As the Obama administration mobilizes 3,000 troops to fight Ebola in Liberia, the State Department is gearing up to fight the battle back at home. This week Secretary of State John Kerry tapped Nancy Powell, former ambassador to India, to lead the Ebola Coordination Unit. A 37-year veteran of the Foreign Service, Powell famously orchestrated a swift, organized response to the 2006 avian influenza scare that nearly erased it from history.
With close to four decades of experience fostering friendships with international leaders from Ghana to Nepal, Powell is, in some ways, the perfect choice. She knows infectious diseases and epidemics—but more importantly, she knows Africa.
Those that are hesitant about Powell may point to her contentious “resignation” as the first female ambassador to India in March. The move came on the heels of the controversial arrest of a junior Indian Foreign Service officer who allegedly lied about her cleaning lady's rate on a visa. Quashing rumors that the White House had pushed her out, Powell told the press that she'd been planning to retire for months. “Retirement, it’s an important distinction,” spokeswoman Marie Harf told reporters questioning the suspicious resignation. “It’s a much needed rest, yes.”
Given the news of Powell’s new assignment, it seems the Iowa native has gotten all the rest she needs. On a train from the U.N. to the White House, the ambassador took the time to share some of her thoughts on the epidemic.
What will your role be in enhancing some of the efforts that are already underway?
The State Department will be supporting the efforts to contain the outbreak and that includes marshaling resources, encouraging people to contribute manpower, and resolving logistical difficulties… to support and encourage coherent leadership.
Longer term we’re also, at the State Department, looking at how to mitigate the secondary impacts—things like food-security potential, disruptions to travel, things that are happening along that way and how those can be mitigated in countries that were on the fragile side anyway and now have started recovery. The last one is to integrate these longer-term plans with our overall global health security strategy. There will be a meeting at the White House tomorrow involving over 40 countries that works on that.
What I took out of listening to the president give his speech today was the line of “We haven’t done enough and we haven’t done it fast enough.” My office is engaged in making sure we’re doing enough and making sure we’re doing it fast enough. And that will be a big part of our focus. But it will change—I’m sure—from day to day in terms of what it is we do and where we need to put our attention.
Have you ever experienced Ebola firsthand?
While I was in Uganda in the period of 1997-1999, quite frankly I can’t tell you exactly when it was, but there was a very small outbreak in northern Uganda. It was just very small and it was contained in that area. Once again the health workers were among the victims of this. But it stayed in that particular area and it was able to be isolated. That was back in the more typical pattern rather than what’s happening in West Africa.
How does it differ from avian influenza?
This is a much bigger challenge and a very, very different disease, and our medical professionals and volunteers, the people that are doing this are real heroes in my eyes. I also see a much stronger U.S. government response and a much better integrated response from the various components. When I sit at the table with the U.S. government we have people from not only CDC and USAID but also from the military, the Department of Defense, NIH, and the private sector. So you have a very, very, close knit group where people have learned from the other periods we’ve been through and are working together—I think very well. And it will take that. We can’t afford to have people doing individual things. It won’t work that way; it’s too big an effort.
What will be your top priority—and how hard will it be to achieve?
Obviously we’ve got to get resources, and get them there quickly. I have not lived in these three countries, I lived in Uganda and Ghana. I know the infrastructure challenges in these three nations in particular are very severe. It’s rainy season. The roads are bad to start with and then you add the rain and it becomes even harder to transport materials in and out. Some of the areas are quite remote, where this is occurring. That’s one of them.
But also looking at how we do the isolation piece. This is the key way to bend the curve, to break the trend is to isolate the people, be able to track them—and with whom they’ve had contact. You see what happens in Nigeria when you can do that. They had one cross-border case, they were able to isolate that person and then his contacts, some of whom also exhibited some symptoms. So that’s what you’re looking to do but the numbers are quite difficult to do that and the bigger the case gets out, the more difficult it is, particularly when you’re out to 21 days. Just the sheer way the disease is transmitted in terms of the pure incubation period, how long you have to watch is part of that, but ours will be looking at how to help people who are working these, trying to train people in the basic care, working to get the labs that are needed. Or setting up treatment units whether they are home community care units or Ebola treatment units.
The CDC’s report suggests that the epidemic could reach millions. Do you think that is a possibility?
They were worst-case-scenario models, as if no one did anything in response. And clearly what has happened over the past 10 days, and before with private efforts, the mobilization of the international community. The U.S. over the last 10 days—we have people already working on the ground. You’re getting commitments that are moving rapidly from the U.N. The modeling is if nothing happened. No one has gone back yet to look, but the key thing is getting this isolation and then being able to bend the curve. It requires discipline, it requires accurate reporting of the caseloads, and it requires training of the people who are doing the care, whether they are at home or in these centers so that they do not contaminate themselves and spread the disease.
You’ve seen people step up. The World Bank announced today a doubling of their money for Ebola.
You were commended after the avian flu pandemic for your ability to forge such close friendships with international leaders. How big of a role will that play in this outbreak?
There are so many avian-influenza people that are involved in this effort. In addition to the world leaders and the senior leaders of our government communicating that a number of us who worked on avian influenza are at this again, so on a personal level it’s been very nice to reconnect with them at this time—but also to have the confidence in their ability having watched what they did with the avian influenza. I went off and did other things but I’ve come back again.
Can you elaborate on the Ebola Coordination Unit itself, how many are a part of this team?
We’re still very much a work in progress and we’ve pulled people from the State Department, various bureaus that deal with our health issues, our West Africa desk has been of course trying to pull people in from the Department of Defense since they will be playing a major role—particularly in Liberia. We’re building up toward 10; we’re not quite there yet.
You were in retirement when you got the call for this assignment. What convinced you to take this on?
A couple of things: I have lived in North Africa and I have very fond memories of that time and those people. But watching this from what I call my “bench on the beach” in Delaware I had been watching [Ebola coverage] all summer. There was a certain amount on PBS and others, and I was just recognizing that it was getting worse and that the international community needed to act quickly. I had hoped that perhaps my experience coordinating for avian influenza could be useful, but I don’t intend to stay at this permanently. This will be a temporary position—to help us get started and to respond to the “We need to do more, we need to do it faster.” So that’s my effort. I’m hoping I can make a personal contribution as well as a bureaucratic one.