In Foreign Policy, Shannon Kellman and Mark Lagon of the Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, make the point that disease outbreaks in states with weak governance and high rates of poverty often spread to other countries. With respect to eastern Congo’s Ebola outbreak, they highlight the fact that the disease has spread out of eastern Congo to the border with Rwanda and into Uganda. The World Health Organization has designated the outbreak as a “public health emergency of international concern.”
Disease outbreaks like Ebola also exacerbate other health issues in weak states; in Congo’s North Kivu province where the Ebola outbreak started, they cite an eight-fold increase in the incidence malaria. In addition to Ebola, eastern Congo faces myriad other issues, including endemic militia activity that is often hostile to government and widespread distrust of medical professionals trying to bring Ebola under control.
The authors advocate increased international health assistance to fragile states such as Congo, especially by the United States. Though the Trump administration has proposed cuts, they highlight bipartisan congressional support for global health assistance. They suggest that increased assistance has the potential to improve governance and stability in affected areas, both of which are in the interest of the United States. In fact, it is likely that U.S. funding for global health could be increased, as it was last year. The authors argue that such health crises should be seen in the context of combating state fragility, the spread of terrorism, and of improving governance.
The outbreak has become a security issue that is already affecting Congo’s neighbors. Like the Ebola epidemic in West Africa in 2014, Congo’s outbreak could lead to disruptions to international travel and trade, and its knock-on effects in health and security could threaten the stability of an already unstable region. However distant the outbreak may seem at present, its far-reaching effects are yet more reason why aggressive and substantial support for disease-fighting efforts must be advanced.