fauci’s office walls are plastered with certificates, magazine articles, and other mementos from his 34-year career as niaid director, including photos of him with various presidents. In one picture, he stands in the Oval Office with Bill Clinton and Al Gore, pointing to a photo of HIV latching onto a white blood cell. In another, George W. Bush fastens the Presidential Medal of Freedom around his neck. Fauci has counseled every president from Ronald Reagan through Barack Obama about the problem of epidemics, because each of them has needed that counsel. “This transcends administrations,” he tells me.
Reagan and the elder Bush had to face the emergence and proliferation of HIV. Clinton had to deal with the arrival of West Nile virus. Bush the younger had to contend with anthrax and sars. Barack Obama saw a flu pandemic in his third month in office, mers and Ebola at the start of his second term, and Zika at the dusk of his presidency. The responses of the presidents varied, Fauci told me: Clinton went on autopilot; the younger Bush made public health part of his legacy, funding an astonishingly successful anti-HIV program; Obama had the keenest intellectual interest in the subject.
And Donald Trump? “I haven’t had any interaction with him yet,” Fauci says. “But in fairness, there hasn’t been a situation.”
[---]
With patience and money—not even very much money compared with the vastness of rich-country spending—this kind of victory could be commonplace. An international partnership called the Global Health Security Agenda has already laid out a road map for nations to plug their vulnerabilities against infectious threats. Back in 2014, the U.S. committed $1 billion to the effort over five years. With it came a clear, if implicit, statement: Pandemic threats should be a global priority. Nous sommes ensemble.
Given that sense of commitment, and with the related funding in hand, the CDC made a large bet: It began helping 49 countries improve their epidemic preparedness, on the assumption that demonstrating success would assure a continued flow of money. But that bet now looks uncertain. Trump’s budget for 2019 would cut 67 percent from current annual spending.
If investments start receding, the CDC will have to wind down its activity in several countries, and its field officers will look for other jobs. Their local knowledge will disappear, and the relationships they have built will crumble. Trust is essential for controlling outbreaks; it is hard won, and not easily replaced. “In an outbreak, there’s so little time to learn things, make connections, learn how to not offend people,” Rimoin tells me. “We’re here in the Congo all the time. People know us.”
- More Here from Ed Young
When Ebola flared in 2014, the science-minded President Barack Obama calmly and quickly took the reins. The White House is now home to a president who is neither calm nor science-minded. We should not underestimate what that may mean if risk becomes reality.
[---]
Anthony fauci’s office walls are plastered with certificates, magazine articles, and other mementos from his 34-year career as niaid director, including photos of him with various presidents. In one picture, he stands in the Oval Office with Bill Clinton and Al Gore, pointing to a photo of HIV latching onto a white blood cell. In another, George W. Bush fastens the Presidential Medal of Freedom around his neck. Fauci has counseled every president from Ronald Reagan through Barack Obama about the problem of epidemics, because each of them has needed that counsel. “This transcends administrations,” he tells me.
Reagan and the elder Bush had to face the emergence and proliferation of HIV. Clinton had to deal with the arrival of West Nile virus. Bush the younger had to contend with anthrax and sars. Barack Obama saw a flu pandemic in his third month in office, mers and Ebola at the start of his second term, and Zika at the dusk of his presidency. The responses of the presidents varied, Fauci told me: Clinton went on autopilot; the younger Bush made public health part of his legacy, funding an astonishingly successful anti-HIV program; Obama had the keenest intellectual interest in the subject.
And Donald Trump? “I haven’t had any interaction with him yet,” Fauci says. “But in fairness, there hasn’t been a situation.”
[---]
With patience and money—not even very much money compared with the vastness of rich-country spending—this kind of victory could be commonplace. An international partnership called the Global Health Security Agenda has already laid out a road map for nations to plug their vulnerabilities against infectious threats. Back in 2014, the U.S. committed $1 billion to the effort over five years. With it came a clear, if implicit, statement: Pandemic threats should be a global priority. Nous sommes ensemble.
Given that sense of commitment, and with the related funding in hand, the CDC made a large bet: It began helping 49 countries improve their epidemic preparedness, on the assumption that demonstrating success would assure a continued flow of money. But that bet now looks uncertain. Trump’s budget for 2019 would cut 67 percent from current annual spending.
If investments start receding, the CDC will have to wind down its activity in several countries, and its field officers will look for other jobs. Their local knowledge will disappear, and the relationships they have built will crumble. Trust is essential for controlling outbreaks; it is hard won, and not easily replaced. “In an outbreak, there’s so little time to learn things, make connections, learn how to not offend people,” Rimoin tells me. “We’re here in the Congo all the time. People know us.”
- More Here from Ed Young
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