Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
THE UNITED STATES INTERESTS IN THE EBOLA
OUTBREAK IN WEST AFRICA
SHEKIRA RAMDASS
U.S. DEPARTMENT OF STATE
The Ebola outbreak in West Africa is one of the world’s deadliest health crises. It has claimed
the lives of more than 24,000 people by March 2015. Highly concentrated in Guinea, Liberia,
and Sierra Leone, the virus caused devastating fear and insecurity within the region and
international community at large.
Ebola Affected West African Nations
Source: PBS Frontline January 2015
The purpose of this research project is to understand the importance of U.S. involvement
in preventing the escalation of global health crises, such as the Ebola epidemic. As one of the
world’s dominant superpowers, the United States has a social and moral obligation to advance
the welfare and prosperity of all people by focusing on the importance of global health. This
project will therefore evaluate the need for U.S. participation and specific reasons why the U.S.
should play a vital role in the Ebola crisis.
What are the U.S. strategic interests in preventing the proliferation of the Ebola virus in West
Africa?
The United States has several strategic interests in preventing the proliferation of the
Ebola virus in West Africa. Firstly, the Ebola crisis poses a severe global security threat to the
United States and its allies. Due to the outbreak’s close proximity to terrorist groups such as
221
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
Boko Haram and Al-Qaeda, affected West African nations become vulnerable to terrorist
invasions and takeovers. This can ultimately lead to civil unrest and political instability, which in
turn can further pave the way to violence and war. In addition, the Ebola crisis raises great
economic concerns for the United States. In relation to global trade and business, the outbreak
has the potential to affect the supply and demand of commercial goods such as cocoa, cashews,
iron, and oil. Further, as a global leader, the United States has a social responsibility to provide
humanitarian assistance to victims of the Ebola crisis. Should the disease persist, West African
nations have the potential to succumb to persistently weak and economically lagging nations,and
ultimately, their emergence as failed states. Therefore, it is imperative for the United States to
assist in containing the epidemic in order to enhance peace, maintain economic stability, and
ensure global security.
Methodology
Qualitative research was performed to analyze and understand reasons why the United
States has an interest in the Ebola Outbreak in West Africa. Several journals and reports from
the White House Press, UN, WHO, CDC, U.S. Institute of Peace, and Somatosphere served as
primary references for the paper. Articles from the popular press including: CNN, BBC, Times,
Foreign Policy, Aljazeera, Washington Post, and Foreign Affairs. Furthermore, an in-depth
interview with African Affairs specialist, Dr. Cara Jones, took place in order to gain additional
insight into the potential impact of the Ebola crisis on West African nations and the international
community at large.
Background
To understand the vitality of the disease it is important to provide a medical analysis of
Ebola. The Ebola Virus disease (EVD), formerly known as the Ebola haemorrhagic fever, is a
severe, often fatal illness in humans. Common symptoms of EVD, according to the Centers for
Disease Control and Prevention (CDC), include the following: high fever, vomiting, unexplained
hemorrhage (bleeding and bruising), diarrhea, muscle pain, and severe headaches.1 These
particular symptoms may appear anywhere from two to twenty one days after exposure to Ebola,
although the average is roughly eight days. EVD is commonly transmitted through human to
human transmission via direct contact with bodily fluids (blood, saliva, mucus, urine, or
vomiting) of a person who is dead or alive.2 It is important to note that an asymptomatic person
is not contagious. Therefore, an asymptomatic person who is treating or caring for an Ebola
victim, even if he or she is infected, would not be contagious.3 CDC reports that the average
1
Drazen, Jeffrey, Rupa Kanapathipillai, and Edward Campion. "Ebola and Quarantine." New England Journal of
Medicine. October 27, 2014. Accessed October 28, 2014. doi:10.1056/NEJMe1413139.
2
Ibid
3
Asymptomatic: showing not symptoms of the Ebola virus
222
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
EVD case fatality rate is 50%. However, in past outbreaks, fatality rates have varied between
25% to 90%.4
There are many reasons why the Ebola outbreak has severely affected several West
African nations. Weak health systems and a lack of health infrastructure in the region, for
example, serve as the main reasons for EVD diffusion. Experiencing years of conflict within the
last few decades, West African nations have witnessed destruction of their medical
infrastructure, including hospitals, clinics, and medical schools. Liberia, for example, has
suffered from a decimated health care system due to a civil war that ended roughly ten years ago.
The ongoing war destroyed an estimated 354 of Liberia’s 550 medical facilities, thus leaving the
nation with poor quality health service and care.5 This devastation has ultimately left the
population with limited access to trained health care professionals, health equipment and medical
supplies and protective gear. As a result, the local communities in West Africa are left
dangerously vulnerable to health crises such as the current Ebola outbreak. Poor health
infrastructure in the region also prevents affected nations from engaging in basic medical
interventions, which when used early, can significantly improve an Ebola victim’s chance of
survival.
In addition, traditional West African cultural practices have contributed greatly to the
spread of EVD. According to West African medical anthropologist, Sharon Alan Abramowitz,
Africans traditionally are presumed to believe in spirits and witchcraft as the main causes for
diseases.6 These beliefs have encouraged cultural behaviors and customs in the West African
region which are responsible for the initial Ebola outbreak and have further facilitated its spread.
For example at funerals, deceased people are washed and clothed by a family member, typically
with bare hands, before presenting the corpse to mourners for a final touch and kiss.7 Practiced
by Christians, Muslims, and several West African ethnic groups such as Kissi, the Mende, the
Sherbro, and the Kona, the burial ritual is considered sacred and spiritually important to maintain
peaceful bonds between the living and the dead. Such practice, however, increases the chance for
a person to contract Ebola. Doctors Without Borders mentions that the highest risk of infection
occurs when a person dies. As a result, locals present at the funerals or involved in the burial
ritual are at risk of contamination. Although locals are aware of the avenues for Ebola
transmission, West African families continue to perform such practice. Medical anthropologist
Dr. Ann Kelly mentions that failure to perform burial rites puts the community in danger, thus
causing harm and illness to the family by the deceased person’s spirit (Tibo).8 As a result, people
4
CDC. "2014 Ebola Outbreak in West Africa - Outbreak Distribution Map." Centers for Disease Control and
Prevention. January 27, 2015. Accessed February 01, 2015. http://www.cdc.gov/vhf/ebola/outbreaks/2014-westafrica/distribution-map.html.
Ricks, Alan, and Micheal Murphy. "Ebola Outbreak: Liberia’s Health Care Infrastructure Is Underdeveloped - The
Boston Globe." BostonGlobe.com. September 17, 2014. Accessed February 01, 2015.
5
6
WHO. "Sierra Leone: A Traditional Healer and a Funeral." WHO. September 2014.
7
Ibid
8
Thomas, Kate. "Fighting Ebola with Anthropology." Ebola Deeply. October 2014.
223
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
refuse to take Ebola infected family members to medical facilities because it would be regarded
as a “death sentence.”
Furthermore, locals have a strong connection with traditional healers, whose knowledge
and “special powers” have been used to cure diseases for centuries. Many people trust traditional
practitioners because treatment is much cheaper and sensitive to cultural beliefs. However, the
unique treatments offered to cure diseases have caused people to suffer greatly. Traditional
remedies, such as bathing, cutting and applying infected blood to the skin have been common
high risk practices which have contributed significantly to the spread of EVD.9 In addition,
traditional healers have influenced locals to believe Ebola is nonexistent and the sickness is
caused by evil spirits. These false ideas have influenced the emergence of several conspiracy
theories about Ebola which have further discouraged victims to seek proper health treatment.
Getting health advice from traditional healers in West Africa has complicated efforts for the
Ministry of Health in Guinea, Liberia, and Sierra Leone, ultimately preventing the region from
controlling EVD.
Lastly, bush meat consumption is a traditional African practice that has influenced the
spread of Ebola. Triggering the outbreak in Guinea, bush meat consumption has claimed the
lives of Patient Zero and many others who hunt, slaughter, and eat raw bush meat.10 Serving as a
source of dietary protein, many people in West African nations consume bush meat out of
desperation and food scarcity. 80%-90% of Liberians, for example, consume game meat, and
55% of Sierra Leonean households consider it a staple food.11 This cultural practice, however, is
the likely origin of the Ebola virus. According to the New England Journal of Medicine, Ebola is
a zoonotic disease transmitted between vertebrate animals and humans. Certain animals such as
the straw-coloured fruit bat, which is often hunted and eaten in West Africa, carry zoonotic
pathogens, which can spread to humans through bites, scratches, and bodily fluids.12 Continued
interaction with game meat increases the likelihood of Ebola transmission in the West African
region.
Brief Ebola Outbreak Timeline
The Ebola virus was first identified in 1976 in the Sub-Saharan African region, notably in
the DRC and Uganda.13 According to the CDC, fewer than 500 cases were reported each year
since the first outbreak. The current Ebola crisis in West Africa is the 26th outbreak and is
considered the most severe and devastating outbreak historically noted. The outbreak began in
Guinea in December 2013 after the virus infected a 2-year old Guinean boy (patient zero) who
9
Thomas, Kate. "Fighting Ebola with Anthropology." Ebola Deeply. October 2014.
10
Patient Zero: First person who contracted Ebola
11
Restif, Olivier. "Understanding the Bushmeat Market: Why Do People Risk Infection from Bat Meat?" University
of Cambridge. October 09, 2014. Accessed February 18, 2015.
12
Karluki, Dr. Jullus G., ed. "Bushmeat and The Future of Protein in West Africa." The African Center for Economic
Transformation, no. 4 (2014): 1-16.
13
Ebola Outbreak. Directed by Frontline. PBS Frontline. September 9, 2014.
224
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
lived in Meliandou village.14 Several months later, Liberia reported several Ebola cases which
was later followed by Sierra Leone’s confirmation of Ebola diffusion beginning on March 25,
2014.15 By the beginning of August 2014, the death count from the outbreak reached 1,000,
while the number of total cases crossed 2,000. After the World Health Organization declared the
current health crisis an “international public health emergency,” two American missionary
workers become infected, and later recovered from Ebola.16 A month later, Thomas Eric Duncan,
a Liberian national, became the first patient diagnosed with Ebola in the United States who later
died of the disease. Eight American citizens, including seven healthcare workers, were later
infected with Ebola, but survived. By January 15, 2015, CDC reported more than 19,000 people
have been infected, and more than 8,000 have died.17 Ebola has reached at least nine nations—
Guinea, Liberia, Sierra Leone, Nigeria, Senegal, the United States, Spain, Mali, and Scotland.
The CDC warns that the number of Ebola cases may rise significantly before the virus is
controlled.18
A Brief Timeline of U.S. Response to the Ebola Outbreak in West Africa
Under the direct leadership of the U.S. State Department and USAID, the United States
has been involved in providing diplomatic, development and humanitarian assistance to affected
Ebola countries in West Africa. Working closely with the international community and nongovernmental organizations including Doctors without Borders, the United Nations,World
Health Organization, and countries such as the United Kingdom, France and Canada; the United
States has focused on mobilizing a global response to counter the Ebola epidemic. Beginning in
early August 2014, the USAID office of U.S. Foreign Disaster Assistance (OFDA) deployed a
Disaster Assistance Response Team (DART) to Guinea, Liberia, Sierra Leone, and Mali to lead
the on the ground U.S. response to the crisis.19 Besides USAID, DART is comprised of other
government entities including CDC, DOD and U.S. Forest Service. On 11 August 2014, days
following the first DART deployment, the United Stated ordered family members of U.S.
embassy employees to leave Liberia.20 Much of the U.S. active response toward the outbreak,
however, took place in early September—six months after the Ebola epidemic began. After
receiving an appeal for aid on September 13, 2014, from Liberian President Ellen Johnson
14
Ibid
15
CDC. "2014 Ebola Outbreak in West Africa - Outbreak Distribution Map." Centers for Disease Control and
Prevention. January 27, 2015.
16
Ibid
17
CDC. "2014 Ebola Outbreak in West Africa - Outbreak Distribution Map." Centers for Disease Control and
Prevention. January 27, 2015.
18
Ibid
19
White House. "FACT SHEET: Progress in Our Ebola Response at Home and Abroad." The White House: Office of
the Press Secretary. February 11, 2015.
20
Ibid
225
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
Sirleaf, the United States outlined a strategy to address the outbreak.21 On September 16, 2014,
the White House released a fact sheet detailing the U.S. response to containing and eliminating
the epidemic at its source, while also taking precautions domestic measures.22 The ongoing U.S.led international response includes: deployment of key medical and expert personnel, increasing
DOD presence in the region, providing financial support, community outreach and safe burial
practices, building health infrastructure, and Ebola treatment Unit development. Following the
release of the White House fact sheet, President Obama delivered a video statement about the
Ebola outbreak and announced his decision to remove all American Peace Corps volunteers from
most heavenly affected countries.23 Days later, the United States convened a special session with
the U.N. Security Council calling on international support to fight the outbreak. On September
24, 2014, Secretary of State John Kerry named Nancy J. Powell, former ambassador to India, to
head the Ebola coordination Unit, which focuses on leading DOS outreach to international
partners.24 By early October 2014, U.S. Africa Command (AFRICOM) established a Joint Force
Command headquarters in Monrovia, Liberia, led by Major General Volesky.25 Weeks later the
United States deployed over 3,000 military troops to provide regional support to U.S. military
activities and facilitate coordination with U.S. government and international relief efforts. The
U.S. continues to play a proactive role in the fight against Ebola, but more work needs to be done
in order to ensure that there are zero-related Ebola deaths in West Africa.
Social Responsibility
As a global leader in the international community, the United States has a social
responsibility to ensure that people, families, and communities worldwide live healthy and
productive lives. Such obligation does not focus on U.S. personal interests, but rather serves as
the right thing to do. The expectation of a major superpower, like the United States, to provide
humanitarian support is deeply rooted in Peter Singer’s utilitarian idea of a good samaritan. In
Singer’s essay Famine, Affluence, and Morality, he argues that everyone has an obligation of
humanitarian assistance to help others in need, if the cost or burden is minimal.26 The current
estimated cost to control the Ebola outbreak, according to the UN is 1 billion USD.27 This cost is
relatively small to the United States, but even more trivial to West African nations affected with
the disease. According to the World Bank, Sierra Leone’s GDP in 2014 was 6 billion USD and it
21
White House. "FACT SHEET: Progress in Our Ebola Response at Home and Abroad." The White House: Office of
the Press Secretary. February 11, 2015.
22
Ibid
23
Ibid
24
LaFranchi, Howard. "Ebola Crisis: Why Obama Is Involving the US (+video)." The Christian Science Monitor.
September 16, 2014.
25
Ibid
26
Singer, Peter. Famine, Affluence, and Morality. Report. 1st ed. Vol. 1. 1972. Accessed March 24, 2015.
http://www.utilitarian.net/singer/by/1972----.htm.
27
Ibid
226
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
had a public debt worth 31.9% of its GDP.28 The World Bank also reports that Liberia’s GDP in
2014 was 1.95 billion USD, which represents less than 0.01% of the world’s economy.29 Unlike
the United States, the affected West African nations are among the poorest in the world and their
economies are extremely underdeveloped. Thus, these West African nations are themselves
financially incapable of handling the Ebola outbreak. The United States, however, is a high
income nation with an annual GDP of $17, 711 trillion USD in 2014. Internationally recognized
as having the largest national economy, the United States is financially able to provide
humanitarian assistance to fight the Ebola crisis. $1 billion USD needed to contain the Ebola
outbreak is a minimal cost to the U.S. compared to the immense financial burden it is on Liberia,
Guinea, and Sierra Leone.
Moreover, according to Lisa Monaco, who is the Homeland Security and Chief
Counterterrorism Advisor for President Obama, the United States has the specialists and proper
containment strategies needed to help fight the Ebola outbreak in West Africa.30 Skilled medical
and public health workers, infrastructure capabilities, and specialized physicians, for example,
are in abundance in the United States, and can serve as valuable tools to help suffering Ebolaaffected nations, without sacrificing much. Under these circumstances, the United States
government has a social responsibility to act and help deter the spread of Ebola in West Africa.
If, however, the United States fails to do so, the nation risks criticism and social stigmatization
from the global community.
In addition, the United States also has a social responsibility to advance and protect
human security around the world, especially during health crises. According to the U.N. Trust
Fund for Human Security, “human security aims at ensuring the survival, livelihood, and dignity
of people in response to current and emerging threats.”31 As a member of the U.N. General
Assembly, the U.S. Government acknowledges the importance of human security and the social
responsibility for global leaders to provide immediate action to prevent, detect, and rapidly
respond to health crises. As a result, the United States established the Global Health Security
Agenda (GHSA) in February 2014, which places global health intervention and security at the
forefront of the nation’s foreign policy agenda. The mission of GHSA is to advance a “world
safe and secure from infectious disease threats”, and to respond collectively with other nations to
establish commitments to improve global health security.32 Therefore, in the midst of a health
disaster, such as the Ebola outbreak, the United States has a commitment, based on the nation’s
28
World Bank. "Ebola: Economic Impact Could Be Devastating." World Bank: Africa. September 2014. Accessed
March 23, 2015.
29
World Bank. "Ebola: Economic Impact Could Be Devastating." World Bank: Africa. September 2014. Accessed
March 23, 2015.
30
LaFranchi, Howard. "Ebola Crisis: Why Obama Is Involving the US (+video)." The Christian Science Monitor.
September 16, 2014.
31
Deloffre, Maryam Z. "Human Security in the Age of Ebola: Towards People-centered Global Governance."
EInternational Relations. October 2014
32
DOS-Office of the Historian. "Founding of Liberia, 1847 - 1830–1860 - Milestones - Office of the Historian."
Founding of Liberia, 1847 - 1830–1860 - Milestones - Office of the Historian. Accessed March 29, 2015.
227
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
GHSA to support West African nations affected by the epidemic. The current outbreak further
demonstrates the urgency for immediate action by the U.S. government to respond to Ebola on
the basis of the outbreak being a threat to human security.
In addition, the United States has a unique social responsibility to help Liberia, in
particular, with the Ebola outbreak. As the only African country founded by the United States,
Liberia serves as the “closest thing America ever has as a colony in Africa.”33 Also known as
“another America,” Liberia is a country established by freed slaves in 1847 who named their
capital, Monrovia, after James Monroe. Sharing a close historical connection, the United States
has an obligation to help Liberia contain Ebola and prevent the disease from ruining the nation’s
prosperity and wellbeing.
The United States has the opportunity to demonstrate global leadership by fulfilling its
responsibility to save and improve the quality of lives for millions in the region. By taking an
active role in the Ebola outbreak, the United States accomplishes its role as an international
leader and global super power; ultimately enhancing America’s prestige, respect, and recognition
around the world.
U.S. Social Responsibility Response
The United States has taken several actions in order to fulfill its social responsibility to
help West African Ebola affected nations. Financially, the United States has contributed roughly
$861.4 million USD and pledges to provide an additional US $45 million to contain the
outbreak.34 Currently serving as the top humanitarian aid donor followed by the United Kingdom
($305 million USD), Germany ( $160.4 million USD), and the World Bank( $117.4 million
USD), the United States has allocated humanitarian funding to deliver medical and relief
supplies to Guinea, Sierra Leone, and Liberia.35 Under the control of USAID, the United States
has delivered roughly 2,200 rolls of heavy duty plastic sheeting, which was used in constructing
Ebola treatment units across the region. The U.S. has also sent 140,000 sets of protective
equipment such as medical gloves, goggles, coveralls, face shields, and other personal protective
supplies.36 USAID has also provided more than 10, 000 Ebola kits to the Liberian Institute of
Biological Research and to the Kenema Government Hospital in Sierra Leone.37 In addition to
providing essential medical equipment, the United States has organized safe burial teams in order
to prevent Ebola transmission due to unsafe burial practices. U.S. partners such as the Medical
Teams International(MTI), have established and operated over 190 burial teams in West
33
Ibid
34
Brady, James S. "Press Briefing on Government Response to the Ebola Epidemic in West Africa, 10/3/2014." The
White House. October 2014. Accessed March 23, 2015.
35
Ibid
36
Ibid
37
Ibid
228
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
Africa—seventy in Liberia, fifty in Sierra Leone, and seventy in Guinea.38 Furthermore, the
United States has organized community outreach campaigns and social mobilization in Liberia,
Sierra Leone, and Guinea to educate the public about the virus, and learn safe and appropriate
ways to treat and prevent the spread of EVD. Furthermore, under the leadership of USAID, the
United States has mobilized volunteers to go door-to-door in each village, passing out life-saving
information and speaking with locals about prevention measures. Additionally, CDC has worked
closely with community members from affected countries reaching out to community leaders,
religious leaders, journalists, and celebrities in order to spread accurate and consistent
information about Ebola to the locals. Using community members to foster health education
campaigns also encourages the public to seek medical assistance if a neighbor is symptomatic or
ill. Moreover, the National Institute of Allergy and Infectious Diseases (NIAID) has developed
an experimental Ebola vaccine known as Zmapp, which was created as a potential treatment for
the Ebola virus.39 Thus far, phase one clinical trials have taken place in Liberia, but more
research is underway to ensure that Zmapp is a reliable and sustainable drug to fight Ebola.
Economic Concerns:
Before the Ebola outbreak took place, affected West African nations were making
remarkable economic progress in the region. Liberia and Sierra Leone, especially, experienced
rapid economic growth in recent years after overcoming decades of civil strife. In 2013, both
nations ranked second and sixth, respectively, among the top countries with the highest GDP
growth in the world.40 Guinea, although it was growing at a much slower past in 2013, had high
expectations for future growth as a result of prosperous economic projects with international
investors. However, the emergence of the Ebola outbreak in the West African has the potential to
negatively influence economic development and progress in the region, ultimately reversing
economic gains. According to the president of Sierra Leone, Ernest Bai Koroma, the Ebola crisis
causes an “ economic blockage” for many West African nations because it can affect key
economic sectors that make up the majority of revenue for Liberia, Guinea, and Sierra Leone.41
These sectors include agriculture, mining, and trade.
Agriculture is the largest sector in many African economies, which account for a very
large portion of crop production and employment. Liberia, Guinea, and Sierra Leone, especially,
have a very high percentage of employed farmers who depend on agricultural development for
basic survival and overall economic growth. In Sierra Leone farmers make up 66% of the overall
38
Ibid
39
White House. "FACT SHEET: Progress in Our Ebola Response at Home and Abroad." The White House: Office of
the Press Secretary. February 11, 2015.
40
Copley, Amy, and Amadou Sy. "Understanding the Economic Effects of the 2014 Ebola Outbreak in West Africa."
The Brookings Institution. October 01, 2014.
41
Copley, Amy, and Amadou Sy. "Understanding the Economic Effects of the 2014 Ebola Outbreak in West Africa."
The Brookings Institution. October 01, 2014.
229
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
population, according to the World Bank.42 Most of the cities, including Kailahun in Sierra
Leone, are the nation’s most productive food-producing area, yet it is also the epicenter of the
Ebola virus. The emergence of Ebola has caused many farmers in West Africa to abandon their
agricultural responsibilities because they have either contracted the disease or fear possible
infection. As a result, production yield for many West African staple crops such as rice, maize,
and cassava has decreased. This is a major concern because agriculture production accounts for
57% of Sierra Leone’s GDP, 39% of Liberia’s GDP, and 20% of Guinea’s GDP.43 As West
African nations witness a decrease in the supply of crops, there remains a high demand in crops
for domestic consumption, thus food prices rise. As of September 2014, Ebola affected West
African nations have suffered from an increase in the price of staple crops. According to the
Food and Agricultural Organization (FAO), prices of staple crops have doubled. Empirical
observation performed by the United Nations Population Fund in the Red Light Market, one of
the largest and popular market places in Monrovia, Liberia, revealed a major increase in staple
food prices and commodities in November 2014.44 Cassava, for example, rose by 150%, palm oil
by 53%, plantains by 66%, and fresh peppers by 133%.45 An increase in food prices can cause an
immense financial burden on locals, and worse, forces many to remain hungry. Moreover, an
increase in food prices in West Africa has the potential to lead to inflation. According to the
International Monetary Fund, nations such as Liberia have already witnessed an increase in
inflation. The IMF reports that Liberia inflation rose to 13.1% in 2014 from a solid 7.7% before
the outbreak in 2013. 46
The trade sector has also been impacted by the Ebola outbreak, which places an immense
burden on the West African economies. In order to contain the spread of Ebola, affected nations
have imposed quarantines and have closed borders. West African neighboring nations such as
Senegal and the Ivory Coast have also imposed restrictions on the movement of people and
goods. Such actions, as a result, have negatively affected regional trade. Cross-border trade has
been the most impacted from August- November 2014, disturbing the import and export trade
flow of goods from Sierra Leone, Guinea and Liberia.47 According to the World Food
Programme, Guinea relies on local rice and ginger imports from Sierra Leone, and Liberia and
Sierra Leone both rely on palm oil exports from Guinea. Trade flows also take place with Mali,
Senegal, and Nigeria in exchange for livestock, nuts, and additional staple foods. With the
emergence of Ebola, however, import prices of goods have risen roughly 30%, according to the
42
The World Bank. "Reviving Agriculture in Ebola-hit Guinea, Liberia and Sierra Leone." The World Bank. February
2015.
43
Bridges. "FAO: Ebola Outbreak Putting West African Trade, Food Security in Jeopardy." International Center for
Trade and Sustainable Development. September 2014.
44
Bridges. "FAO: Ebola Outbreak Putting West African Trade, Food Security in Jeopardy." International Center for
Trade and Sustainable Development. September 2014.
45
Ibid
46
Endsor, Mick. "Ebola in West Africa: A Growing Economic and Humanitarian Crisis | ROM Economics." ROM
Economics.
47
Konneh, Amara. "The Economics of Ebola." WSJ. August 2014.
230
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
World Food Programme, which has caused a reduction in food trade.48 This ultimately has the
potential to reduce food availability in local markets, thus increasing market prices for crops
because the demand of crops is greater than the supply.
The mining sector is another economic booster from many affected West African nations
which has been affected by the Ebola virus. The World Bank reports that the mining sector in
Liberia, for example, accounts for 17% of the nation’s GDP and 56% of the $559 million USD
worth of exports in 2013.49 In Sierra Leone, mining accounts for 85% of the nation’s industry
and 20% of the economy.50 However, with emergence of the Ebola outbreak, mining activity has
been reduced significantly, thus threating West African nations economic development. Two
major iron ore mining companies, ArcelorMittal and China Union, in Liberia, for example, have
cancelled mining investment projections that focused on the extraction of gold, diamonds,
bauzite, and rutile. Due to the reduction of major economic activities in the West African region,
affected West African actions have suffered from fiscal challenges, which ultimately decrease
economic stability. Liberia’s economy, for example, has declined $113 million USD (5.1% of
GDP) for 2014, as a result of the Ebola crisis.51 Further, Sierra Leone’s economy has declined by
$95million USD and Guinea’s has declined by $120 million USD.52
The economic decline in the affected nations and the rise of Ebola poses a huge economic
concern to the United States and allies for many reasons. Firstly, it impacts global trade of cash
crops such as cocoa, which currently serves as a $12 billion USD global market good.53 60% of
the world’s cocoa production neighbors nations currently affected by the Ebola outbreak—
Nigeria, Ghana, and Ivory Coast.
West African Cocoa Suppliers
48
Konneh, Amara. "The Economics of Ebola." WSJ. August 2014.
49
The World Bank. "The Economic Impact of the 2014 Ebola Epidemic." The World Bank Group. 2014. Accessed
March 2015.
50
Ibid
51
Bridges. "FAO: Ebola Outbreak Putting West African Trade, Food Security in Jeopardy." International Center for
Trade and Sustainable Development. September 2014.
52
Ibid
53
Wexler, Alexandra. "Cocoa Prices Surge on Ebola Fears." WSJ. September 19, 2014. Accessed March 24, 2015.
231
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
Source: Politico October 2014
As the West African region witnesses a declining economy and rising Ebola cases, the
supply of cash crops decreases and thus the global price of crops increases. The United Nations
reported that international cocoa prices increased by 18.5% in October 2014 due to the drop in
production as a result of the outbreak.54 This negatively impacts U.S. chocolate companies such
as The Hershey Company and Tootsie Roll Industrial Inc., who gather cocoa supplies from West
Africa. The Food and Agricultural Organization (FAO) predicts an increase in trading prices
from $2,000 per ton to a high of $ 3,400 per ton, if the Ebola virus is not contained. This is a
major concern for the U.S. companies.55
In addition, the rising Ebola crises makes nations vulnerable to becoming persistently
weak and economically lagging nations, as a result of the economic declines West African
nations are facing. This is a significant concern to the United States because it has the potential
to lead to an increase in food shortages in the region. According to the Food and Agricultural
Organization, food insecurity could affect over 470,000 people in Guinea, 300,000 in Liberia,
and 280,000 in Sierra Leone by April 2015.56 Food insecurity can further increase the amount of
people living in poverty in the affected West African region. The World Bank estimates that the
percentage of people living in poverty can increase up to 22% if Ebola is not contained.57 This is
a major concern for the United States because poverty places a huge pressure on governments
and threatens economic stability, which can ultimately lead to failed states or failing states in
West Africa.
54
Konneh, Amara. "The Economics of Ebola." WSJ. August 2014.
55
Bridges. "FAO: Ebola Outbreak Putting West African Trade, Food Security in Jeopardy." International Center for
Trade and Sustainable Development. September 2014.
56
Ibid
57
The World Bank. "The Economic Impact of the 2014 Ebola Epidemic." The World Bank Group. 2014. Accessed
March 2015.
232
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
National Security
Economic concerns posed by the Ebola crisis have the potential to create failed states or
failing states, which pose a severe global security threat, especially toward the United States.
Affected Ebola nations such as Liberia and Sierra Leone have warned the international
community of their vulnerability to becoming failed states. According to African affairs
specialist Dr. Cara Jones, the Ebola crisis “is making economic and political recovery even more
difficult for West African nations.” 58 Liberia and Sierra Leone, countries that are struggling to
recover from over a decade of civil war, see the Ebola outbreak as a pushback to national
development. This ultimately can lead to civil unrest, political instability, weak governmental
institutions, corruption, and immense poverty. As a result, the West African region could witness
destabilization which could cause an increase in transitional crime and terrorist activity, thus
threating security and peace for Americans in the region and at home.
In regards to transnational crime, West African nations affected by Ebola may encounter
an increase in maritime piracy off their coast, especially in the Gulf of Guinea. According to the
International Chamber of Commerce’s Commercial Crime and Services, several areas in the
region including Lagos and Bonny River in Nigeria the Guinean capital, Conakry; and the
Douala Outer Anchorage in Cameroon, are currently piracy prone areas located relatively close
to affected Ebola nations.59 If the Ebola outbreak continues to weaken governmental institutions
in Guinea, for example, there will be a lack of law enforcement, governmental authority, and
surveillance to monitor and control piracy attacks in the area. As a result, African pirates can use
the opportunity to engage in oil theft and other criminal activities for political and economic
gain. This in turn will reduce safety for American allies in the region and American citizens who
are near pirate-prone areas. In addition, failing and failed states in West Africa as a result of the
Ebola outbreak can increase the trafficking of firearms in the region. Rebel groups and African
terrorists can easily buy or rent weapons from corrupt police and military official who are
desperate for economic survival in Liberia, Sierra Leone, and Guinea. These weapons can further
be used to attack American citizens in the area and impose authority within the failing states in
West Africa. In addition, rebels can use borders within affected Ebola nations to have access to
more routes to smuggle weapons to neighboring terrorists groups in Nigeria, Mali, Burkino Faso,
and Guinea Bissau.60 Furthermore, the Ebola outbreak has the potential to expand and increase
the flow of illicit drugs, thus increasing America’s fear of the creation of “narco-states” in the
region. West Africa in recent decades has emerged as main transit points for drug cartel activity,
in particular cocaine, heroin, and methamphetamine, from Latin American nations to Europe.
According to Senate Subcommittee on African Affairs, Colombian and Venezuelan drug
traffickers, for example, have cultivated strong relationships with African criminals in the West
58
"U.S. Interest in the Ebola Outbreak." Interview with Cara Jones. February 2015.
59
Mason, Jeff, and James Harding Giahyue. "Citing Security Threat, Obama Expands U.S. Role Fighting Ebola."
Reuters. September 16, 2014.
60
Luna, David. "Trans-African Security: Combating Illicit Trafficking Along the Crime-Terror Continuum." U.S.
Department of State. February 26, 2014.
233
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
African region.61 As drug criminals in the region seek new routes of drug transmission and
replacement routes for those that no longer exist, emerging failed states such as Guinea, Liberia,
and Sierra Leone can become substitutions. Guinea, in particular, is highly at risk because the
nation is located near Highway 10 – the current shortest route across the Atlantic that is used to
smuggle cocaine from Latin America.62 The rising threat of drug activity in the West African
region due to Ebola further increases political instability, violence by drug gangs, and civil wars
with neighboring West African counties. This in turn weakens peace and regional security for
American citizens in the area.
Furthermore, emerging failed states and failing states due to the Ebola outbreak can lead
to an expansion of terrorist activity. Ebola affected nations in West Africa are in close proximity
to several anti-American terrorist groups. Boko Haram (meaning “Western education is
forbidden”) located in Nigeria, for example, is an African Jihadist group that has recently
pledged allegiance to the anti-American terrorist group ISIS.63 Mourabitounes, Ansar Al
Sunnah, and the Movement for Unity and Jihad in West Africa(MUJAO) are additional African
Jihadist groups located in Mali, Niger and Libya, neighboring nations of Ebola affected
countries. The United States fears that terrorist groups in the region could take full advantage of
Guinea, Liberia, and Sierra Leone, if they emerge as failed or failing states.
Terrorist Groups in Africa
61
Ibid
62
Ibid
63
Mason, Jeff, and James Harding Giahyue. "Citing Security Threat, Obama Expands U.S. Role Fighting Ebola."
Reuters. September 16, 2014.
234
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
Source: The Economist September 2013
Terrorist groups have the opportunity to spread power and authority over weak Ebola
affected nations, thus increasing their presence and strength in the region. This possibility
increases America’s regional and domestic vulnerability to terrorist threats or attacks. American
citizens such as U.S. ambassadors, Foreign Service officers, and Peace Corps representatives in
affected Ebola nations, for example, are at high-risk. According to Department of State
spokeswoman, Jen Psaki, terrorist groups “are calling for more attacks and kidnappings on
westerns.”64 If terrorists get a hold of additional West African nations as a result of Ebola, the
chances of additional tortures, kidnappings, and beadings of U.S. citizens are likely. Attacks on
U.S. embassies in Liberia, Sierra Leone, and Guinea are also possible.
In addition, the potential terror risk posed by Ebola as a bioterrorist weapon has brought
immense concern to the U.S. Department of Defense. Terrorists in the West African region or
terrorist affiliates of ISIS can turn the Ebola virus into a powerful weapon of mass destruction.
Cara Jones mentioned that bioterrorist activity can threaten U.S. national security both
domestically and abroad.65 Islamic extremists and other Jihadist terror groups can take full
advantage of the Ebola outbreak to increase terrorist casualties at very low cost. There are
several methods to spread Ebola in a way that will maximize the number of anti-ISIS victims.
Firstly, terrorists in the region could perform suicide missions in which they could purposely
infect themselves with Ebola and quickly leave West Africa heading to the U.S. before becoming
symptomatic. Terrorists also have the ability to weaponize Ebola by preparing Ebola bombs or
spraying agents which can be transported into luggage bound to the West. Once the biological
agent arrives to the United States, it can be sprayed or exploded in crowded subways, sport
facilities, recreational parks, etc. Captain Al Shimkus, professor of national security affairs at the
U.S. Naval War College, mentioned that such a scenario is plausible.66 The idea of using Ebola
as a bioterrorist weapons has been a topic of discussion for many Jihadist groups. The Middle
East Media Research Institute (MEMRI) reported talks by Jihadist social media and online
chatter websites about the possibility of using “Ebola as a weapon against the U.S. and West.”67
A member of the Jihadi Media Platform, Mata Al-Sa’a, was one of many ISIS members who has
threatened to use the virus against ISIS enemies. MEMRI quotes Mata Al-Sa’a saying “it is
enough to carry a Pepsi bottle in your briefcase and transport it from Africa to America.[ Once
there,] you open the bottle in one of the air ducts, or place it at the tip of public drinking water
pipelines, and doors of elevators, and the air and water will take care of the rest.”68Similar threats
were also discussed in September 2014 by ISIS media company, Al-Furqan.
64
Roulo, Claudette. "United States Department of Defense." Defense.gov News Article: DoD Releases Breakdown
of Ebola Response Effort. January 08, 2015.
65
"U.S. Interest in the Ebola Outbreak." Interview by Cara Jones. February 2015.
66
Maron, Dina F. "Weaponized Ebola: Is It Really a Bioterror Threat?" Scientific American Global RSS. September
2014.
67
TRAC. "Movement for the Unity and Jihad in West Africa (MUJAO)." Terrorism Research & Analysis Consortium.
2011.
68
Ibid
235
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
The United States is well aware of the national security risks associated with the Ebola
outbreak in West Africa. The potential of emerging failed states, which could further increase
transitional crime and terrorist activities, including weaponizing Ebola towards America, are
concerns that have influenced the United States decision to respond to the Ebola crisis.
U.S. National Security Response
The United States has framed the Ebola outbreak as a matter of national security that
requires a military response. As a result, the United States African Command (AFRICOM) has
played a key role in providing assistance to control the outbreak. AFRICOM’s mission,
according to the Department of Defense (DOD), is to “deter and defeat transnational threats
[such as the Ebola crisis] in order to advance U.S. interests and promote regional security,
stability, and prosperity.”69 Thus far, AFRICOM, with the support of an additional 3,000 U.S.
troops, has accomplished many tasks in order to respond to the devastating outbreak. Building
isolation and treatment facilities, for example, has been a U.S. military priority in West Africa,
primarily in Liberia. Over 15 Ebola treatment units and 17 treatment centers with roughly 100
beds have been constructed in the region, helping to safely isolate and treat hundreds of Ebola
patients.70 The U.S. military has also built a special medical hospital in Liberia called the
Monrovia Medical Unit (MMU) in order to treat Ebola infected healthcare workers.71 In
addition, DOD has provided transportation services in order to airlift U.S. health workers and
medical supplies into West Africa more quickly and efficiently. The U.S. military has also
provided mobile laboratories to reduce the time of Ebola diagnosis from days to hours.
Moreover, DOD has trained more than 1,500 health workers to enable them to provide safe
medical care to Ebola patients.72
In addition to helping affected West Africa nations, DOD has also taken measures to
deter the spread of Ebola in the United States. For example, DOD and CDC have worked closely
with Customs and Border Protection at international airports to perform routine check-ups to
identify travelers who show Ebola symptoms. DOD and CDC are also assisting with exit
screening in West Africa to prevent sick travelers from boarding planes to the U.S. Efforts by the
United States to contain the Ebola outbreak not only reduce the number of causalities and the
potential of emerging failed states, but also reduce the opportunity for terrorists to use Ebola as a
bioterror weapon against the United States.
Additional Actions the United Stated Should Consider
69
McDaniel, Erin, Kim Yi Dionne, and Laura Seay. "AFRICOM's Ebola Response and the Militarization of
Humanitarian Aid." Washington Post. September 2014.
70
White House. "FACT SHEET: Progress in Our Ebola Response at Home and Abroad." The White House: Office of
the Press Secretary. February 11, 2015.
71
Ibid
72
Ibid
236
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
The United States has made significant efforts to fight the Ebola outbreak and ensure that
the epidemic does not progress into neighboring nations and abroad. Affected nations such as
Liberia, Guinea, and Sierra Leone are receiving support with health equipment, infrastructure
development, and monitoring systems in order to reduce the amount of Ebola cases and properly
treat victims that are infected with the virus. Despite the efforts of the United States, however,
more work needs to be done in order to ensure a complete end to the health crisis and to prevent
future Ebola outbreaks from reappearing.
The most significant action forward that will be most beneficial to deterring the spread of
Ebola is addressing stigma associated with the disease. On a much broader scale, the United
States must continue to work collaboratively with international partners and the affected West
African nations to educate and inform communities about Ebola transmission and prevention.
The United States should take a leading role in organizing community volunteers and healthcare
workers who can routinely work at the grassroots level to promote Ebola stigma reduction. Such
measures should continue to take place now, as the Ebola crisis remains, and also when it deters.
The United States should further help to empower surviving victims of Ebola so they have the
ability to deal with social stigma they face as they return to their villages and local communities.
Working closely with the ministries of health in Liberia, Sierra Leone, and Guinea, the United
States can help develop strategies that could reduce Ebola-related stigma. Counseling, promoting
public contact with people who have had Ebola, and training of coping skills, would be valuable
strategies to consider.
Furthermore, the United States must work in the cultural context of affected Ebola
communities in order to ensure an end to the outbreak. It is important for the United States to be
more culturally sensitive to traditional practices in West Africa, especially in relation to the role
of traditional healers and cultural burial practices. The United States must work closely with
medical anthropologists who can provide cultural recommendations that would be useful to
medical workers and the local people. Suggesting alternative ways to engage in mourning
practices, for example, would allow locals to feel closer to the decease, and would also prevent
Ebola from spreading from one person to another.73 Medical anthropologists could also ensure a
proper balance between resistance from locals and the need to bring Ebola under control. For
example, encouraging international medical workers to use the term “treatment centers”, rather
than “isolation centers”, would eliminate anxiety and fear, which could potentially allow more
people to seek help and treatment.74 Furthermore, the U.S. medical response team should work
closely with traditional healers in West Africa allowing them to have a more powerful and
influential role in the fight against Ebola. With the help of medical anthropologists, traditional
healers can serve as ambassadors in the community by conveying the right messages and advice
about Ebola treatment and prevention which would be influential to locals who have deep respect
73
Abramowitz, Sharon. "Somatosphere." Somatosphere Ten Things That Anthropologists Can Do to Fight the West
African Ebola Epidemic Comments. September 26, 2014., pg 15
74
Alland, Alexander, Jr. "Biocultural Adaptation and Medical Anthropology." Medical Anthropology Quarterly 4, no.
3 (September 1990): 342-44.
237
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
and admiration for them. This would ultimately lessen the chances of Ebola contraction and
encourage people to seek medical help if they have EVD symptoms.
Moreover, the United States must create a West African “Marshall Plan” that would
focus specifically on rebuilding the shattering economy and redeveloping the healthcare system
from the ground up.75 Building hospitals, investing in long term training of specialized medical
workers, increasing medial staff in each village, and providing sanitation and water services
would allow West African nations to better respond to future Ebola outbreaks.
Implementation of these initiatives allows the United States to remain an active
international supporter in the fight against Ebola. The West African region deeply relies on the
United States to deter the spread of the virus and promote a more stable and peaceful
environment. Such efforts not only serve in the best interests of West African nations but also the
United States.
Bibliography
Abramowitz, Sharon. "Somatosphere." Somatosphere Ten Things That Anthropologists Can Do to
Fight the West African Ebola Epidemic Comments. September 26, 2014. Accessed February 17,
2015. http://somatosphere.net/2014/09/ten-things-that-anthropologists-can-do-to-fight-the-westafrican-ebola-epidemic.html.
Adegun, Olusegun. "Impact of Ebola on West African Economies through the Trade Channel."
Academia.edu. January 2015. Accessed April 01, 2015.
http://www.academia.edu/8391695/Impact_of_Ebola_on_West_African_Economies_through_th
e_trade_channel.
Alexandru, Andra. "Failed States: Security Threats for the International Community or Victims of
Great Powers' Interests." Center for European Policy Evaluation. May 22, 2012. Accessed
February 18, 2015. http://cepeoffice.com/2012/05/22/failed-states-security-threats-for-theinternational-community-or-victims-of-great-powers-interests/.
Aljazeera. "West African Leaders Urge Ebola 'Marshall Plan' | Al Jazeera America." African Leaders
Urge Ebola 'marshall Plan' March 2015. Accessed March 26, 2015.
http://america.aljazeera.com/articles/2015/3/3/african-leaders-urge-ebola-marshall-plan.html.
Alland, Alexander, Jr. "Biocultural Adaptation and Medical Anthropology." Medical Anthropology
Quarterly 4, no. 3 (September 1990): 342-44. Accessed February 18, 2015.
http://www.jstor.org/stable/649101.
Ameringen, Benjamin. "Ebola, Anarchy, and Failing States: The Crisis in West Africa Geopoliticalmonitor.com." Geopoliticalmonitorcom Ebola Anarchy and Failing States The Crisis
75
Aljazeera. "West African Leaders Urge Ebola 'Marshall Plan' | Al Jazeera America." African Leaders Urge Ebola
'marshall Plan' March 2015. Accessed March 26, 2015.
238
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
in West Africa Comments. November 24, 2014. Accessed March 22, 2015.
http://www.geopoliticalmonitor.com/ebola-anarchy-failing-states-crisis-west-africa/.
Anderson, Sulome. "I Was an ISIS Hostage for 5 Months." Daily Intelligencer. March 20, 2015.
Accessed March 23, 2015. http://nymag.com/daily/intelligencer/2015/03/i-was-an-isis-hostagefor-5-months.html.
Baker, Aryn. "Ebola Highlights Historical Ties Between U.S. and Liberia." Time. September 17, 2014.
Accessed February 19, 2015. http://time.com/3394122/us-ebola-aid-focuses-on-liberia-not-otheraffected-countries/.
Baker, Aryn. "Ebola Highlights Historical Ties Between U.S. and Liberia." Time. September 17, 2014.
Accessed March 18, 2015. http://time.com/3394122/us-ebola-aid-focuses-on-liberia-not-otheraffected-countries/.
BBC. "Why Ebola Is so Dangerous." BBC News. October 8, 2014. Accessed February 11, 2015.
http://www.bbc.com/news/world-africa-26835233.
Brady, James S. "Press Briefing on Government Response to the Ebola Epidemic in West Africa,
10/3/2014." The White House. October 2014. Accessed March 23, 2015.
https://www.whitehouse.gov/the-press-office/2014/10/03/press-briefing-government-responseebola-epidemic-west-africa-1032014.
Breslow, James M., Evan Wexler, and Chris Amico. "MAP: HOW THE EBOLA OUTBREAK
SPREAD THROUGH AFRICA." PBS. September 9, 2014. Accessed February 18, 2015.
http://www.pbs.org/wgbh/pages/frontline/health-science-technology/ebola-outbreak/map-howthe-ebola-outbreak-spread-through-africa/.
Bridges. "FAO: Ebola Outbreak Putting West African Trade, Food Security in Jeopardy." International
Center for Trade and Sustainable Development. September 2014.
http%3A%2F%2Fwww.ictsd.org%2Fbridges-news%2Fbridges%2Fnews%2Ffao-ebolaoutbreak-putting-west-african-trade-food-security-in-jeopardy.
Brown, Hannah. "Material Proximities and Hotspots: Toward an Anthropology of Viral Hemorrhagic
Fevers." Medical Anthropology Quarterly 28, no. 2 (June 01, 2014): 280-303.
CDC. "2014 Ebola Outbreak in West Africa - Outbreak Distribution Map." Centers for Disease Control
and Prevention. January 27, 2015. Accessed February 01, 2015.
http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map.html.
CDC. "Signs and Symptoms." Centers for Disease Control and Prevention. November 02, 2014.
Accessed January 31, 2015. http://www.cdc.gov/vhf/ebola/symptoms/index.html.
CEPEOFFICE. "Failed States: Security Threats for the International Community or Victims of Great
Powers' Interests." Center for European Policy Evaluation. May 22, 2012. Accessed March 22,
2015. http://cepeoffice.com/2012/05/22/failed-states-security-threats-for-the-internationalcommunity-or-victims-of-great-powers-interests/.
Copley, Amy, and Amadou Sy. "Understanding the Economic Effects of the 2014 Ebola Outbreak in
West Africa." The Brookings Institution. October 01, 2014. Accessed March 05, 2015.
239
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
http://www.brookings.edu/blogs/africa-in-focus/posts/2014/10/01-ebola-outbreak-west-africa-sycopley.
Deloffre, Maryam. "Will AFRICOM's Ebola Response Be Watershed Moment for International Action
on Human Security?" Washington Post. September 2014. Accessed March 23, 2015.
http://www.washingtonpost.com/blogs/monkey-cage/wp/2014/09/29/will-africoms-ebolaresponse-be-watershed-moment-for-international-action-on-human-security/.
Deloffre, Maryam Z. "Human Security in the Age of Ebola: Towards People-centered Global
Governance." EInternational Relations. October 2014. Accessed March 22, 2015. http://www.eir.info/2014/10/25/human-security-in-the-age-of-ebola-towards-people-centered-globalgovernance/.
Dinne, Kim Yi. "Obama's Ebola Failure." Global. September 15, 2014. Accessed February 18, 2015.
http://www.foreignaffairs.com/articles/141986/kim-yi-dionne/obamas-ebola-failure.
Dionne, Kim Yi, and Laura Seay. "It’s Columbus Day. Let’s Talk about Geography (and Ebola)."
Washington Post. October 13, 2014. Accessed February 18, 2015.
http://www.washingtonpost.com/blogs/monkey-cage/wp/2014/10/13/its-columbus-day-lets-talkabout-geography-and-ebola/.
DOS-Office of the Historian. "Founding of Liberia, 1847 - 1830–1860 - Milestones - Office of the
Historian." Founding of Liberia, 1847 - 1830–1860 - Milestones - Office of the Historian.
Accessed March 29, 2015. https://history.state.gov/milestones/1830-1860/liberia.
Drazen, Jeffrey, Rupa Kanapathipillai, and Edward Campion. "Ebola and Quarantine." New England
Journal of Medicine. October 27, 2014. Accessed October 28, 2014.
doi:10.1056/NEJMe1413139.
Ebola Outbreak. Directed by Frontline. PBS Frontline. September 9, 2014. Accessed February 16,
2015. http://www.pbs.org/wgbh/pages/frontline/ebola-outbreak/.
The Economist. "The Unquenchable Fire." The Economist. September 28, 2013. Accessed March 24,
2015. http://www.economist.com/news/briefing/21586834-adaptable-and-resilient-al-qaeda-andits-allies-keep-bouncing-back-unquenchable-fire.
Endsor, Mick. "Ebola in West Africa: A Growing Economic and Humanitarian Crisis | ROM
Economics." ROM Economics. August 03, 2014. Accessed March 24, 2015.
http://www.romeconomics.com/ebola-west-africa-growing-economic-humanitarian-crisis/.
Epakto, Lariso. "Bringing Safer Burial Rituals to Ebola Outbreak Countries." PBSnewshour. October
14, 2014. Accessed December 2014.
http%3A%2F%2Fwww.pbs.org%2Fnewshour%2Fupdates%2Fbringing-safer-burial-ritualsebola-countries%2F.
Faden, Ruth. "Public Health Ethics." Stanford University. April 12, 2010. Accessed March 22, 2015.
http://plato.stanford.edu/entries/publichealth-ethics/.
FAO. "EBOLA OUTBREAKIN WEST AFRICA." Food and Agricultural Organization of the United
Nations. February 2015. Accessed March 01, 2015.
http://www.fao.org/emergencies/crisis/ebola/en/.
240
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
FEWS NET. "Ebola-related Fears Disrupt Markets and Livelihoods; Elevated Levels of Food
Insecurity Expected." Famine Early Warning System Network. September 2014. Accessed April
01, 2015. http://www.fews.net/west-africa/special-report/september-8-2014.
Gallucci, Maria. "Tootsie Roll Industries Joins Candy-Makers Concerned About Ebola Outbreak's
Effect On West African Cocoa Production." International Business Times. November 2014.
Accessed April 01, 2015. http://www.ibtimes.com/tootsie-roll-industries-joins-candy-makersconcerned-about-ebola-outbreaks-effect-1720904.
Harman, Sophie. "Ebola and the Politics of a Global Health Crisis." E-International Relations. October
2014. Accessed February 18, 2015. http://www.e-ir.info/2014/10/20/ebola-and-the-politics-of-aglobal-health-crisis/.
Harris, Paul G., and Patricia Siplon. "International Obligation and Human Health: Evolving Policy
Responses to HIV/AIDS [Full Text]." Carnegie Council for Ethics in International Affairs.
December 2001. Accessed March 22, 2015.
http://www.carnegiecouncil.org/publications/journal/15_2/articles/501.html.
Institute on Medicine Committee on the US Commitment to Global Health. "The US Commitment to
Global Health: Recommendations for the Public and Private Sectors." National Institute for
Health. 2009. Accessed October 2014. http://www.ncbi.nlm.nih.gov/books/NBK23801/.
Jones, Jared. "Ebola, Emerging: The Limitations of Culturalist Discourses in Epidemiology." Journal
of Global Health. Spring 2011. Accessed February 18, 2015. http://www.ghjournal.org/ebolaemerging-the-limitations-of-culturalist-discourses-in-epidemiology/.
Karluki, Dr. Jullus G., ed. "Bushmeat and The Future of Protein in West Africa." The African Center
for Economic Transformation, no. 4 (2014): 1-16.
www.easybib.com/cite/pdf?url=http://www.rockefellerfoundation.org/uploads/files/05f03ea80fcd-4a8b-9c6c-c2eaad3be607-monitoring.pdf.
Kelly, Ann, Hannah Brown, and Almudena M. Saez. "Notes from Case Zero: Anthropology in the
Time of Ebola." Somatosphere. September 16, 2014. Accessed February 2014.
http://somatosphere.net/2014/09/notes-from-case-zero-anthropology-in-the-time-of-ebola.html.
Kimery, Anthony. "Jihadi Online Chatter Discusses Using Ebola As Weapon Against The West."
Homeland Security Today: Jihadi Online Chatter Discusses Using Ebola as Weapon Against the
West. October 2014. Accessed March 22, 2015. http://www.hstoday.us/single-article/jihadionline-chatter-discusses-using-ebola-as-weapon-against-thewest/21f8d75af53bbcd0f9f973c567ea3994.html.
Konneh, Amara. "The Economics of Ebola." WSJ. August 2014. Accessed March 23, 2015.
http://www.wsj.com/articles/amara-konneh-the-economics-of-ebola-1407709918.
Koplowitz, Howard. "Ebola Outbreak Update: Withdrawal Of US Troops From Liberia Isn't 'Mission
Accomplished,' Obama Says." International Business Times. February 2015. Accessed March
23, 2015. http://www.ibtimes.com/ebola-outbreak-update-withdrawal-us-troops-liberia-isntmission-accomplished-obama-1813160.
Kuwonu, Franck. "Ebola Disruption Could Spark New Food Crisis | Africa Renewal Online." African
Renewal: UN News Center. February 2015. Accessed April 01, 2015.
241
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
http://www.un.org/africarenewal/magazine/december-2014/ebola-disruption-could-spark-newfood-crisis.
LaFranchi, Howard. "Ebola Crisis: Why Obama Is Involving the US (+video)." The Christian Science
Monitor. September 16, 2014. Accessed March 22, 2015.
http://www.csmonitor.com/USA/Foreign-Policy/2014/0916/Ebola-crisis-why-Obama-isinvolving-the-US-video.
Luna, David. "Trans-African Security: Combating Illicit Trafficking Along the Crime-Terror
Continuum." U.S. Department of State. February 26, 2014. Accessed March 22, 2015.
http://www.state.gov/j/inl/rls/rm/2014/222591.htm.
Luther, Jerelyn. "The War on Ebola." The Yale Globalist. October 13, 2014. Accessed March 22, 2015.
http://tyglobalist.org/onlinecontent/blogs/the-war-on-ebola-military-humanitarianism-and-usnational-security-interests-in-west-africa/.
Marmon, Brooks, and Blair Glencorse. "The Cure for Ebola Is Accountability." Foreign Policy The
Cure for Ebola Is Accountability Comments. August 14, 2014. Accessed February 18, 2015.
http://foreignpolicy.com/2014/08/14/the-cure-for-ebola-is-accountability/.
Maron, Dina F. "Weaponized Ebola: Is It Really a Bioterror Threat?" Scientific American Global RSS.
September 2014. Accessed March 22, 2015.
http://www.scientificamerican.com/article/weaponized-ebola-is-it-really-a-bioterror-threat/.
Mason, Jeff, and James Harding Giahyue. "Citing Security Threat, Obama Expands U.S. Role Fighting
Ebola." Reuters. September 16, 2014. Accessed March 22, 2015.
http://www.reuters.com/article/2014/09/16/us-health-ebola-obama-idUSKBN0HB08S20140916.
Maxmen, Amy. "How the Fight Against Ebola Tested a Culture's Traditions." National Geographic.
January 30, 2015. Accessed February 18, 2015. http://newsbeta.nationalgeographic.com/2015/01/150130-ebola-virus-outbreak-epidemic-sierra-leonefunerals/.
McDaniel, Erin, Kim Yi Dionne, and Laura Seay. "AFRICOM's Ebola Response and the Militarization
of Humanitarian Aid." Washington Post. September 2014. Accessed March 23, 2015.
http://www.washingtonpost.com/blogs/monkey-cage/wp/2014/09/25/africoms-ebola-responseand-the-militarization-of-humanitarian-aid/.
Mirzayev, Elvin. "Ebola's Economic Impacts on Liberia, Sierra Leone and Guinea." Investopedia.
October 13, 2014. Accessed March 23, 2015.
http://www.investopedia.com/articles/investing/101314/ebolas-economic-impacts-liberia-sierraleone-and-guinea.asp.
Moore, Jennifer. "The Responsibility to Protect in the Ebola Outbreak | OUPblog." OUPblog The
Responsibility to Protect in the Ebola Outbreak Comments. September 22, 2014. Accessed
March 22, 2015. http://blog.oup.com/2014/09/responsibility-protect-r2p-west-africa-ebolaoutbreak-pil/.
Office of the Press Secretary. "FACT SHEET: The U.S. Response to the Ebola Epidemic in West
Africa." The White House. September 16, 2014. Accessed February 18, 2015.
242
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
http://www.whitehouse.gov/the-press-office/2014/10/06/fact-sheet-us-response-ebola-epidemicwest-africa.
O'GRADY, SIOBHÁN. "Colonial Lines Drawn Again for Ebola Aid." Foreign Policy Colonial Lines
Drawn Again for Ebola Aid Comments. September 2014. Accessed March 23, 2015.
http://foreignpolicy.com/2014/09/22/colonial-lines-drawn-again-for-ebola-aid/.
Ohlheiser, Abby. "People Are Struggling to Bury the Ebola Dead. Here’s Why." Washington Post.
October 7, 2014. Accessed February 18, 2015.
http://www.washingtonpost.com/news/world/wp/2014/08/07/people-are-struggling-to-bury-theebola-dead-heres-why/.
Okonedo, Enase. "Ebola's Impact on the West African Economy." The Conversation. October 2014.
Accessed March 23, 2015. http://theconversation.com/ebolas-impact-on-the-west-africaneconomy-33327.
Ori, Konye. "Liberia: Ebola Threatens Statehood Success, Post-civil War." The Africa Report. October
2014. http%3A%2F%2Fwww.theafricareport.com%2FWest-Africa%2Fliberia-ebola-threatensstatehood-success-post-civil-war.html.
PBS. "Liberia and the United States:A Complex Relationship." PBS. 2002. Accessed March 22, 2015.
http://www.pbs.org/wgbh/globalconnections/liberia/essays/uspolicy/.
Restif, Olivier. "Understanding the Bushmeat Market: Why Do People Risk Infection from Bat Meat?"
University of Cambridge. October 09, 2014. Accessed February 18, 2015.
http://www.cam.ac.uk/research/news/understanding-the-bushmeat-market-why-do-people-riskinfection-from-bat-meat.
Ricks, Alan, and Micheal Murphy. "Ebola Outbreak: Liberia’s Health Care Infrastructure Is
Underdeveloped - The Boston Globe." BostonGlobe.com. September 17, 2014. Accessed
February 01, 2015. http://www.bostonglobe.com/opinion/2014/09/17/ebola-outbreak-liberiahealth-care-infrastructure-underdeveloped/lTN5s8n77upOQkMclDIseK/story.html.
Rid, Annette, and Ezekiel Emanuel. "Why Should High-Income Countries Help Combat Ebola?"
JAMA Network. October 2014. Accessed March 23, 2015.
http://jama.jamanetwork.com/article.aspx?articleid=1905876&resultClick=3#jvp140124r10.
Robinson, James A., and Daron Acemoglu. "10 Reasons Countries Fall Apart." Foreign Policy 10
Reasons Countries Fall Apart Comments. June 18, 2012. Accessed February 18, 2015.
http://foreignpolicy.com/2012/06/18/10-reasons-countries-fall-apart/.
Rotberg, Robert I. Council of Foreign Relations. July/August 2002. Accessed December 2014.
http://www.cfr.org/fragile-or-failed-states/failed-states-world-terror/p4733.
Rotberg, Robert I. "When States Fail: Causes and Consequences." Foreign Affairs. May/June 2004.
Accessed February 18, 2015. http://www.foreignaffairs.com/articles/59734/g-johnikenberry/when-states-fail-causes-and-consequences.
Roulo, Claudette. "United States Department of Defense." Defense.gov News Article: DoD Releases
Breakdown of Ebola Response Effort. January 08, 2015. Accessed March 22, 2015.
http://www.defense.gov/news/newsarticle.aspx?id=123935.
243
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
Shmuel, John. "How Ebola Could Affect Your Stock Portfolio." Financial Post. October 2014.
Accessed March 23, 2015. http://business.financialpost.com/2014/10/02/how-ebola-could-affectyour-stock-portfolio/.
Singer, Peter. Famine, Affluence, and Morality. Report. 1st ed. Vol. 1. 1972. Accessed March 24, 2015.
http://www.utilitarian.net/singer/by/1972----.htm.
Spencer, Alexander. "Humanitarian Funding Analysis: West African Ebola Crisis." Global
Humanitarian Assistance, January 2015. www.globalhumanitarianassistance.org.
Sprague, Gabe. "Sprague: America Has an Obligation to Help Liberia with Ebola Outbreak." The
University Daily Kansan. October 15, 2014.
http%3A%2F%2Fwww.kansan.com%2Fopinion%2Fsprague-america-has-an-obligation-to-helpliberia-with-ebola%2Farticle_d53a67ea-54a9-11e4-b20d-673473fe8e6e.html.
Susan, Rice E. "The New National Security Strategy: Focus on Failed States." The Brookings
Institution. February 2003.
http%3A%2F%2Fwww.brookings.edu%2Fresearch%2Fpapers%2F2003%2F02%2Fterrorismrice.
Thomas, Ann-Claire, Tharcisse NKUNZIMANA, Ana PEREZ HOYOS, and François KAYITAKIRE.
"Impact of the West African Ebola Virus Disease Outbreak on Food Security." European
Commission Joint Research Centre Institute for Environment and Sustainability. December
2014. Accessed March 2015.
file:///C:/Users/Shekira%20Ramdass/Downloads/JRC94257_ebola_impact_on_food_security_jrc
_h04_final_report.pdf.pdf.
Thomas, Kate. "Fighting Ebola with Anthropology." Ebola Deeply. October 2014. Accessed March 26,
2015. http://www.eboladeeply.org/articles/2014/10/6224/culture-factor-fighting-ebolaanthropology/.
Thompson, Dick. "Ebola’s Deadly Spread in Africa Driven by Public Health Failures, Cultural
Beliefs." National Geographic. July 2, 2014. Accessed December 2014.
http%3A%2F%2Fnews.nationalgeographic.com%2Fnews%2F2014%2F07%2F140702-ebolaepidemic-fever-world-health-guinea-sierra-leone-liberia%2F.
Tomson, Bill. "Ebola Threatens Chocolate." POLITICO. October 2014. Accessed April 01, 2015.
http://www.politico.com/story/2014/10/ebola-chocolate-industry-africa-effects111809.html#ixzz3W0vFGSLy.
TRAC. "Movement for the Unity and Jihad in West Africa (MUJAO)." Terrorism Research & Analysis
Consortium. 2011. Accessed March 22, 2015.
http://www.trackingterrorism.org/group/movement-unity-and-jihad-west-africa-mujao.
United with Israel Staff. "Jihadist Plot to Attack US with Ebola Exposed." United with Israel. October
2014. Accessed March 22, 2015. http://unitedwithisrael.org/jihadist-plot-to-attack-us-with-ebolaexposed/.
"U.S. Interest in the Ebola Outbreak." Interview by Cara Jones. February 2015.
244
Virginia Review of Asian Studies
Volume 17 (2015): 221-245
Ramdass: Ebola
Wexler, Alexandra. "Cocoa Industry Group Raises Money for Ebola Prevention." WSJ. October 2014.
Accessed April 01, 2015. http://www.wsj.com/articles/cocoa-industry-group-raises-money-forebola-prevention-1413360002.
Wexler, Alexandra. "Cocoa Prices Surge on Ebola Fears." WSJ. September 19, 2014. Accessed March
24, 2015. http://www.wsj.com/articles/cocoa-surges-on-ebola-fears-1411137838.
White House. "FACT SHEET: Progress in Our Ebola Response at Home and Abroad." The White
House: Office of the Press Secretary. February 11, 2015. Accessed March 22, 2015.
https://www.whitehouse.gov/the-press-office/2015/02/11/fact-sheet-progress-our-ebolaresponse-home-and-abroad.
White House. "Liberia | United States Trade Representative." Liberia | United States Trade
Representative. April 17, 2014. Accessed March 24, 2015. https://ustr.gov/countriesregions/africa/west-africa/liberia.
WHO. "Sierra Leone: A Traditional Healer and a Funeral." WHO. September 2014. Accessed February
18, 2015. http://www.who.int/csr/disease/ebola/ebola-6-months/sierra-leone/en/.
World Bank. "Ebola: Economic Impact Could Be Devastating." World Bank: Africa. September 2014.
Accessed March 23, 2015. http://www.worldbank.org/en/region/afr/publication/ebola-economicanalysis-ebola-long-term-economic-impact-could-be-devastating.
The World Bank. "The Economic Impact of the 2014 Ebola Epidemic." The World Bank Group. 2014.
Accessed March 2015.
https%3A%2F%2Fopenknowledge.worldbank.org%2Fbitstream%2Fhandle%2F10986%2F2059
2%2F9781464804380.pdf%3Fsequence%3D6.
The World Bank. "Reviving Agriculture in Ebola-hit Guinea, Liberia and Sierra Leone." The World
Bank. February 2015. Accessed March 2015.
http%3A%2F%2Fwww.worldbank.org%2Fen%2Ftopic%2Fagriculture%2Fbrief%2Frevivingagriculture-in-ebola-hit-guinea-liberia-and-sierra-leone.
245