FROM: THE STATE DEPARTMENT
Samantha Power
U.S. Permanent Representative to the United Nations
Accra, Ghana
October 29, 2014
AS DELIVERED
Special Representative Banbury: Good afternoon, ladies and gentlemen, my name is Tony Banbury and I am the Head of the United Nations Mission for Ebola Emergency Response. Myself and all of my colleagues are delighted to welcome Ambassador Samantha Power, United States Ambassador to the United Nations, to our headquarters here in Accra. I’d like to just make a couple of brief comments and then hand it over to her. First of all, the picture we are seeing now on Ebola in the three most infected countries is a very mixed one. We still have a very serious crisis on our hands; there are people dying every day; there are people who are becoming newly infected every day; and there are still some serious requirements to put in place the necessary capabilities to bring the crisis to an end. On the other hand, we are seeing a lot of progress. Work by national governments, NGOs, UN Agencies, bilateral partners like the United States and UNMEER as well, and we are starting to see the impact of all these efforts. There has been a very significant mobilization of international personnel, resources, capabilities, to work side-by-side with the governments and those efforts are starting to pay off.
What we need are three basic things to get this crisis under control. To add to the effort we need people, especially trained medical personnel, people who can operate clinics, Ebola treatment clinics, community care centers. We need material and we need money.
The United Nations, UNMEER , myself, we’re very grateful to the United States who has been a leader in providing all of those things. They are putting their people on the ground; civilian and military, USAID civilian teams, DART teams; they are providing a lot of supplies; and they are proving a lot of money. So we hope that others will also, like the United States, contribute in such a generous way.
UNMEER – we are doing everything possible working side by side with the United States and other partners, national governments, to achieve the results that have been set for – the objectives that have been set of 70% of new cases under treatment, and 70% of burials being done safely. If we can do that, we can turn this crisis around. That’s our objective and we are working very, very hard to achieve it, and I am confident that all of the international community working with the national governments will make it. So with that I’d like to hand it over please to Ambassador Power.
Ambassador Power Thank you, Tony; and thank you to all the people who work with you, both here in Accra and in the broader region, in Ebola-affected countries away from their families. They are doing God’s work. It is the most important work anybody can be doing on Earth today. The second thank you I would like to offer is to Ghana, to the people of Ghana, to the generosity of the leadership of Ghana and the communities here. Ebola is a virus that has generated a lot of fear and a fair amount of misinformation and misunderstanding; and it is extremely important that Ghana has recognized that this is a virus that does not see borders, that is an equal opportunity demon. If we cannot stop it at its source, it will spread. And UNMEER, which has set up its headquarters here in Ghana –again thanks to the Ghanaian people and the government here – is a critical weapon in the battle to stop Ebola at its source so it doesn’t come to Ghana, so it doesn’t spread further on the continent of Africa, and so it is contained and defeated.
The curve of infections in the three affected countries is something that has alarmed people near and far, including here in this country, and Tony and I and others in the international community have been speaking now for many months about the need to bend the curve of infections. There is a need for far more commitments and far more deliveries upon commitments in order to bend the curve. There is a need for more beds; there is a need for more bleach, more cash in order to pay community mobilizers or people who pick up bodies so as to do safe burial. The list goes on and on, and UNMEER, and each of the three affected countries, are the keepers of those lists, and we in the United States and in the broader international community need to be responsive to those demands and to the specifics of what is on those lists, and that is what we are trying to do.
I will say that out of my trip to the region and having visited all three affected countries and now having toured the UNMEER response headquarters, I think we need to be very clear that our goal is not simply to bend the curve; it is to end the curve. And this is something, because of the commitments that have been made, because of the mobilization that is being done, that we are confident will result – because it must result – in the outstanding gaps being filled. We can see the day when those gaps are filled and when the curve is not simply bent, but is ended. And when that day is achieved, people will thank the people of Ghana and the government of Ghana for your role in being part of ending the stigma of Ebola, ending the fear, and focusing on the most important thing, which is the response.
There are – one of the things one experiences here in this warehouse is a recognition that there are a lot of supplies out there in the world. This is just one example of a place where you’re surrounded by supplies. What we need to do is to get quicker in moving supplies in warehouses like this into the affected countries. And warehouses like this don’t just exist here in UNMEER headquarters; they exist all around world.
We have the capabilities in all of our countries to end the curve, and the question is how do we take supplies that exist in warehouses like this around the world and get them where they’re needed, where people are desperate for our help, and when doing so will protect not only the people in the affected countries, but also people in our own countries.
So that is the enterprise that we are part of. I am very, very encouraged by some of the steps that have been taken, particularly in the last couple of weeks, in terms of the governments’ leadership in the affected countries and in terms of the international community’s ability to get supplies into places of need. But the main message, again, for the world is: fill the gaps so we can bend and end the curve. Thanks.
Moderator: Thank you, Ambassador. Folks, the Ambassador has a plane to catch very shortly, so time is short. A reminder: one question per person. Also, wait for the microphone to come to you. We have time for, maybe, four questions. To begin with, Metro TV, please.
And please let us know who the question is for: the Ambassador or for Mr. Banbury.
Reporter: I want to find out what you’re doing to make sure that countries who have not contracted the disease do not contract it? Thank you.
Ambassador Power: Thank you for the question. I know it is a question on the minds of many here in Ghana but also in places like the United States where we have seen several cases come into the United States from the region, and so screening procedures are extremely important. I came this morning from the country of Liberia, from the airport in Monrovia, and I and my delegation had our temperatures taken three times between the time we arrived at the airport and the time that we boarded the plane. While we were in the affected countries, we internalized the habits, now, of people in those countries, which is to avoid physical contact as much as possible. Every place we entered in the three countries involved washing our hands with bleach, washing our shoes. These are precautions taken out of an abundance of caution, and out of a recognition that in order to be able to concentrate our efforts on the places that are most affected, we need to ensure that in so doing we don’t bring the virus to other countries and we contain it where it is, and then slay it where it is.
The three affected countries have been extremely aggressive in recent weeks and months in stepping up those screening procedures. And the country of Ghana, when we arrived, also was extremely vigilant in taking our temperature, asking us questions about whether we had had contact with Ebola-infected patients, and so forth. And they will take measures accordingly on the basis of whether someone has come to the country has had contact or not. I want to stress that the vast majority of people in the affected countries who are contributing to the Ebola response are not themselves in physical contact with people who have Ebola. So, for instance, most of the people who comprise the UN Mission here –maybe even all – all, I am told—are people who do not have that kind of contact and are not wearing PPEs and then taking them off when they come back to Ghana. That’s not what this is. This is a logistic operation and so, again, the likelihood of Ebola being brought into one of the neighboring countries by the international support network is extremely, extremely narrow. These individuals do everything in their power to eliminate that risk all together again by these precautions.
Moderator: Next question – Reuters in the front row.
Reporter: Hi, Michelle Nichols from Reuters. You both mentioned the need for more beds, and yet we’re seeing in Liberia that there are empty beds. What’s the explanation for that? Is this a sign of progress or are there concerns that people are staying away from treatment centers?
Special Representative Banbury: The need for beds – we’re estimating under worst case scenario planning that we need a total of, for instance, 53 Ebola Treatment Units. And in terms of the ones that are now built, or in process, we have a gap of about 20. For community care centers, which are absolutely critical to all this, we are planning about 329 and we have a gap of about 300. So there is a very serious need for beds.
We have to make sure, though, that the beds are placed at the right locations, and that depends on good information on exactly where the disease is. And it’s very hard to get accurate epidemiological information of what exactly are the new cases, where are they, what are the causes of transmission. And to properly fight this disease, that information is critical so that we can allocate scarce resources, whether they’re beds or burial teams or community mobilizers, against those critical needs.
Reporter: Are you trying to suggest, then, there’s more than enough beds (inaudible)?
Special Representative Banbury: No, no, I’m definitely not saying there are more than enough ETUs, because we don’t know where we’re going to be in four weeks’ time. And we’re not just worried about what the situation is today; we’re planning for the worst. We’re hoping for much better; were planning for the worst. And by planning for it we will avoid it. By bringing in all this capability, it means we’ll bend the curve earlier and, as Ambassador Power said, we will end the curve earlier. All this extra capability means saved lives. And for the United Nations, for UNMEER – I’m sure for all our partners – it’s all about saving lives. Empty beds is a great sign, but right now we know that there are people dying in all three countries outside of Ebola Treatment Units who should not be dying. Just about two weeks ago, I was – after I traveled to all three countries – I was able to brief the Security Council and Ambassador Power was there and I said we’re in a race against Ebola and Ebola is winning the race. Well, we’re starting to catch up – the international community, all of us – by putting everything we have into this – we are accelerating, we’re starting to catch up. But, we’re not there yet; and every day we’re not there means people are dying unnecessarily. So we have to build more beds, get more foreign medical teams in place, build more community care centers, have more safe burial teams, more community mobilization. We need to do all of it, and the faster we do it the more lives we’ll save.
Moderator: Folks, we have time for two more questions. That man in the third row. Wait for the microphone.
Reporter: I am (inaudible) TV3. I want to find out what is the major prevailing challenge between facing and reducing the threat of Ebola?
Ambassador Power: It’s hard to choose one prevailing challenge as Tony just indicated, and I’d ask him also to respond.
The challenge you think you had yesterday is something that may be a different form of that challenge tomorrow. And so, just to give you one example in light of the previous discussion about beds: at the start of this crisis, when the presence of epidemiologists out in the countryside – particularly the very remote areas that are very hard to get to, or there are very bad roads, or no paved roads – the knowledge of what was happening in some of those communities was not so great, but the knowledge in certain communities was very great and we were able – working with the CDC and the WHO and with the affected country governments – to come up with some projections about where the virus was going and how many beds you would need, as Tony has described.
As the international presence has ramped up, and as some road repair has occurred, and as people have been given mobile phones with SIM cards and are able to call in sort of what they are experiencing, we are learning about pockets of need that we may not have been aware of before. And as a result, in addition to the question of the number of beds, a core question now is the geographic distribution of beds. And so you know you need a ton of beds because you know you need to isolate 70% of the patients in order to bend and then end the curve. But, the more we know, the more we will adapt where those beds go, accordingly.
In addition, to give you two bright spots, in both Freetown and Monrovia in the last, really, week, we have seen extraordinary improvements in the rate of safe burial within 24 hours. In Sierra Leone, in Freetown, the estimate is that the safe burial rate has gone from somewhere between 30 and 40 percent being safe to around 98 percent. If fewer infections are occurring by virtue of unsafe burial, that over time is going to change the number of beds that are needed in a particular community or in a particular part of the country.
And so these kinds of adaptations, because Sierra Leone and Liberia did such a great job, the people of those countries – comprising these burial teams, you know, donning the PPE, taking the risk, going out into the communities, managing that risk – they’re not getting infected now that they’ve been trained in the protocols. They performed a critical intervention that then has implications for how UNMEER and the governments in question think about allocating resources. So that is just in terms of how the challenge has evolved.
But I guess I would still say the number one – I’d say there are two core challenges that remain. The first is the gaps that are still profound, whether it’s something as basic as soap or whether it’s the underfunded UN appeals, whether it’s the number of helicopters that can get people into the remote areas, there are huge gaps. And countries that have not stepped up at this point have to step up. They can be part of a winning enterprise. They can be part of ending Ebola, or not. And so that is an opportunity, you might say, in the face of this tragedy.
The second prevailing challenge, and arguably the most important, particularly in the long term, is fear. Fear that causes people to stigmatize people who’ve survived the epidemic, who have a huge amount to offer in actually being a part of treatment and care. Fear and confusion about how the epidemic has spread and will spread, that causes countries to take measures that ultimately will deter the infusion of health workers, potentially, and others who can be part of the solution. And so, as President Obama said yesterday in his remarks, we need to conquer our fear so that we can conquer this epidemic.
Moderator: Guys, we have time for one more question, please. I think, Chris Stein. Chris Stein, AFP.
Reporter: For Ambassador Power: Given the enormity of the outbreak in West Africa, how do you see the U.S. reaction – given the enormity of the outbreak in West Africa, how do you see the reaction at home to the relatively few cases that have occurred in the U.S.?
Ambassador Power: I’m going to give Tony the last word because I think he’d have a very important response to the prior question, but, I would say first of all that the part of the U.S. response that is getting attention now is the fear that recent infections have generated in the broader public. And as people in Africa know, when Ebola comes to your country or your region it is frightening and it’s going to take people time to get educated about how the virus is spread. And so we are in a phase of self-education, understanding how this works.
The fact that certainly the nurses who were infected in Dallas have now both been released from their treatment and have survived and indeed are thriving – they’re great messengers for the nobility of the health workers who are part of the overall solution to this crisis. So when people talk about the response in the United States – I believe in your question you are talking about, again, some of the concerns that have been generated – but I think the most important feature of the American response to this epidemic is that we are not running away from the epidemic. We as a nation, under President Obama’s leadership and thanks to the selflessness of our aid workers, our military, and health workers who have no official affiliation with the U.S. government – we are running toward it, deploying our men and women in uniform, infusing the region with all kinds of supplies and resources that are urgently needed, and embracing both the challenge and the responsibility of helping this region come out of, you know, a terrible time. And we do so because we have a humanitarian solidarity and great empathy for people who are going through something this trying and this horrific, particularly the countries that are affected – particularly Liberia and Sierra Leone, that have made such strides and have come so far. We want to stand with the people in those countries and help them get through this. But we also recognize, in coming toward the epidemic, running into the burning building as it were, that it is in our national security interest to do this. And so the United States is with the people of Africa, it’s with the people of Guinea, Sierra Leone, and Liberia, and it is in this for the long haul until we bend and end the curve.
Tony, last word?
Special Representative Banbury: Thank you, Ambassador Power. Just a remark on the earlier question about the most significant challenge. For UNMEER, from an operational perspective, the most difficult thing is that we have to put in place every part of the response; we have to put it in place everywhere; and we need to do it super fast. If there is a gap anywhere in the operational response, it leaves a place for this virus to continue to spread, infect people, kill people, destroy families and communities. And that’s a big responsibility. But we are working very, very hard together with partners, such as the United States, all the UN Family, NGOs, and national governments, to make sure we put that response capability in place everywhere so that there are no gaps in the response and so we can bring this crisis to a close, and it’s thanks to partnerships like – with the United States, who is running into the burning building, as well as the presidents of the three most affected countries, other partners who are contributing in very serious ways, as well as President Mahama and his leadership, to show that working together as an international community, focusing on the very serious challenges, that we can bring this crisis to a close. And we will, we’ll get it done. The only question is how long does it take and how many people are going to die. We’re going to try to make it as fast as possible and save as many lives as possible.
I’d just like to close by, again, thanking Ambassador Power and her delegation for visiting us and for all the fantastic support from the United States Government and the people of the United States for our efforts. Together we’ll make it happen. Thank you.
