The Foreign Service Journal, July-August 2020

30 JULY-AUGUST 2020 | THE FOREIGN SERVICE JOURNAL And that takes presidential leadership, at the end of the day. To get the government to do things it’s not used to doing, to push the bureaucracy outside of what it’s built to do, that doesn’t hap- pen organically. Bureaucracies don’t do that organically. It takes leadership, so we were fortunate that we had that. JB: Focusing on the U.S. interagency, where resources and policy decisions flow from and then project out to the field, what is the role of U.S. diplomats, the State Department and the field presence that comes with our USAID missions and embassies in most countries? How did that play into the Ebola response? Would you share with us lessons learned there? JK: At the Washington level, the State Department really struggled at first, because they couldn’t figure out things like who would they send to the deputies meeting. Who’s the right policy lead on this in the department? Is it an Africa regional issue, a health issue, a science issue, a multilateral outreach issue? Because it’s all of those things. Eventually what they did do was set up a special Ebola unit within the State Department, and they brought back [Ambassa- dor] Nancy Powell and, later, [Ambassador] Steve Browning. Once they went to that format, it really helped, because it gave the State Department a senior-level focal point who could bring together all the different strands of what the department had to do. One of the important, innovative things they did was set up a medical unit that organized medical evacuations. They took the lead on identifying one of the only companies in the world that had a medevac capability that could handle the biosecurity containment standards that were required for Ebola patient transport. They locked those two planes down on a contract; and in a show of global solidarity, they opened that up to the world. Americans had the right of first refusal, but it was something the whole world could buy into. If it were a choice between Ameri- can and non-American, the American would take precedence; but we didn’t then just keep it for ourselves. JB: What role did our diplomats play in mobilizing support in West Africa? JK: Globally, the State Department was very involved in reach- ing out to other countries and encouraging them to join the fight. This was a very big priority for the president; he didn’t just want us to go in and do our part, but also to galvanize global action. It really started with President Obama convening world leaders at the United Nations General Assembly in September 2014. He organized and led, along with [then U.N. Secretary- General] Ban Ki-moon, a kind of impromptu world leaders’ summit on Ebola. He spent countless hours on the phone talk- ing to foreign leaders to encourage them to join the fight. The State Department played a huge role in facilitating that whole process. If we were going to make a specific ask of a country, which we often did, the State Department and the embassies had the role of formulating what they thought that country might be able to do, facilitating the call between the heads of state, and then fol- lowing up to make sure that the country was actually moving to deliver on what they had committed to do. There was also the constant demarching to other countries that this was a U.S. priority, especially in the early stages. The embassies in the affected countries also played a major role. In Liberia, President Johnson-Sirleaf set up something called the President’s Advisory Committee on Ebola, and U.S. Ambassador [to Liberia] Deborah Malac joined those meetings, but so did the Centers for Disease Control and Prevention and the USAID rep, and they were allowed to speak and give their expertise. Ambassador Malac did a masterful job of keeping everyone aligned, allowing everyone to speak and making sure all the different components that had been deployed in her country were staying in sync, but enabling them to share and speak their expertise—which not all ambassadors necessarily do. She did a fabulous job. One of the challenges with this kind of novel outbreak is that it’s not just a health issue. As we see today with COVID, it becomes a political issue with implications for all sectors of soci- ety, the economy and security, so all those channels need to be engaged. The ambassador has an important role in doing that, facilitating that dialogue and that engagement, and doing that in a way that also is respectful to and enabling of public health expertise. It’s always a matter of how to balance the science and the public health guidance, and navigating the political reality of the country. That relationship between the outbreak responders, the ambassador and the embassy is just extraordinarily important. One of the challenges is that it’s not just a health issue. As we see today with COVID, it becomes a political issue with implications for all sectors of society, the economy and security.