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The Obama Line, Samantha Power, and U.S. Intervention in West Africa During the Ebola Epidemic

By Jean-Philippe Stone (Posted Jan 29, 2022)

Health, Movements, StrategyAfricaCommentary, Monthly Review EssaysFeatured

December 2013 marked the beginning of the worst Ebola outbreak in history. Ebola, a severe hemorrhagic virus which causes muscle and joint pain, diarrhea, vomiting, and bleeding, spread from Guinean forests to the capitals of Liberia and Sierra Leone by the summer of 2014.1 The World Health Organization (WHO) declared the epidemic a “public health emergency of international concern” in August, sparking a tardy international medical and humanitarian response spearheaded by president Barack Obama’s three thousand-strong troop transfer to West Africa a month later. Belying expectations, the number of cases had dropped precipitously by December 2014 and the epidemic was over in Liberia in June 2015.2A total of 28,600 people were infected and 11,325 died.

On January 13, 2016, Obama delivered his final State of the Union Address as president. It was an ideal opportunity to remind a deeply disillusioned public what the Obama administration had achieved, or at least claimed to have achieved, during its eight years in power. The president reminisced about the Affordable Care Act and how the Iran Nuclear Deal made the planet a safer place. Obama’s speech also conveyed a striking message: his administration restored the rightful place of the United States as the first among equals on the world stage. In response to crises in Libya, Syria, Iran, and Ukraine, the United States did not act alone but in concert with various nations: “we will mobilize the world to work with us and make sure other countries pull their own weight.”3

Obama cited the global response to the Ebola epidemic of 2014–16 as another sterling example of how the United States single-handedly “mobilized” the globe to combat the virus: “Our military, our doctors, and our development workers—they were heroic; they set-up the platform that allowed other countries to join in behind us and stamp out that epidemic. Hundreds of thousands, maybe a couple million lives were saved.” This address concretized what some might call the “Obama line” regarding the U.S. response to Ebola. Adherents of the Obama line tend to follow a strict catechism: embellish or oversell what the U.S. intervention in West Africa accomplished, emphasize “collaboration” (code for U.S. leadership) with a vast UN coalition of nations to beat the epidemic, and you ostracize, minimize, omit, or avoid inconvenient truths that contradict or distract from the reigning narrative.4

The Donald Trump administration’s calamitous response to the COVID pandemic throughout 2020 breathed new life into the Ebola Obama line. The former president’s colleagues came out in force to remind everyone just how well they performed when faced with a virus—their supposed efficiency and intellect a glaring contrast to Trump’s deadly incompetence. Joe Biden’s presidential campaign team touted the former vice president’s record during the Ebola epidemic as proof of his credentials: “Biden knows how to mount an effective crisis response and elevate the voices of scientists, public health experts, and first responders.… He helped lead the Obama-Biden administration’s effective response to the 2009 H1N1 pandemic and the Ebola epidemic.” Ron Klain, Obama’s “Ebola Czar,”  recalled how the U.S. government marshalled all its resources to mount a swift response to Ebola, while Trump failed to do the same to fight COVID. Laura Baer, senior advisor to Hillary Clinton, praised the Obama administration for creating an office entirely dedicated to pandemic response and relief. Obama’s secretary of state John Kerry railed against Trump’s science denial and lamented: “President Obama put together a playbook for any administration that followed us—it happened to the Trump administration—and they threw it away…we knew we had to summon a global response.” Former deputy national security advisor Ben Rhodes hailed this U.S.-led “global response” as well, while officials who worked for Susan Rice, Obama’s national security advisor who was tapped as a potential vice president for Biden in 2020, claimed they would follow her into hell after bearing witness to her bravura performance under pressure while handling the Ebola crisis. Peddling the Obama line proved very useful indeed, as a weapon to attack Trump’s gross mismanagement of COVID, to counter MAGA-style antiglobalization nationalism, and to further professional ambitions.5

Samantha Power, former U.S. ambassador to the United Nations, is another fervent advocate of the Obama line. Her best-selling memoir, The Education of an Idealist, devotes a whole chapter to detailing how the United Statesreacted to the West African Ebola epidemic. The chapter’s concluding remarks are perhaps the most perfect reproduction of Obama’s claims about Ebola in his last State of the Union Address: “President Obama ordered a mission that played an essential role supporting Africans fighting the disease. Obama’s leadership also gave despairing people a reason to believe that Ebola could be beaten.… He maintained leverage to rally other world leaders to resist as well.” Power exalts “Obama and American doctors, nurses, health workers, aid workers, diplomats, and soldiers” for their efforts in preventing spread of the virus, using the Ebola response as a prime example for why “the world needed the United Nations, because no one country—even one as powerful as the United States—could have slayed the epidemic on its own.”6 After reading Power’s chapter, one is left with the overwhelming impression that the United States played an outsized role, if not the critical role, in leading the world-wide charge against Ebola via its unparalleled military might, unequalled logistical capabilities, and an unshakeable devotion to “do the right thing.”

Yet, scholars have demonstrated that the U.S. response to Ebola was not the roaring success Power makes it out to be in her memoir. In fact, according to public health experts at John Hopkins, “the epidemic curve began decreasing before most global efforts were in place, limiting their impact on stopping the epidemic’s spread.”7 Global health specialists also agree that no one precisely knows why Ebola petered out in late 2014, but it had little to do with U.S. involvement. There is simply no evidence to support Obama’s extraordinary claim that U.S. health workers and soldiers helped save “hundreds of thousands, maybe a couple million lives” in West Africa. This is why Power’s interpretation of the Ebola Obama line warrants careful scrutiny. It is necessary to juxtapose her claims and statements, especially her comments on U.S.-made Ebola treatment units (ETUs), China’s response to Ebola, and U.S. lab technology, with what really happened on the ground.

To paraphrase journalist Tom Engelhardt and historian Karen Greenberg, the Obama administration declared a “war on Ebola” armed with the U.S. military. An organization already fighting a losing battle in the “war on terror” was suddenly thrust onto the frontlines of a war against a pandemic. It is a miracle that U.S. intervention in West Africa was not a monumental disaster, but for Power to call it “a stunning tribute to American ingenuity” and “creativity” is quite the exaggeration, if not an outright denial of the myriad problems that have plagued the U.S. military since the beginning of its operations.8

Power singles out the ETUs constructed by the U.S. military in West Africa as testaments to U.S. benevolence and quick thinking—another tool in President Obama’s “awesome demonstration of U.S. leadership and capability.” She observes that Tom Frieden, head of the Centers for Disease Control and Prevention(CDC), claimed the military “would rapidly assemble what were called Ebola treatment units, the specifically designed, tented field hospitals where patients could be treated,” and which Power states allowed “up to 1,700 patients at a time to receive treatment.” Further on, Power claims a Liberian health worker told her that, because the United States and other nations “were furiously building Ebola treatment units across Liberia,” Doctors Without Borders clinics were able to care “for all those who arrived seeking medical attention.” On hearing about the ETUs’ seemingly stellar contribution to the war on Ebola, Power left West Africa convinced “we” (the U.S.-steered and engineered global response) could save the day and emerge triumphant.9

Power severely overestimated the efficacy of costly U.S.-built ETUs. Contrary to what Frieden promised, the U.S.military did not build ETUs rapidly, and ETUs that finally did see the light of day, long after the dreaded Ebola curve flattened, did not treat hundreds of Ebola patients. At best, ETU utility proved extremely uneven across Liberia, Sierra Leone, and Guinea. At worst, U.S.-made ETUs, particularly in Liberia, played no part in defeating Ebola. As Norimitsu Onishi amply illustrated in his investigation for the New York Times, only twenty-eight Ebola patients were actually treated in the eleven ETU facilities erected on Liberian territory by April 2015. Nine out of the eleven ETUs never treated anyone infected with Ebola and ten ETUs opened after December 22, 2014—too late to make any difference in containing the virus. Public health experts like Swedish Dr. Hans Rosling and Doctors Without Borders staff tried in vain to warn numerous international bodies that precious money spent building expensive ETUs (approximately $20 million apiece) should instead have been invested in local health care initiatives or communities. A U.S. Agency for International Development report concluded that the U.S. military based their ETU blueprints in accordance with the CDC’s “worst-case” epidemic scenario and therefore did not adapt ETU designs to fit improving conditions on the ground. Conversely, cheap treatment centers Doctors Without Borders established, consisting of wood pallets and plastic sheeting, had a far greater impact than Department of Defense-constructed ETUs. Had the U.S. military followed the example of simply made nonprofit treatment units, more lives may have been saved.10

Even the Department of Defense disagrees with Power’s rosy impression of the ETUs. U.S. Africa Command’s own evaluation of Operation United Assistance, the codename for the U.S. military’s intervention into West Africa, admitted ETUs “turned out to be underutilized” and were hastily conceived. Army captain Andrew Hill quickly sketched an ETU design while embedded with a Disaster Assistance Response Team since the military had no standard design outlined before the operation began. The Liberian Ministry of Health hoped the United Stateswould build an ETU per county but the construction process encountered numerous impediments. The Department of Defense clearly did not sufficiently prepare to overcome Liberia’s chronically poor infrastructure, collapsing bridges, low water supply, lack of gravel, sparse access to wells, uneven terrain, and woeful weather. As a result, a five-week construction schedule had to be extended “to nearly two months at some locations.” Rather than concede that the Department of Defense had failed to anticipate these predictable challenges, team members just blamed Liberia for not completing their mission on time. The report even implied the delayed completion of ETUs adversely effected essential health workers’ training, as they had to be transferred to other facilities to finish their programs. Similar hindrances beset the British in Sierra Leone as the lengthy erection of “semi-permanent” ETUs lowered the number of beds available out in the field. Studies estimate over 12,500 Ebola cases could have been avoided had the beds been in service a month before their delivery in December 2014. Once again, pricey and showy ETUs trumped economical, maneuverable, and reliable field hospital alternatives.11

What if U.S.-made ETUs had been repurposed to combat diseases other than Ebola? After all, the German Armed Forces, Ebola Task Force, Red Cross, and representatives of the Liberian Ministry of Health and Social Welfare converted a standard-issue ETU near the Samuel Doe Stadium in Monrovia into a “severe infections temporary treatment unit” for patients afflicted with malaria or other Ebola-like symptoms. Why would the United States not do the same? Doug Mercado, an expert in refugee protection and former Disaster Assistance Response Team leader during the epidemic, cast doubts on the feasibility of repurposing ETUs: “If we can leave something behind, that’s great but it’s not the key goal.” The ETUs were not built to last, made as they are of fragile plastic sheeting that deteriorates after prolonged exposure to harsh weather. Sturdier bamboo-structured ETUs were handed over to local communities but they were exceptions rather than the norm. Many, though not all, warehouses and lab facilities had to be dismantled as well. As U.S. ambassador to Liberia Deborah Malac opined: “It’s hard to move from disaster response to development. The colour of money is one issue. People don’t want to give up resources.”As the world’s foremost exponent of for-profit and neoliberalized health care, the United States has little incentive to support large-scale redistributions of medical apparatus and supplies to West African populations affected by years of underfunded, understaffed, and increasingly privatized health systems.

Journalist Jennifer Lazuta witnessed first-hand the uncertain fate of abandoned ETUs. She interviewed a member of the child-development group Plan International, who revealed West African governments had not a clue what to do with stranded ETUs. Aid workers hoped ETUs would strengthen primary health care services but there was no guarantee such massive structures could ever be maintained. Petrified locals feared retired ETUs contained traces of Ebola, no matter how many times they were decontaminated. To make matters worse, corrosive chlorine disinfectants damaged ETUs, putting their survival in even greater doubt. Four months later, Jason Beaubien discovered Liberia still had not figured out what to do with them, especially a three hundred-bed behemoth in Monrovia. Though some former isolation ward tents remained relatively intact, pierced partition tarps quickly frayed without regular repair. The “lavish” Chinese ETU near the Samuel Doe Stadium, equipped with air-conditioned private rooms and video monitors that kept nurses at a safe distance from infected patients, looked imperishable and high-tech compared to rapidly disintegrating U.S. ETUs. So much for U.S. innovation and creativity.

Speaking of China, Power could not resist insinuating that the country endeavored to help West Africans fight Ebola just to flex its burgeoning superpower muscles: “China, which was increasingly looking for ways to show off its superpower status, declared fighting Ebola ‘a common responsibility of all countries in the world.’” This is a breath-taking, although not at all surprising, case of the pot calling the kettle black. A glib comment redolent of a Washington elite terrified of its own waning influence. Are we, the public, really expected to believe that the U.S.government’s financial contribution of $750 million dollars to fighting Ebola was a disinterested act of unalloyed generosity and definitely not another excuse “to show off its superpower status”? Did the pursuit of self-interest happen to be on sick leave when the White House decided to invest so much capital into intervening in West Africa?14

Power mentions China once more in the chapter when she describes a scene of herself on a plane conversing with President Obama via videoconference: “Knowing the President’s frustration about ‘free-riding’ in the international system, I also laid out in detail what China, the UK, France, and even small countries like Cuba were contributing.” The Obama line strikes again as Power panders to U.S. exceptionalism: the United States“collaborates” with the rest, the argument goes, but behind the scenes it really does all the hard work no one else bothers to—and deserves all the credit. Western governments initially castigated China in 2014 for not doing enough to combat Ebola. Yet, when news broke that hundreds of Chinese medical staff readied for battle against the virus, officials changed their tune and painted the Chinese as a bunch of calculating opportunists out to save African lives for political gain. Damned if you do, damned if you do not. Power’s subtle jab at China echoes the media’s incessant habit of obscuring or belittling the achievements of the United States’ chief enemy whenever and however possible.15

China’s Ebola response has been underrated and merits further study. Chinese medical teams ranked among the very first responders to Guinea’s Ebola outbreak in March 2014, “in stark contrast to the delayed response of the rest of the international community.” Thanks in large part to China’s considerable medical footprint in the form of anti-malaria centers established throughout the continent, the Chinese had a head start in facing Ebola as medical teams were already present in West Africa. By August, Beijing had sent plane-loads of emergency antiepidemicgear, drugs, food, and sterilization equipment. In September, dozens of Chinese lab technicians landed in Sierra Leone. In November, China announced the arrival of one thousand medical experts over the following months.16

It is worth stressing that of all the nations to send troops into West Africa, including the United States, United Kingdom, Canada, Germany, France, and African Union states, China was the only nation to deploy mostly medical personnel from the People’s Liberation Army.The crucial difference between Chinese and U.S. approaches to virus eradication lies in what human security specialists call “empowerment.” The Chinese understood we can only combat diseases like Ebola if we first eliminate poverty and promote development. A strategy prioritizing “long-term capacity building,” such as China’s promise to send hundreds of medical workers to African states over a three-year period, is likely to bear more fruit for West Africans in the long run than Obama’s one-off troop and supply surge in autumn 2014. Unlike the United States, China was attuned to conditions on the ground and reacted accordingly.17

U.S. Navy doctors even acknowledge China’s global health strategy during the Ebola epidemic far outmatched that of the United States. The Department of Defense’s global health strategy is generally obsessed with quantifying its performance without actually measuring its impact in the real world. Meanwhile, China, inspired by its own “barefoot doctors” from the Maoist era (regular farmers who received medical and first-aid training to help treat common illnesses in far-flung communities bereft of health clinics), updated this tradition and applied it to Ebola-stricken West Africa. While deploying the U.S. military cost $360 million, not including expenses for running often useless ETUs, China invested in comparatively inexpensive long-term projects such as sending out teams ranging from six to one hundred health care providers for nearly two years. This kind of grassroots embeddedness is an expression of forward-thinking health diplomacy, beneficial not only for a China seeking to widen its influence, but for local African recipients as well. A sign in Monrovia neatly summarized the health strategy Liberians preferred: “China 1 USA 0.”18

Confronted with inquiries about ineffectual ETUs, some respondents pointed to successful public health worker or volunteer training courses the United States, United Kingom, United Nations, or WHO implemented as better indicators of the long-term value or goals that medical interventions intended to accomplish in West Africa. But this does not change the fact that nations like China wasted nowhere near the amount of money the United Statesspent on ETUs—and probably trained just as many if not more volunteers to boot. The U.S. army in Liberia only trained 1,539 health care workers by February 2015. In Guinea, infection prevention and control courses trained around 3,250 Guineans, frontline health workers, and supervisors between October and December 2014. CDC safety training courses aiming to prepare U.S. health care workers for ETUs in West Africa trained 570 participants between September 2014 and March 2015. The International Organization for Migration collaborated with the WHO, CDC, and Sierra Leonean Health Ministry to train 4,500 health workers in Freetown by March 2015. In comparison, Chinese public health training teams who arrived in Sierra Leone in November 2014 had trained “10,000 residents, including medical staff, community healthcare workers, government officials and volunteers” by August 2015. This is not an exhaustive list of all the courses administered or the exact number of those who took part in public health training in West Africa, but it gives a fair indication of the incredible scale of Chinese humanitarian operations undertaken during the epidemic. How could such monumental efforts be so casually dismissed as mere showing off? Are they not proof that the international community can, to borrow Obama’s phrase, “pull their own weight” in a global crisis without U.S. stewardship?19

While other nations’ efforts to subdue Ebola receive fleeting cameos within the chapter, Power reserves high praise for the “impact of U.S. lab technology” in Liberia and U.S. Navy technicians who helped set up Ebola testing labs.20 Test results were delivered in five hours instead of five days, speeding up the isolation of Ebola patients and therefore cutting down transmission rates. Power’s comments are intriguing for two reasons.

First, according to a paper analyzing interventions in Liberia during the epidemic, the impact of laboratories on transmission rates in 2014 was limited. The names of laboratory-confirmed cases were “not provided back to the county teams responsible for contact tracing and isolation.” This meant families and communities did not know if a loved one had Ebola and forced labs to trace both suspected and confirmed contacts—draining already meagre resources further. Even after an influx of supplies and labs in October 2014, contact tracing did not substantially improve as late as February 2015.21

Second, Power never mentions that U.S. labs and their staffs collected thousands of blood samples that were then opaquely expedited from West Africa without patients’ assent. French journalists Emmanuel Freudenthal and Chloé Hecketsweiler discovered that the U.S. military inventoried and stored around five thousand blood samples within the Liberia Institute for Biomedical Research in Monrovia before their eventual dispatch to Fort Detrick, Maryland—a premier biodefense research site of the U.S. Army Medical Research Institute of Infectious Disease. Le Monde revealed labs analyzed 269,000 blood samples in West Africa throughout the epidemic, a biological gold mine for scientists in the United States, Canada, Europe, China, and Russia. A fierce competition erupted to acquire blood samples for projects and papers unrelated to diagnostics. One French pharmacist ruefully noted UN planes and medical teams treated Guinea like a colander and not a country, sneaking boxloads of samples away from Guinean border guards and police with impunity. The CDC has officially admitted to expediting a few hundred samples from Sierra Leone with no permission from local authorities. One doctor alleged blood sampleswere stolen “without the greenlight from Liberia.” Ebola survivors, many of whom lost family or jobs due to the virus, were disgusted to learn Western labs exploited their blood for biodefense purposes or to make exorbitantly priced vaccines.22

Freudenthal and Hecketsweiler probed deeper into biosecurity machinations in West Africa and found military personnel in 2019 still staffed Russian labs assembled in Guinea during the epidemic. Across the Atlantic, virologists in the employ of the U.S. Army Medical Research Institute of Infectious Disease are openly conducting “threat characterization” experiments with Ebola (making the virus more virulent or airborne in order to test new vaccines and predict what kind of biological weapons terrorists may unleash in future). Boundless research into lethal pathogens like Ebola or anthrax can have devastating consequences should an accidental “lab leak” ever occur.23

Some scholars suspect the CDC may have enjoyed even greater access to blood samples and other sensitive data stored in laboratories installed throughout Sierra Leone’s sixteen districts during the epidemic. Though different countries nominally ran each lab, the U.S. military helped set them up and the CDC processed whatever entered these labs—namely blood samples extracted from Ebola patients and donors. When journalists like Freudenthalstarted asking questions as to why West African countries could not retain their own people’s blood, Western officials feigned concern that Sierra Leone, Guinea, and Liberia did not have enough labs to safely store samples. Western biosecurity units, universities, and possibly pharmaceutical companies would hold onto them for safekeeping. Trespassing on West African sovereignty and trampling over the human rights of vulnerable people obviously did not arouse the same level of concern.24

The “lost” Ebola blood samples scandal is a clear-cut example of bio-imperialism: the West’s extraction of biological material from Global South nations. Recovered microbes become the basis for formulating and manufacturing vaccines most countries in the Global South are unable to afford or reproduce. For a contemporary iteration of this practice, see the United States, the United Kingdom, Canada, and the European Union’s enormous COVID vaccine purchase and accumulation spree in 2021, while 130 poorer nations may not organize mass vaccine distributions until 2023. Pushing back against bio-colonialism is a risky business, although Indonesia’s refusal to hand over avian flu samples to Australian companies in 2007 is proof that protecting biological raw materials from predatory pharmaceutical corporations can be done. The WHO did create a framework designed to force vaccine manufacturers to hand over profits to countries from whence virus strains arose. Yet, the pandemic influenza preparedness framework only covers flus and does not prevent the wealthy North from pillaging the South. The Nagoya Protocol, a subsidiary of the Convention on Biological Diversity, is exceptional in that it seeks to enforce “the fair and equitable sharing of benefits arising” from the use of genetic resources. However, as Maryn McKenna noted, the United States refuses to ratify the Convention and therefore the Protocol as well. Considering that former settler-imperial powers greatly fear demands for reparations will eventually encompass past environmental and biological crimes, the likelihood of more Nagoya-like legislation seeing the light of day anytime soon is slim. Power is correct to a degree. U.S. lab technology certainly did have an impact in West Africa: it facilitated the harvesting of blood samples and data without the consent of their owners—to the delight of paranoid biosecurity experts and insatiable corporations.25

One question still remains: What role did Power ultimately play in the Ebola drama? Her main contribution lies in corralling international support at the United Nations for Resolution 2177 on Ebola Relief. Judging from Power’s account of the build-up toward the resolution’s passing, it seems Tom Frieden and Liberian health worker Jackson Niamah deserve just as much credit, if not more, than Power. The former scared the living daylights out of every UN ambassador Power sent his way, the infamous “slide” of doom projecting over a 1.4 million infections and thousands dead if Ebola went unchecked. The latter’s vivid testimony at the UN Security Council relating Ebola’s rampage surely convinced the rest to pledge their support for the resolution. But credit where credit is due. Power had a hand in bringing UN Resolution 2177 on Ebola Relief to life. However, the bill also announced the unprecedented militarization and “securitization” of humanitarian responses to the Ebola epidemic. The virus granted U.S. Africa Command a cover to expand its presence in the oil-rich Gulf of Guinea and gave the United States free rein to interfere and intervene wherever it chose in the Global South. This is quite the feat for someone like Power, who claims in her memoir’s afterword to abhor the “militarization of U.S. foreign policy.”26

Overall, in light of the ETUs ineffectiveness, the superiority of China’s response, U.S. lab complicity in the unethical reaping of West African blood samples, and the weaponization of humanitarian aid in the name of “human security,” the U.S. response to Ebola feels less like the heroic feel-good, fist-pumping victory that Power claims it was, and more like another display of imperial grandstanding. From now on, perhaps the n should be removed from the “Ebola Obama line.”

Notes:

  1. ↩ “Timeline of Ebola Virus Disease Progress in West Africa,” in Lawrence O. Gostin and Eric A. Friedman, “A Retrospective and Prospective Analysis of the West African Ebola Virus Disease Epidemic: Robust National Health Systems at the Foundation and an Empowered WHO at the Apex,” Lancet 385 (2015): 1902–09.
  2. ↩ “Remarks of President Barack Obama–State of the Union Address as Delivered,” White House, January 13, 2016.
  3. ↩ “Remarks of President Barack Obama.” Medical anthropologist Adia Benton from Northwestern University, Illinois, coined the term “the Obama line” to describe the official narrative regarding the U.S. response to Ebola in a Zoom discussion on August 19, 2021.
  4. ↩ Sabrina Siddiqui and Warren P. Strobel, “Joe Biden Points to Ebola Experience in Pitching Coronavirus Plan,” Wall Street Journal, March 29, 2020; Gabriel Debenedetti, “Obama’s Ebola Czar, Ron Klain, on How Trump Has Bungled the Coronavirus Response,” New York Intelligencer, March 12, 2020; Hari Sreenivasan, “Lessons Learned in the Battle Against Ebola,” PBS, April 12, 2020; Chloe Taylor, “Trump’s Coronavirus Response Is a ‘Denial’ of Science, Experts and Facts, John Kerry Says,” CNBC, June 10, 2020; Blake Hounshell, “What Ebola Taught Susan Rice About the Next Pandemic,” Politico, June 8, 2020; Samantha Power, The Education of an Idealist (London: Harper Collins, 2019), 456–57.
  5. ↩ Thomas D. Kirsch et al., “Impact of Intervention and the Incidence of Ebola Virus Disease in Liberia: Implications for Future Epidemics,” Oxford Journals Health and Police Plan 32, no. 2(2017): 205–14.
  6. ↩ Global health professor at the University of Iowa Sokheing Au, in an e-mail on August 9, 2021, stated: “No one knows precisely why the curve dived at the end of 2014, but it certainly had little to do with U.S. involvement.”
  7. ↩ Tom Engelhardt and Karen Greenberg, “Fighting the Last War: Will the War on Terror Be the Template for the Ebola Crisis?,” Tom Dispatch, October 21, 2014.
  8. ↩ Power. The Education of an Idealist, 437–38, 450–53.
  9. ↩ Power, The Education of an Idealist, 437–38, 452.
  10. ↩ Norimitsu Onishi, “Empty Ebola Clinics in Liberia Are Seen as Misstep in U.S. Relief Effort,” New York Times, April 11, 2015; Jennifer Widner, All Hands on Deck: The U.S. Response to West Africa’s Ebola Crisis (Princeton: Princeton University, 2018).
  11. ↩ Operation United Assistance: The DOD Response to Ebola in West Africa (Suffolk, VA: Joint and Coalition Operational Analysis, 2016), 47–49, 99–100; Emma Ross, Gita Honwana Welch, and Philip Angelides, “Sierra Leone’s Response to the Ebola Outbreak: Management Strategies and Key Responder Experiences” (research paper, London, Royal Institute of International Affairs, 2017). See Adam J. Kucharski et al., “Measuring the Impact of Ebola Control Measures in Sierra Leone,” Proceedings of the National Academy of Sciences 112, no. 46 (2015): 14366–71.
  12. ↩ Christian Janke et al., “Beyond Ebola Treatment Units: Severe Infection Temporary Treatment Units as an Essential Element of Ebola Case Management During an Outbreak,” BMC Infectious Diseases 124, no. 17 (2017).
  13. ↩ Widner, All Hands on Deck, 26.
  14. ↩ Jennifer Lazuta, “Fate of Ebola Treatment Units Is Unclear,” Voice of America News, January 30, 2015; Jason Beaubien, “What Should Liberia Do with Its Empty Ebola Treatment Units,” NPR News, May 5, 2015; Power, The Education of an Idealist, 443, 453.
  15. ↩ Shunji Cui, “China in the Fight Against the Ebola Crisis: Human Security Perspectives,” in Human Security and Cross-Border Cooperation in East Asia, ed. Carolina G. Hernandez, Eun Mee Kim, Yoichi Mine, and Ren Xiao (Cham: Palgrave Macmillan, 2019), 155–80; Adia Benton, “Whose Security?: Militarisation and Securitisation During West Africa’s Ebola Outbreak,” in The Politics of Fear: Médecins sans Frontières and the West African Ebola Epidemic, ed. Michiel Hofman and Sokhieng Au (New York: Oxford University Press, 2017), 45.
  16. ↩ Cui, “China in the Fight Against the Ebola Crisis,” 161; Peilong Liu et al., “China’s Distinctive Engagement in Global Health,” Lancet 9945, no. 384 (2014): 793–804.
  17. ↩ Benton, “Whose Security?,” 30; Cui, “China in the Fight Against the Ebola Crisis,” 162–67.
  18. ↩ Michael Owens, “‘China 1 USA 0’: A Former Ebola Provider’s Explanation Why the United States Is Falling Behind in the Global Health Arena,” Military Medicine 181, no. 9 (2016): 951–52; Onishi, “Empty Ebola Clinics in Liberia Are Seen as Misstep in U.S. Relief Effort.”
  19. ↩ Lazuta, “Fate of Ebola Treatment Units Is Unclear”; Brian Castner and Cheryl Hatch, “Hearts, Minds, and Ebola: The U.S. Army Drops in on Liberia,” Vice, February 17, 2015; Heidi M. Soeters et al., “Infection Prevention and Control Training and Capacity Building During the Ebola Epidemic in Guinea,” Plos One 13, no. 2 (2018); Rupa Narra et al., “CDC Safety Training Course for Ebola Virus Disease Healthcare Workers,” Emerging Infectious Diseases 23, no.1 (2017): 217–24; Nicolas Bishop, “IOM Ebola Response: Training Expands Across Sierra Leone from Academy in Freetown,” International Organization for Migration News, March 17, 2015; Cui, “China In the Fight,” 167.
  20. ↩ Power, The Education of an Idealist, 450–53; Kirsch et al., “Impact of Intervention”; Emmanuel Freudenthal and Chloé Hecketsweiler, “Ebola: La science éprise de sang,” Le Monde, January 23, 2019; Emmanuel Freudenthal and Chloé Hecketsweiler, “Un virus qui intéresse les militaires,” Le Monde, January 23, 2019; Gwen Shuni D’Arcangelis, Bio-Imperialism: Disease, Terror, and the Construction of National Fragility (New Brunswick: Rutgers University Press, 2020), 5.
  21. ↩ Benton spoke at length about the CDC’s alleged role in “processing” blood samples in Sierra Leone during a Zoom conversation on August 19, 2021.
  22. ↩ Maryn McKenna, “Colonialists Are Coming for Blood—Literally,” Wired, March 3, 2019.
  23. ↩ D’Arcangelis, Bio-Imperialism, 1.
  24. ↩ McKenna, “Colonialists Are Coming for Blood.”
  25. ↩ Akin Olla, “Welcome to the New Colonialism: Rich Countries Sitting on Surplus Vaccines,” Guardian, April 14, 2021; McKenna, “Colonialists Are Coming for Blood.”
  26. ↩ Jacob Levich, “The Gates Foundation, Ebola, and Global Health Imperialism,” American Journal of Economics and Sociology 74, no. 4 (2015): 704–42; Power, The Education of an Idealist, 438–42, 551.