Proposed US Ebola facility in Kenya sparks backlash at home and abroad

WASHINGTON/NAIROBI —The United States is setting up a facility in Kenya to quarantine Americans who have been exposed to Ebola, and will not bring them home if they develop symptoms, but instead send them to a third country, ‌the White House said on Thursday. The facility, however, received widespread criticism from both Kenyan doctors and US officials working at the Centers for Disease Control and Prevention (CDC). The main doctors’ union in Kenya and the Law Society of Kenya told CNN they oppose the plan, saying it risks importing Ebola into the East African nation, which has no cases as of Thursday. Meanwhile, CDC officials in the US strongly recommended against the plan to send Americans to Kenya, with the agency’s acting director, Dr. Jay Bhattacharya, also reportedly advising against it, according to a CDC source working on the Ebola response operations. The strategy marks a sharp break from past practice during previous outbreaks as President Donald Trump’s administration seeks to keep all cases out of US territory. Some officers at the US agency “are furious about it” and believe the plan “will make recruiting and staffing for Ebola response activities harder,” the CDC source told CNN. Although the CDC source noted that there are “very proficient colleagues in Kenya,” they also said “it’s hard to imagine the standard of care will be able to meet that of the treatment facilities that have been developed at great cost over many years in the US. Let alone the aspects of wanting to be repatriated and closer to family, other supportive services, etc.” A Trump administration official previously told CNN that “treatment capabilities at the facility are expected to be able to care for the full spectrum of Ebola Virus Disease, including critical care needs, though each case will be evaluated for forward transport for more advanced care as appropriate in order to maximize patient outcomes.” The outbreak, which is centered in the eastern Democratic Republic of Congo (DRC), is believed to have caused at least 238 deaths and more than 1,000 suspected infections so far, according to the World Health Organization (WHO). Driven by the Bundibugyo strain, a rare form of Ebola for which there is no approved vaccine or treatment, the virus has also crossed into neighboring Uganda, which has reported at least seven cases associated with the outbreak, including one death. A senior Trump administration official said Thursday that the US has received approval from the Kenyan government for isolation and quarantine units on its soil. However, the Kenyan government has yet to officially comment on the deal. A 50-bed quarantine unit will be operational as of Friday, another senior administration official said. It will be located on the Laikipia Airbase, about 125 miles north of Nairobi. As of Thursday, no patients are set to go to the unit. Additional isolation and biocontainment units will be available at the site later; if someone develops symptoms or tests positive, they will be evacuated to other facilities, a senior official said. The CDC and Department of State are working to determine where in Europe those facilities will be located. “The United States’ highest priority remains protecting the health and security of the American people by working to prevent the Ebola outbreak from reaching our shores,” the State Department said in a statement. The facility will be equipped to provide more advanced care and support for US citizens who develop symptoms until they are evacuated, the officials told reporters. They will then be taken to third countries, not the US. “They will then be evacuated out to a tertiary facility. The CDC is working with the Department of State to identify where that facility or facilities might be,” one official said. Care will be provided by officers of the Commissioned Corps of the US Public Health Service, who have already departed for Kenya. Around 30 officers received three days of training this week, a senior official said and more will be trained this weekend. Although there are no approved treatments specifically for the Bundibugyo virus, antibody therapies and antivirals including Remdesivir will be available. Kenya’s secretary of public health, Mary Muthoni Muriuki, said on Thursday that the government is having conversations with partners, including the US, and insisted that it’s taking actions to “ensure that every Kenyan is very, very safe.” US Secretary of State Marco Rubio spoke with Kenyan President William Ruto on Thursday to discuss the ongoing Ebola outbreak, with the US committing $13.5 million toward Ebola preparedness in Kenya, including securing vital medical supplies, a State Department spokesperson said. “The two leaders agreed to maintain close coordination as the situation evolves and to continue leveraging the strong US-Kenya health partnership that has proven essential in addressing public health challenges in Kenya and across East Africa,” spokesperson Tommy Pigott said. Public health experts said patients would be better off in high-containment infectious disease centers in the US or Germany rather than in a newly built location in Kenya, and that preventing patients from entering ⁠the country would disincentivize doctors from volunteering for the effort. Last week, a US citizen who was treating patients in the DRC as a medical missionary was confirmed to have contracted Ebola and moved to Germany for treatment along with five others who were exposed. A seventh person was taken to the Czech Republic. The Washington Post, citing five people familiar with the US Ebola response, reported last week that the White House resisted allowing him to return to the country, delaying his evacuation and care. Dr. Davji Bhimji Atellah, secretary-general of the Kenya Medical Practitioners, Pharmacists and Dentists Union (KMPDU), told CNN: “We need total transparency from the Kenyan government on why they agreed to take up this offer.” He also questioned why the Trump administration wants to set up an isolation facility specifically for Americans, when Kenya has a “longstanding gap” in its chronically under-funded healthcare system. “What makes the US choose Kenya when the epicenter of the outbreak is in (the Democratic Republic of) Congo?” asked the leader of the union, which represents more than 10,000 doctors in public and private hospitals. The Kenyan and US governments recently renegotiated the amount of aid funding for Kenyan health efforts, as part of the new US global health strategy. Under the terms of their bilateral agreement signed in December, Kenya will see a 21% reduction in its global health aid funding from the US over the next five years, according to an analysis from KFF, a nonprofit health policy research organization. The new agreement stipulates that the US will provide $1.6 billion to Kenya between 2026 and 2030, with Kenya picking up more of the tab for its own health system, according to KFF. The deal represents a reduction in funding of about $423 million over that period compared to the previous US funding levels. The agreement was immediately challenged in Kenya’s High Court, with opponents criticizing it for unfavorable terms. “We will not sit back and watch Kenya be treated as a containment colony for a lethal pathogen that we did not generate,” Atellah added in the statement criticising the Ebola facility. “If it is too dangerous for America, it is too dangerous for Kenya.” The Katiba Institute, a civil society group focusing on constitutional matters in Kenya, is challenging the proposed American health facility in court. The Law Society of Kenya also asked the Kenyan government to reject the facility. Law Society President Charles Kanjama referred to Marco Rubio’s comments in a cabinet meeting on Wednesday, in which the US secretary of state said “we cannot and will not allow any cases of Ebola to enter” the US. “If America – a first-world country – is apprehensive about the health and safety of their citizens, we’re asking the Kenyan government to have the same standard as the American government does,” Kanjama told CNN. “This is quite paradoxical, and it is clearly trying to create a double standard for healthcare system and public safety; keeping America safe while leaving Kenyans at risk of infection.” Kenya’s two largest newspapers – the Daily Nation and the Standard – both led with news of the health facility deal. It has also dominated the debate on Kenyan television, talk shows and radio, as critics expressed disbelief that President William Ruto’s government had agreed to the Ebola facility. The widespread criticism also made it off the airways and onto the streets, as everyday Kenyans expressed concerns about the deadly virus. “Please tell the government not to bring those sick Americans here,” a security guard in Nairobi told CNN while frisking people entering an office block. “I come into contact with a lot of people every day in this job. How will I keep myself safe if Ebola comes here?” The US Centers for Disease Control and Prevention last week imposed temporary travel bans on people who have been in the DRC, Uganda, or South Sudan, including green card holders, who are typically exempt from such bans. It is also screening Americans traveling from those countries at three US airports. The strategy, which the Trump administration says aims to contain Ebola to the outbreak region, is a departure from the 2014 Ebola outbreak when the US treated patients ‌in some ⁠of its 13 specialized infectious disease centers. Trump at the time publicly criticized then-President Barack Obama for allowing patients into the country. Patients will be transported elsewhere because it is faster, and to protect Americans at home, the officials said on Thursday. They denied the decision was politically motivated. “We want to make sure that Americans on the ground there quickly and efficiently get the care they need,” said one official. “But beyond that, the administration is also working … to ensure that Americans here in the United States don’t contract the disease.”