Remarks by Ambassador Samantha Power at the United Nations Security Council Session on Ebola

Thank you, Madam President. And Madam President, Foreign Minister Bishop – thank you for being here to chair this crucial session. Thank you, Special Envoy Nabarro and Special Representative Banbury, for your briefings. Mr. Mauget, we are grateful for your remarks, but even more for your service, and for the service of all of the doctors, nurses, burial team members, and others on the front lines of this effort.

We also thank the representatives of Guinea, Liberia, Mali, and Sierra Leone, for being here today, and for the valiant efforts of their people and their governments to stand up to this deadly virus. We stand with you.

I’d like to take a moment to recognize the passing of Marcel Rudasingwa, UNMEER’s Ebola Crisis Manager in Guinea. When I met Marcel in Conakry last month, and he had just recently arrived, but he brought great energy to a really tough assignment. And his unexpected death this week by a heart attack is an enormous loss for his family, of course, and for the UN family.

Two months ago, on September 18, at its first emergency meeting on Ebola, a Médecins Sans Frontiers worker named Jackson Niamah addressed the Council from Liberia’s capital, Monrovia. He said people were dying outside the gates of the clinic where he worked because there were no beds to treat them. Jackson said, “I, along with my colleagues here, cannot fight Ebola alone. You, the international community, must help us.”

It was a reckoning. Up to that point – not nearly enough had been done to curb Ebola’s deadly spread. In an unprecedented resolution, this Council recognized that the outbreak constituted a threat to international peace and security, and committed – right alongside the UN General Assembly – to marshaling the resources to stop it.

Two months later, the outbreak continues to grow. When we met in September, more than 2,500 people had died; today, more than 5,000 have died. In September, 5,500 people had been infected; today, more than 15,000 have been infected. The fight is not only ongoing, but it is still tilting in Ebola’s favor.
Yet we are beginning to see the impact of the international community’s collective response. The results so far prove what we have said all along: we know how to win this fight.

The United Nations set a target of 70 percent of burials being completed in a safe and dignified manner within 60 days, in order to reduce new infections from unsafe burials – and the international community is working toward meeting that goal. As part of my trip to the most affected countries at the end of October, I visited Sierra Leone’s capital, where I saw first-hand how the command and control capacity of recently arrived British troops and civilians – in support of their Sierra Leonean counterparts, burial teams, and a robust public information campaign – went from safely burying 30 percent of victims within 24 hours of being reported, to 98 percent. That was all in less than a week.

We set out to improve the accuracy, accessibility, and efficiency of Ebola testing – knowing that prompt and reliable results are critical to slowing the virus’ spread. In Bong County, Liberia, I visited a U.S. Navy-run Ebola testing lab which had cut the time Liberians in the area waited for test results from up to five days down to three to five hours. On November 4, only 33 out of 53 Ebola-affected districts in the affected countries had the ability to transport samples to a lab within 24 hours of collecting them, according to the WHO. By November 17, all 53 districts had that capability.

Now, we know this data is imperfect and by no means the full story. Underreporting is a huge issue in the affected region. Not every victim’s body is reported, and some unsafe burials take place under the radar. And even if every district can get samples to a lab in 24 hours, that says nothing about how fast that they come back.

But even accepting the limits of the data, there is no question that our collective efforts are saving lives. In the past month, the average number of reported cases per week in Liberia has fallen by a third, thanks in large part to the robust international effort in support of the Liberian government’s leadership. At the beginning of October, Sierra Leone’s Kenema district had the second highest number of infections in that country, with 429 cases; as of two days ago, not a single new case had been reported in Kenema in all of November, in large part due to the efforts of NGOs, working with local authorities and communities.

Were it not for the dramatic increase in the global response, Ebola would have continued to spread exponentially in the region, infecting and killing many, many thousands more people, and placing our collective security at even greater risk.

But it would be a huge mistake to think that just because we are seeing signs of progress, we are on track to stop this outbreak. It would be reckless to think that just because we hit some of our benchmarks, we have contained the virus’ deadly spread.

Last week, 533 new cases were confirmed in Sierra Leone – the highest weekly tally since the outbreak began in that country. In Guinea, people in rural villages only kilometers away from where the outbreak began have still never even heard of the virus. And we are facing a new outbreak, of course, in Mali.

Our response needs to be fluid, nimble, and regional. We need to move with the virus, swiftly adapting to flare ups and plugging gaps when they emerge. As Guinea’s Minister of Foreign Affairs so eloquently said when we met in Conakry, “If there’s one sick person in Monrovia, then the epidemic is not over in Guinea.”

I’d like to highlight five key ingredients for not just bending this exponential curve, but ultimately ending it. First, UN Mission for Ebola Emergency Response, UNMEER, must help coordinate and better target the work of multiple UN agencies, Member States, and organizations to maximize the effectiveness of our collective response. This entails identifying the evolving gaps; determining what is needed to fill them; and communicating this information to the governments, organizations, and agencies involved in the effort as quickly as possible. This will require UNMEER to hire quality staff and scale up operations faster, and get teams out of headquarters and into the field, where they can better assess what is needed and immediately plug those gaps at the local level. The Presidential Statement that we as a Council agreed to today reflects that imperative in its request that the Secretary-General “help accelerate efforts to scale-up UNMEER’s presence and activities at the district and prefecture level outside of the capital cities.”

Second, donors must tailor our contributions to the needs of the moment, rather than what best suits our capitals. For example, as the trajectory of the epidemic changes, we recognize that it’s now more effective to support community care centers and build smaller, 10 to 20-bed Ebola Treatment Units across a wider area, than to build a single ETU with 100 beds. We must constantly ask: What is the most effective way to focus the dollar, a Euro, a yen, a mark, or a pound on stopping Ebola today? If the answer is something other than what we are doing, we have to change course, and even turn on a dime.

Third, we need more international healthcare workers to support heroic national health responders. ETUs are useless without doctors and nurses to staff them sustainably. Approximately 1,000 international healthcare workers will be needed on an ongoing basis. Yet in the face of unprecedented demand, groups like MSF and the International Medical Corps have highlighted the challenge of recruiting volunteers. And here I must add, when one looks out two months, it is not at all clear that the supply of international healthcare workers – even the supply that we have today – can be sustained two months from now.

We commend the countries that have sent or pledged foreign medical teams, and the brave men and women who serve in them – from Sweden and Norway to China and the Republic of Korea, the list is long and it’s growing longer. As part of the African Union’s efforts, Nigeria, Ethiopia, Kenya, Tanzania, Uganda, and the Democratic Republic of Congo – which recently helped stop an outbreak of Ebola within its own borders – have promised to make more than a thousand healthcare workers available. More countries need to send teams, and those that have already sent them must maintain a pipeline of trained replacements so that they supply can be replenished in the coming months. The European Union’s recent commitment to provide medevac and treatment in Europe for international healthcare workers infected with Ebola, an effort the United States will support with our own medevac planes, has been crucial to getting more countries to announce commitments.

Governments also must knock down the obstacles that stand in the way of volunteers joining the effort. That means making it easier, and not harder, for volunteers to travel to the affected countries; and treating them like the heroes when they return home, rather than stigmatizing or isolating them.

Fourth, we need to do a better job of protecting healthcare workers and other volunteers from the affected countries, who should be able to serve their countries without fearing for their lives. Last week, Liberia reported that 28 healthcare workers had been infected in the previous 30 days. This week, Sierra Leone lost its sixth and seventh doctors to Ebola; and yesterday, a doctor died of Ebola in Mali. Approximately 330 healthcare workers have died in this outbreak. Healthcare workers need better training and better equipment to prevent more deaths. To help meet this demand, the United States has opened a new center in Monrovia that graduated its first class of 150 Liberian healthcare workers, as well as established a mobile training unit that will move around the country to train Liberians. The U.S. also opened a 25-bed hospital to treat international and Liberian healthcare workers and Ebola responders, the Monrovia Medical Unit, which is staffed currently by the U.S. Public Health Service officials.

While the needs of healthcare workers – who bear the highest risk – will come first, UN peacekeepers serving in Liberia should also have access to the U.S.-run facility in the very unlikely event that they should need it. The peacekeepers in UNMIL – civilians, troops, and police – will be remembered will be remembered for rising to the occasion and joining this historic effort, rather than pulling out at Liberia’s time of greatest need.

Fifth and finally, we need to invest more in preparing neighboring countries to prevent new outbreaks, and to contain those outbreaks swiftly when they occur. That is why the United States is working with international organizations, including the WHO, and officials from more than 40 nations through the Global Health Security Agenda, which is increasing the preparedness of national health systems to respond to infectious disease threats and making global health security an international priority. As the recent events in Mali make clear, if even a single link in the chain of responsibility is broken, the welfare of an entire country – or region – can be put at risk. Ebola punishes us for every mistake.

When people survive Ebola in the affected countries, they are often given an official certificate declaring them “Ebola free.” I met several survivors during my trip to West Africa, and no matter what their individual experience – not one seemed to feel fully free.

A 24-year-old former schoolteacher in Guinea, Fanta Oulen Camara, told me she had lived three lives: her life before Ebola; her life in the hell of her infection; and her life as a survivor. She said the stigma she has suffered since beating the virus had made her current life the hardest. Friends stopped talking to her, and avoided her when they ran into her in public. When, at the end of our meeting, I went to give her a hug goodbye, she demurred and offered a fist bump, afraid, perhaps, that she might infect me. Even she did not seem to fully believe that she was free.

I tell Fanta’s story because we can build all the ETUs required; have access to fast, reliable lab results; have plenty of contact teams and healthcare workers – we can check all those boxes and more – and if we do not tackle the fear and the stigma that still reigns in much of the affected region, we will continue to fall behind. We will not shake ourselves free of Ebola.

In Fanta’s story, though, there is also reason for hope. Besides being an Ebola survivor, Fanta is now an Ebola caregiver. She works in an MSF clinic, where her very presence is testament to patients that the virus can be beaten. And for those who do survive, Fanta provides counseling, preparing them for the stigma that, regrettably, still awaits them outside.

We are a long way from being free of Ebola. But if we choose to fight; if we do what we have seen works to beat back this deadly virus; we will find the bravest, most selfless partners in the world by our side. And there is no fight more noble than that.

Thank you.

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