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How Ebola Conspiracy Theories Are Spreading in the Congo | Time - 0 views

  • “Those people like Ebola. They’re becoming famous and successful from it,” hollers a middle-aged male parishioner wearing a black suit, near the end of an 8-minute ramble. “They can keep it. Ebola will never reach this church,”
  • Mention Ebola in Goma and you’ll hear a riot of rumors, half-truths, and conspiracy theories about the disease: that it doesn’t exist; that it’s been imported for financial gain; that it’s being used to kill people as part of an organ theft plot. A study published in September in the journal PLOS One found that 72% of respondents were dissatisfied with or mistrustful of the Ebola response and 12% believed that the disease “was fabricated and did not exist in the area.” Misinformation is a key factor in making the outbreak so difficult to stamp out
  • Long an incurable disease, Ebola may someday be preventable and treatable thanks to recent drug advances. Still, with an almost 70% fatality rate during this current outbreak, Ebola continues to be obscenely lethal. To survive it, early medical intervention is key. But Pastor Jules Mulindwa, a compact man with a receding hairline and a thin mustache, has his own protocol. While he doesn’t discount medical science, he doesn’t believe it’s necessary.
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  • About 85% of those surveyed had heard statements about the outbreak being “fabricated for financial gains.” About 33% of respondents believed it.
  • “There are extremely poor infection control practices in many of these health clinics. Children are made to lay in beds previously occupied by Ebola patients and the beds have never been cleaned.” It’s potentially lethal and has hampered efforts to contain the outbreak.
  • For reasons that are unclear, however, Pastor Jules says the water available at the Cite de Refuge church is not used to cure Ebola. Rather, it’s the water from his followers’ homes that he transforms into an Ebola cure through prayer.
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Deadliest Ebola Outbreak on Record Is Over, W.H.O. Says - The New York Times - 0 views

  • Deadliest Ebola Outbreak on Record Is Over, W.H.O. Says
  • DAKAR, Senegal — The World Health Organization declared on Thursday the end to the deadliest Ebola outbreak on record, which killed and sickened tens of thousands of people in West Africa, even as it cautioned that more flare-ups of the disease were likely.
  • recent chain of cases in Liberia was snuffed out, marking the first time since the start of the epidemic two years ago that Guinea, Liberia and Sierra Leone
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  • Margaret Chan, the director general of the World Health Organization, hailed the “monumental achievement” in curbing the outbreak
  • United Nations said, killed more than 11,300 people and infected more than 28,500. At the height of the outbreak
  • “our work is not done, and vigilance is needed to prevent new outbreaks.”
  • The risk, although significant, was low, he said. The new cases had occurred on average 27 days apart, but there have been none since mid-November
  • The three West African countries now have the world’s biggest pool of expertise in handling Ebola and greater professionalism, confidence and resources for dealing with it, he said.
  • Sierra Leone was declared free of Ebola transmission in November and Guinea at the end of December; Liberia was declared Ebola-free in May but then reported a few new cases.
  • Beating back Ebola is among the few tangible achievements that senior United Nations officials cite as an example of global cooperation
  • “Relative to its significance to global humanity, there is no issue that gets less attention,” said Lawrenc
  • “Frankly, this has not been on the A-list of global problems in the way that nuclear proliferation, or terrorism, or global climate change has been,
  • Investing roughly $4.5 billion a year to improve health systems, advance research, and strengthen the abilities of the World Health Organization and other bodies could avoid $60 billion in losses in the event of a pandemic, the commission concluded.
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New Ebola outbreak detected in northwest Democratic Republic of the Congo; WHO surge te... - 0 views

  • The Government of the Democratic Republic of the Congo announced today that a new outbreak of Ebola virus disease is occurring in Wangata health zone, Mbandaka, in Équateur province. The announcement comes as a long, difficult and complex Ebola outbreak in eastern Democratic Republic of the Congo is in its final phase, while the country also battles COVID-19 and the world’s largest measles outbreak. Initial information from the Ministry of Health is that six Ebola cases have so far been detected in Wangata, of which four have died and two are alive and under care. Three of these six cases have been confirmed with laboratory testing. It is likely more people will be identified with the disease as surveillance activities increase. “This is a reminder that COVID-19 is not the only health threat people face,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Although much of our attention is on the pandemic, WHO is continuing to monitor and respond to many other health emergencies.”This is the Democratic Republic of the Congo’s 11th outbreak of Ebola since the virus was first discovered in the country in 1976. The city of Mbandaka and its surrounding area were the site of Democratic Republic of the Congo’s 9th Ebola outbreak, which took place from May to July 2018. “It’s happening at a challenging time, but WHO has worked over the last two years with health authorities, Africa CDC and other partners to strengthen national capacity to respond to outbreaks,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “To reinforce local leadership, WHO plans to send a team to support scaling up the response. Given the proximity of this new outbreak to busy transport routes and vulnerable neighbouring countries we must act quickly.”WHO is already on the ground in Mbandaka supporting the response to this outbreak, as part of capacity built during the 2018 outbreak. The team supported the collection and testing of samples, and reference to the national laboratory for confirmation. Contact tracing is underway. Work is ongoing to send additional supplies from North Kivu and from Kinshasa to support the government-led response. A further 25 people are expected to arrive in Mbandaka tomorrow. WHO is also working to ensure that essential health services are provided to communities despite these emergency events.The Democratic Republic of the Congo’s 10th outbreak of Ebola, in North Kivu, South Kivu and Ituri provinces, is in its final stages. On 14 May 2020, the Ministry of Health began the 42-day countdown to the declaration of the end of that outbreak. New outbreaks of Ebola are expected in the Democratic Republic of the Congo given the existence of the virus in an animal reservoir in many parts of the country. 
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Fact check: Donald Trump made 115 false claims in the last two weeks of February - CNNP... - 0 views

  • President Donald Trump made 115 false claims over the last two weeks of February, during which he faced a growing crisis over the coronavirus pandemic, visited India, held four campaign rallies and addressed the Conservative Political Action Conference.Trump made 67 false claims from February 17 through February 23; that was the 11th-highest total of the 34 weeks we've fact checked at CNN. He added 48 false claims from February 24 through March 1; that week ranked 25th out of 34. As usual, many of the false claims were ones he has uttered before.
  • aim: "Russia, if you're listenin
  • The fact that there is notorious video footage showing all this has not stopped Trump from making up an alternative history. He told CPAC on February 29 that he said "Russia, if you're listening" as "a joke," in front "25,000 people," and he was "laughing" afterward along with others in the crowd -- but the media cut off the clip "so quick at the end" so that people couldn't hear all of this laughing.
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  • The most revealing false claim: The flu mortality rate
  • VirusesAwareness of Ebola in 2014Comparing the coronavirus outbreak with the Ebola situation of 2014, Trump said, "At that time, nobody had ever even heard of Ebola." -- February 25 press conference in New Delhi, India "Nobody knew anything about it. Nobody had ever heard of anything like this." -- February 26 coronavirus press conference Facts First: Some Americans certainly didn't know a whole lot about Ebola before 2014, but the claims that "nobody" had ever even heard of Ebola and that "nobody" knew anything about it are absurd. Ebola was discovered in 1976. It had been the subject of considerable media coverage in the next three decades, not to mention scientific study.
  • Gupta, CNN chief medical correspondent, told Trump at a press conference, "Mr. President, you talked about the flu and then in comparison to the coronavirus. The flu has a fatality ratio of about 0.1%." Trump said, "Correct." But Trump later disputed the figure, saying, "And the flu is higher than that. The flu is much higher than that." -- February 26 coronavirus press conferenceFacts First: Even if Trump meant that the flu has a "much higher" fatality rate than 0.1% -- rather than meaning that the flu's mortality rate is "much higher" than that of the novel coronavirus -- he was wrong. The mortality rate for seasonal flu is "about 0.1%, 0.2% at the most," Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health -- who appeared with Trump at this same news conference -- told this to USA Today in mid-February, echoing the comments of other experts and Centers for Disease Control and Prevention data since 2010.
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Guinea tracks potential Ebola contacts, says it can overcome new outbreak | Reuters - 0 views

  • Guinea is tracking down people who potentially had contact with Ebola patients and will rush vaccines to the affected area as soon as possible following at least three deaths from the disease,
  • unlike during the deadliest known outbreak, which tore through West Africa in 2013-2016, Guinea had the means to halt the resurgence of the virus
  • The World Health Organization (WHO) on Monday warned the outbreaks in Guinea and Congo represented a regional risk.
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  • There is hope that with new tools and the experience and lessons learned, this could maybe work better this time,” said Ki-Zerbo, underlining the need to involve local communities and listen to them.
  • She is thought to have had Ebola and seven people who attended her funeral have tested positive for Ebola, with three dying, authorities said.“What worries us the most is the dangerousness of the disease given what we experienced five years ago. We do not want to relive such a situation,
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After Ebola: the darkest days of terror are over | Bintu Sannoh - 0 views

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    "Ebola has now moved on from Kenema and the east. For two months, we have hardly had any cases. People say they are winding up some of the Ebola clinics around. For us here, we hope those dark, darkest days of terror, confusion and pain are past. Ebola is still big in Sierra Leone, though, especially in Freetown. I feel so sad for those people."
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Liberia's Gay Community Under Attack Over Ebola Outbreak - 0 views

  • DAKAR/NEW YORK, Oct 23 (Thomson Reuters Foundation) - Leroy Ponpon doesn't know whether to lock himself in his flat in Monrovia because of the deadly Ebola virus, or because he is gay. Christian churches' recent linking of the two have made life hell for him and hundreds of other gays.
  • "Since church ministers declared Ebola was a plague sent by God to punish sodomy in Liberia, the violence towards gays has escalated. They're even asking for the death penalty. We're living in fear," Ponpon told the Thomson Reuters Foundation by telephone from Monrovia.
  • Ebola has infected almost 10,000 people in West Africa since March, killing around half its victims. Liberia is the worst hit country where poverty, corruption and civil war have left a weak health system unable to cope with the exponential spread of the disease.
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Ebola virus: New case emerges in Sierra Leone - BBC News - 0 views

  • Sierra Leone officials have confirmed a death from Ebola, hours after the World Health Organization declared the latest West Africa outbreak over.
  • he country was declared free of the virus on 7 November, and the region as a whole was cleared when Liberia was pronounced Ebola-free on Thursday.
  • Tests on a person who died in northern Sierra Leone proved positive, an Ebola test centre spokesman told the BBC.
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C.D.C. Issues New Guidelines for Ebola Care - 0 views

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    Many hospital caretakers who have been in contact with ebola patients have re-entered the world and their daily lives - one nurse went on a cruise, potentially endangering all travelers on board. Federal officials have announced new safety precautions for those who have been in contact with these patients. While it has been acknowledged that ebola can only be contracted through direct contact of bodily fluids, these seemingly unnecessary precautions have been taken in hopes of easing worries; however, in some cases they have caused concerns to skyrocket.
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President Obama's Interview With Jeffrey Goldberg on Syria and Foreign Policy - The Atl... - 0 views

  • The president believes that Churchillian rhetoric and, more to the point, Churchillian habits of thought, helped bring his predecessor, George W. Bush, to ruinous war in Iraq.
  • Obama entered the White House bent on getting out of Iraq and Afghanistan; he was not seeking new dragons to slay. And he was particularly mindful of promising victory in conflicts he believed to be unwinnable. “If you were to say, for instance, that we’re going to rid Afghanistan of the Taliban and build a prosperous democracy instead, the president is aware that someone, seven years later, is going to hold you to that promise,” Ben Rhodes, Obama’s deputy national-security adviser, and his foreign-policy amanuensis, told me not long ago.
  • Power is a partisan of the doctrine known as “responsibility to protect,” which holds that sovereignty should not be considered inviolate when a country is slaughtering its own citizens. She lobbied him to endorse this doctrine in the speech he delivered when he accepted the Nobel Peace Prize in 2009, but he declined. Obama generally does not believe a president should place American soldiers at great risk in order to prevent humanitarian disasters, unless those disasters pose a direct security threat to the United States.
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  • Obama’s resistance to direct intervention only grew. After several months of deliberation, he authorized the CIA to train and fund Syrian rebels, but he also shared the outlook of his former defense secretary, Robert Gates, who had routinely asked in meetings, “Shouldn’t we finish up the two wars we have before we look for another?”
  • In his first term, he came to believe that only a handful of threats in the Middle East conceivably warranted direct U.S. military intervention. These included the threat posed by al‑Qaeda; threats to the continued existence of Israel (“It would be a moral failing for me as president of the United States” not to defend Israel, he once told me); and, not unrelated to Israel’s security, the threat posed by a nuclear-armed Iran.
  • Bush and Scowcroft removed Saddam Hussein’s army from Kuwait in 1991, and they deftly managed the disintegration of the Soviet Union; Scowcroft also, on Bush’s behalf, toasted the leaders of China shortly after the slaughter in Tiananmen Square.
  • As Obama was writing his campaign manifesto, The Audacity of Hope, in 2006, Susan Rice, then an informal adviser, felt it necessary to remind him to include at least one line of praise for the foreign policy of President Bill Clinton, to partially balance the praise he showered on Bush and Scowcroft.
  • “When you have a professional army,” he once told me, “that is well armed and sponsored by two large states”—Iran and Russia—“who have huge stakes in this, and they are fighting against a farmer, a carpenter, an engineer who started out as protesters and suddenly now see themselves in the midst of a civil conflict …” He paused. “The notion that we could have—in a clean way that didn’t commit U.S. military forces—changed the equation on the ground there was never true.”
  • The message Obama telegraphed in speeches and interviews was clear: He would not end up like the second President Bush—a president who became tragically overextended in the Middle East, whose decisions filled the wards of Walter Reed with grievously wounded soldiers, who was helpless to stop the obliteration of his reputation, even when he recalibrated his policies in his second term. Obama would say privately that the first task of an American president in the post-Bush international arena was “Don’t do stupid shit.”
  • Hillary Clinton, when she was Obama’s secretary of state, argued for an early and assertive response to Assad’s violence. In 2014, after she left office, Clinton told me that “the failure to help build up a credible fighting force of the people who were the originators of the protests against Assad … left a big vacuum, which the jihadists have now filled.” When The Atlantic published this statement, and also published Clinton’s assessment that “great nations need organizing principles, and ‘Don’t do stupid stuff’ is not an organizing principle,” Obama became “rip-shit angry,” according to one of his senior advisers. The president did not understand how “Don’t do stupid shit” could be considered a controversial slogan.
  • The Iraq invasion, Obama believed, should have taught Democratic interventionists like Clinton, who had voted for its authorization, the dangers of doing stupid shit. (Clinton quickly apologized to Obama for her comments,
  • Obama, unlike liberal interventionists, is an admirer of the foreign-policy realism of President George H. W. Bush and, in particular, of Bush’s national-security adviser, Brent Scowcroft (“I love that guy,” Obama once told me).
  • The danger to the United States posed by the Assad regime did not rise to the level of these challenges.
  • Obama generally believes that the Washington foreign-policy establishment, which he secretly disdains, makes a fetish of “credibility”—particularly the sort of credibility purchased with force. The preservation of credibility, he says, led to Vietnam. Within the White House, Obama would argue that “dropping bombs on someone to prove that you’re willing to drop bombs on someone is just about the worst reason to use force.”
  • American national-security credibility, as it is conventionally understood in the Pentagon, the State Department, and the cluster of think tanks headquartered within walking distance of the White House, is an intangible yet potent force—one that, when properly nurtured, keeps America’s friends feeling secure and keeps the international order stable.
  • All week, White House officials had publicly built the case that Assad had committed a crime against humanity. Kerry’s speech would mark the culmination of this campaign.
  • But the president had grown queasy. In the days after the gassing of Ghouta, Obama would later tell me, he found himself recoiling from the idea of an attack unsanctioned by international law or by Congress. The American people seemed unenthusiastic about a Syria intervention; so too did one of the few foreign leaders Obama respects, Angela Merkel, the German chancellor. She told him that her country would not participate in a Syria campaign. And in a stunning development, on Thursday, August 29, the British Parliament denied David Cameron its blessing for an attack. John Kerry later told me that when he heard that, “internally, I went, Oops.”
  • Obama was also unsettled by a surprise visit early in the week from James Clapper, his director of national intelligence, who interrupted the President’s Daily Brief, the threat report Obama receives each morning from Clapper’s analysts, to make clear that the intelligence on Syria’s use of sarin gas, while robust, was not a “slam dunk.” He chose the term carefully. Clapper, the chief of an intelligence community traumatized by its failures in the run-up to the Iraq War, was not going to overpromise, in the manner of the onetime CIA director George Tenet, who famously guaranteed George W. Bush a “slam dunk” in Iraq.
  • While the Pentagon and the White House’s national-security apparatuses were still moving toward war (John Kerry told me he was expecting a strike the day after his speech), the president had come to believe that he was walking into a trap—one laid both by allies and by adversaries, and by conventional expectations of what an American president is supposed to do.
  • Late on Friday afternoon, Obama determined that he was simply not prepared to authorize a strike. He asked McDonough, his chief of staff, to take a walk with him on the South Lawn of the White House. Obama did not choose McDonough randomly: He is the Obama aide most averse to U.S. military intervention, and someone who, in the words of one of his colleagues, “thinks in terms of traps.” Obama, ordinarily a preternaturally confident man, was looking for validation, and trying to devise ways to explain his change of heart, both to his own aides and to the public
  • The third, and most important, factor, he told me, was “our assessment that while we could inflict some damage on Assad, we could not, through a missile strike, eliminate the chemical weapons themselves, and what I would then face was the prospect of Assad having survived the strike and claiming he had successfully defied the United States, that the United States had acted unlawfully in the absence of a UN mandate, and that that would have potentially strengthened his hand rather than weakened it.
  • Others had difficulty fathoming how the president could reverse himself the day before a planned strike. Obama, however, was completely calm. “If you’ve been around him, you know when he’s ambivalent about something, when it’s a 51–49 decision,” Ben Rhodes told me. “But he was completely at ease.”
  • Obama also shared with McDonough a long-standing resentment: He was tired of watching Washington unthinkingly drift toward war in Muslim countries. Four years earlier, the president believed, the Pentagon had “jammed” him on a troop surge for Afghanistan. Now, on Syria, he was beginning to feel jammed again.
  • The fourth factor, he said, was of deeper philosophical importance. “This falls in the category of something that I had been brooding on for some time,” he said. “I had come into office with the strong belief that the scope of executive power in national-security issues is very broad, but not limitless.”
  • Obama’s decision caused tremors across Washington as well. John McCain and Lindsey Graham, the two leading Republican hawks in the Senate, had met with Obama in the White House earlier in the week and had been promised an attack. They were angered by the about-face. Damage was done even inside the administration. Neither Chuck Hagel, then the secretary of defense, nor John Kerry was in the Oval Office when the president informed his team of his thinking. Kerry would not learn about the change until later that evening. “I just got fucked over,” he told a friend shortly after talking to the president that night. (When I asked Kerry recently about that tumultuous night, he said, “I didn’t stop to analyze it. I figured the president had a reason to make a decision and, honestly, I understood his notion.”)
  • The president asked Congress to authorize the use of force—the irrepressible Kerry served as chief lobbyist—and it quickly became apparent in the White House that Congress had little interest in a strike. When I spoke with Biden recently about the red-line decision, he made special note of this fact. “It matters to have Congress with you, in terms of your ability to sustain what you set out to do,” he said. Obama “didn’t go to Congress to get himself off the hook. He had his doubts at that point, but he knew that if he was going to do anything, he better damn well have the public with him, or it would be a very short ride.” Congress’s clear ambivalence convinced Biden that Obama was correct to fear the slippery slope. “What happens when we get a plane shot down? Do we not go in and rescue?,” Biden asked. “You need the support of the American people.”
  • At the G20 summit in St. Petersburg, which was held the week after the Syria reversal, Obama pulled Putin aside, he recalled to me, and told the Russian president “that if he forced Assad to get rid of the chemical weapons, that that would eliminate the need for us taking a military strike.” Within weeks, Kerry, working with his Russian counterpart, Sergey Lavrov, would engineer the removal of most of Syria’s chemical-weapons arsenal—a program whose existence Assad until then had refused to even acknowledge.
  • The arrangement won the president praise from, of all people, Benjamin Netanyahu, the Israeli prime minister, with whom he has had a consistently contentious relationship. The removal of Syria’s chemical-weapons stockpiles represented “the one ray of light in a very dark region,” Netanyahu told me not long after the deal was announced.
  • John Kerry today expresses no patience for those who argue, as he himself once did, that Obama should have bombed Assad-regime sites in order to buttress America’s deterrent capability. “You’d still have the weapons there, and you’d probably be fighting isil” for control of the weapons, he said, referring to the Islamic State, the terror group also known as isis. “It just doesn’t make sense. But I can’t deny to you that this notion about the red line being crossed and [Obama’s] not doing anything gained a life of its own.”
  • today that decision is a source of deep satisfaction for him.
  • “I’m very proud of this moment,” he told me. “The overwhelming weight of conventional wisdom and the machinery of our national-security apparatus had gone fairly far. The perception was that my credibility was at stake, that America’s credibility was at stake. And so for me to press the pause button at that moment, I knew, would cost me politically. And the fact that I was able to pull back from the immediate pressures and think through in my own mind what was in America’s interest, not only with respect to Syria but also with respect to our democracy, was as tough a decision as I’ve made—and I believe ultimately it was the right decision to make.”
  • By 2013, Obama’s resentments were well developed. He resented military leaders who believed they could fix any problem if the commander in chief would simply give them what they wanted, and he resented the foreign-policy think-tank complex. A widely held sentiment inside the White House is that many of the most prominent foreign-policy think tanks in Washington are doing the bidding of their Arab and pro-Israel funders. I’ve heard one administration official refer to Massachusetts Avenue, the home of many of these think tanks, as “Arab-occupied territory.”
  • over the past few months, I’ve spent several hours talking with him about the broadest themes of his “long game” foreign policy, including the themes he is most eager to discuss—namely, the ones that have nothing to do with the Middle East.
  • I have come to believe that, in Obama’s mind, August 30, 2013, was his liberation day, the day he defied not only the foreign-policy establishment and its cruise-missile playbook, but also the demands of America’s frustrating, high-maintenance allies in the Middle East—countries, he complains privately to friends and advisers, that seek to exploit American “muscle” for their own narrow and sectarian ends.
  • “Where am I controversial? When it comes to the use of military power,” he said. “That is the source of the controversy. There’s a playbook in Washington that presidents are supposed to follow. It’s a playbook that comes out of the foreign-policy establishment. And the playbook prescribes responses to different events, and these responses tend to be militarized responses. Where America is directly threatened, the playbook works. But the playbook can also be a trap that can lead to bad decisions. In the midst of an international challenge like Syria, you get judged harshly if you don’t follow the playbook, even if there are good reasons why it does not apply.”
  • For some foreign-policy experts, even within his own administration, Obama’s about-face on enforcing the red line was a dispiriting moment in which he displayed irresolution and naïveté, and did lasting damage to America’s standing in the world. “Once the commander in chief draws that red line,” Leon Panetta, who served as CIA director and then as secretary of defense in Obama’s first term, told me recently, “then I think the credibility of the commander in chief and this nation is at stake if he doesn’t enforce it.” Right after Obama’s reversal, Hillary Clinton said privately, “If you say you’re going to strike, you have to strike. There’s no choice.”
  • Obama’s defenders, however, argue that he did no damage to U.S. credibility, citing Assad’s subsequent agreement to have his chemical weapons removed. “The threat of force was credible enough for them to give up their chemical weapons,” Tim Kaine, a Democratic senator from Virginia, told me. “We threatened military action and they responded. That’s deterrent credibility.”
  • History may record August 30, 2013, as the day Obama prevented the U.S. from entering yet another disastrous Muslim civil war, and the day he removed the threat of a chemical attack on Israel, Turkey, or Jordan. Or it could be remembered as the day he let the Middle East slip from America’s grasp, into the hands of Russia, Iran, and isis
  • spoke with obama about foreign policy when he was a U.S. senator, in 2006. At the time, I was familiar mainly with the text of a speech he had delivered four years earlier, at a Chicago antiwar rally. It was an unusual speech for an antiwar rally in that it was not antiwar; Obama, who was then an Illinois state senator, argued only against one specific and, at the time, still theoretical, war. “I suffer no illusions about Saddam Hussein,” he said. “He is a brutal man. A ruthless man … But I also know that Saddam poses no imminent and direct threat to the United States or to his neighbors.” He added, “I know that an invasion of Iraq without a clear rationale and without strong international support will only fan the flames of the Middle East, and encourage the worst, rather than best, impulses of the Arab world, and strengthen the recruitment arm of al-Qaeda.”
  • This speech had made me curious about its author. I wanted to learn how an Illinois state senator, a part-time law professor who spent his days traveling between Chicago and Springfield, had come to a more prescient understanding of the coming quagmire than the most experienced foreign-policy thinkers of his party, including such figures as Hillary Clinton, Joe Biden, and John Kerry, not to mention, of course, most Republicans and many foreign-policy analysts and writers, including me.
  • This was the moment the president believes he finally broke with what he calls, derisively, the “Washington playbook.”
  • “isis is not an existential threat to the United States,” he told me in one of these conversations. “Climate change is a potential existential threat to the entire world if we don’t do something about it.” Obama explained that climate change worries him in particular because “it is a political problem perfectly designed to repel government intervention. It involves every single country, and it is a comparatively slow-moving emergency, so there is always something seemingly more urgent on the agenda.”
  • At the moment, of course, the most urgent of the “seemingly more urgent” issues is Syria. But at any given moment, Obama’s entire presidency could be upended by North Korean aggression, or an assault by Russia on a member of nato, or an isis-planned attack on U.S. soil. Few presidents have faced such diverse tests on the international stage as Obama has, and the challenge for him, as for all presidents, has been to distinguish the merely urgent from the truly important, and to focus on the important.
  • My goal in our recent conversations was to see the world through Obama’s eyes, and to understand what he believes America’s role in the world should be. This article is informed by our recent series of conversations, which took place in the Oval Office; over lunch in his dining room; aboard Air Force One; and in Kuala Lumpur during his most recent visit to Asia, in November. It is also informed by my previous interviews with him and by his speeches and prolific public ruminations, as well as by conversations with his top foreign-policy and national-security advisers, foreign leaders and their ambassadors in Washington, friends of the president and others who have spoken with him about his policies and decisions, and his adversaries and critics.
  • Over the course of our conversations, I came to see Obama as a president who has grown steadily more fatalistic about the constraints on America’s ability to direct global events, even as he has, late in his presidency, accumulated a set of potentially historic foreign-policy achievements—controversial, provisional achievements, to be sure, but achievements nonetheless: the opening to Cuba, the Paris climate-change accord, the Trans-Pacific Partnership trade agreement, and, of course, the Iran nuclear deal.
  • These he accomplished despite his growing sense that larger forces—the riptide of tribal feeling in a world that should have already shed its atavism; the resilience of small men who rule large countries in ways contrary to their own best interests; the persistence of fear as a governing human emotion—frequently conspire against the best of America’s intentions. But he also has come to learn, he told me, that very little is accomplished in international affairs without U.S. leadership.
  • Obama talked me through this apparent contradiction. “I want a president who has the sense that you can’t fix everything,” he said. But on the other hand, “if we don’t set the agenda, it doesn’t happen.” He explained what he meant. “The fact is, there is not a summit I’ve attended since I’ve been president where we are not setting the agenda, where we are not responsible for the key results,” he said. “That’s true whether you’re talking about nuclear security, whether you’re talking about saving the world financial system, whether you’re talking about climate.”
  • One day, over lunch in the Oval Office dining room, I asked the president how he thought his foreign policy might be understood by historians. He started by describing for me a four-box grid representing the main schools of American foreign-policy thought. One box he called isolationism, which he dismissed out of hand. “The world is ever-shrinking,” he said. “Withdrawal is untenable.” The other boxes he labeled realism, liberal interventionism, and internationalism. “I suppose you could call me a realist in believing we can’t, at any given moment, relieve all the world’s misery,” he said. “We have to choose where we can make a real impact.” He also noted that he was quite obviously an internationalist, devoted as he is to strengthening multilateral organizations and international norms.
  • If a crisis, or a humanitarian catastrophe, does not meet his stringent standard for what constitutes a direct national-security threat, Obama said, he doesn’t believe that he should be forced into silence. He is not so much the realist, he suggested, that he won’t pass judgment on other leaders.
  • Though he has so far ruled out the use of direct American power to depose Assad, he was not wrong, he argued, to call on Assad to go. “Oftentimes when you get critics of our Syria policy, one of the things that they’ll point out is ‘You called for Assad to go, but you didn’t force him to go. You did not invade.’ And the notion is that if you weren’t going to overthrow the regime, you shouldn’t have said anything. That’s a weird argument to me, the notion that if we use our moral authority to say ‘This is a brutal regime, and this is not how a leader should treat his people,’ once you do that, you are obliged to invade the country and install a government you prefer.”
  • “I am very much the internationalist,” Obama said in a later conversation. “And I am also an idealist insofar as I believe that we should be promoting values, like democracy and human rights and norms and values
  • “Having said that,” he continued, “I also believe that the world is a tough, complicated, messy, mean place, and full of hardship and tragedy. And in order to advance both our security interests and those ideals and values that we care about, we’ve got to be hardheaded at the same time as we’re bighearted, and pick and choose our spots, and recognize that there are going to be times where the best that we can do is to shine a spotlight on something that’s terrible, but not believe that we can automatically solve it. There are going to be times where our security interests conflict with our concerns about human rights. There are going to be times where we can do something about innocent people being killed, but there are going to be times where we can’t.”
  • If Obama ever questioned whether America really is the world’s one indispensable nation, he no longer does so. But he is the rare president who seems at times to resent indispensability, rather than embrace it.
  • “Free riders aggravate me,” he told me. Recently, Obama warned that Great Britain would no longer be able to claim a “special relationship” with the United States if it did not commit to spending at least 2 percent of its GDP on defense. “You have to pay your fair share,” Obama told David Cameron, who subsequently met the 2 percent threshold.
  • Part of his mission as president, Obama explained, is to spur other countries to take action for themselves, rather than wait for the U.S. to lead. The defense of the liberal international order against jihadist terror, Russian adventurism, and Chinese bullying depends in part, he believes, on the willingness of other nations to share the burden with the U.S
  • This is why the controversy surrounding the assertion—made by an anonymous administration official to The New Yorker during the Libya crisis of 2011—that his policy consisted of “leading from behind” perturbed him. “We don’t have to always be the ones who are up front,” he told me. “Sometimes we’re going to get what we want precisely because we are sharing in the agenda.
  • The president also seems to believe that sharing leadership with other countries is a way to check America’s more unruly impulses. “One of the reasons I am so focused on taking action multilaterally where our direct interests are not at stake is that multilateralism regulates hubris,”
  • He consistently invokes what he understands to be America’s past failures overseas as a means of checking American self-righteousness. “We have history,” he said. “We have history in Iran, we have history in Indonesia and Central America. So we have to be mindful of our history when we start talking about intervening, and understand the source of other people’s suspicions.”
  • In his efforts to off-load some of America’s foreign-policy responsibilities to its allies, Obama appears to be a classic retrenchment president in the manner of Dwight D. Eisenhower and Richard Nixon. Retrenchment, in this context, is defined as “pulling back, spending less, cutting risk, and shifting burdens to allies
  • One difference between Eisenhower and Nixon, on the one hand, and Obama, on the other, Sestanovich said, is that Obama “appears to have had a personal, ideological commitment to the idea that foreign policy had consumed too much of the nation’s attention and resources.”
  • But once he decides that a particular challenge represents a direct national-security threat, he has shown a willingness to act unilaterally. This is one of the larger ironies of the Obama presidency: He has relentlessly questioned the efficacy of force, but he has also become the most successful terrorist-hunter in the history of the presidency, one who will hand to his successor a set of tools an accomplished assassin would envy
  • “He applies different standards to direct threats to the U.S.,” Ben Rhodes says. “For instance, despite his misgivings about Syria, he has not had a second thought about drones.” Some critics argue he should have had a few second thoughts about what they see as the overuse of drones. But John Brennan, Obama’s CIA director, told me recently that he and the president “have similar views. One of them is that sometimes you have to take a life to save even more lives. We have a similar view of just-war theory. The president requires near-certainty of no collateral damage. But if he believes it is necessary to act, he doesn’t hesitate.”
  • Those who speak with Obama about jihadist thought say that he possesses a no-illusions understanding of the forces that drive apocalyptic violence among radical Muslims, but he has been careful about articulating that publicly, out of concern that he will exacerbate anti-Muslim xenophobia
  • He has a tragic realist’s understanding of sin, cowardice, and corruption, and a Hobbesian appreciation of how fear shapes human behavior. And yet he consistently, and with apparent sincerity, professes optimism that the world is bending toward justice. He is, in a way, a Hobbesian optimist.
  • The contradictions do not end there. Though he has a reputation for prudence, he has also been eager to question some of the long-standing assumptions undergirding traditional U.S. foreign-policy thinking. To a remarkable degree, he is willing to question why America’s enemies are its enemies, or why some of its friends are its friends.
  • It is assumed, at least among his critics, that Obama sought the Iran deal because he has a vision of a historic American-Persian rapprochement. But his desire for the nuclear agreement was born of pessimism as much as it was of optimism. “The Iran deal was never primarily about trying to open a new era of relations between the U.S. and Iran,” Susan Rice told me. “It was far more pragmatic and minimalist. The aim was very simply to make a dangerous country substantially less dangerous. No one had any expectation that Iran would be a more benign actor.”
  • once mentioned to obama a scene from The Godfather: Part III, in which Michael Corleone complains angrily about his failure to escape the grasp of organized crime. I told Obama that the Middle East is to his presidency what the Mob is to Corleone, and I started to quote the Al Pacino line: “Just when I thought I was out—”“It pulls you back in,” Obama said, completing the thought
  • When I asked Obama recently what he had hoped to accomplish with his Cairo reset speech, he said that he had been trying—unsuccessfully, he acknowledged—to persuade Muslims to more closely examine the roots of their unhappiness.“My argument was this: Let’s all stop pretending that the cause of the Middle East’s problems is Israel,” he told me. “We want to work to help achieve statehood and dignity for the Palestinians, but I was hoping that my speech could trigger a discussion, could create space for Muslims to address the real problems they are confronting—problems of governance, and the fact that some currents of Islam have not gone through a reformation that would help people adapt their religious doctrines to modernity. My thought was, I would communicate that the U.S. is not standing in the way of this progress, that we would help, in whatever way possible, to advance the goals of a practical, successful Arab agenda that provided a better life for ordinary people.”
  • But over the next three years, as the Arab Spring gave up its early promise, and brutality and dysfunction overwhelmed the Middle East, the president grew disillusioned. Some of his deepest disappointments concern Middle Eastern leaders themselves. Benjamin Netanyahu is in his own category: Obama has long believed that Netanyahu could bring about a two-state solution that would protect Israel’s status as a Jewish-majority democracy, but is too fearful and politically paralyzed to do so
  • Obama has also not had much patience for Netanyahu and other Middle Eastern leaders who question his understanding of the region. In one of Netanyahu’s meetings with the president, the Israeli prime minister launched into something of a lecture about the dangers of the brutal region in which he lives, and Obama felt that Netanyahu was behaving in a condescending fashion, and was also avoiding the subject at hand: peace negotiations. Finally, the president interrupted the prime minister: “Bibi, you have to understand something,” he said. “I’m the African American son of a single mother, and I live here, in this house. I live in the White House. I managed to get elected president of the United States. You think I don’t understand what you’re talking about, but I do.”
  • Other leaders also frustrate him immensely. Early on, Obama saw Recep Tayyip Erdoğan, the president of Turkey, as the sort of moderate Muslim leader who would bridge the divide between East and West—but Obama now considers him a failure and an authoritarian, one who refuses to use his enormous army to bring stability to Syria
  • In recent days, the president has taken to joking privately, “All I need in the Middle East is a few smart autocrats.” Obama has always had a fondness for pragmatic, emotionally contained technocrats, telling aides, “If only everyone could be like the Scandinavians, this would all be easy.”
  • The unraveling of the Arab Spring darkened the president’s view of what the U.S. could achieve in the Middle East, and made him realize how much the chaos there was distracting from other priorities. “The president recognized during the course of the Arab Spring that the Middle East was consuming us,”
  • But what sealed Obama’s fatalistic view was the failure of his administration’s intervention in Libya, in 2011
  • Obama says today of the intervention, “It didn’t work.” The U.S., he believes, planned the Libya operation carefully—and yet the country is still a disaster.
  • “So we actually executed this plan as well as I could have expected: We got a UN mandate, we built a coalition, it cost us $1 billion—which, when it comes to military operations, is very cheap. We averted large-scale civilian casualties, we prevented what almost surely would have been a prolonged and bloody civil conflict. And despite all that, Libya is a mess.”
  • Mess is the president’s diplomatic term; privately, he calls Libya a “shit show,” in part because it’s subsequently become an isis haven—one that he has already targeted with air strikes. It became a shit show, Obama believes, for reasons that had less to do with American incompetence than with the passivity of America’s allies and with the obdurate power of tribalism.
  • Of France, he said, “Sarkozy wanted to trumpet the flights he was taking in the air campaign, despite the fact that we had wiped out all the air defenses and essentially set up the entire infrastructure” for the intervention. This sort of bragging was fine, Obama said, because it allowed the U.S. to “purchase France’s involvement in a way that made it less expensive for us and less risky for us.” In other words, giving France extra credit in exchange for less risk and cost to the United States was a useful trade-off—except that “from the perspective of a lot of the folks in the foreign-policy establishment, well, that was terrible. If we’re going to do something, obviously we’ve got to be up front, and nobody else is sharing in the spotlight.”
  • Obama also blamed internal Libyan dynamics. “The degree of tribal division in Libya was greater than our analysts had expected. And our ability to have any kind of structure there that we could interact with and start training and start providing resources broke down very quickly.”
  • Libya proved to him that the Middle East was best avoided. “There is no way we should commit to governing the Middle East and North Africa,” he recently told a former colleague from the Senate. “That would be a basic, fundamental mistake.”
  • Obama did not come into office preoccupied by the Middle East. He is the first child of the Pacific to become president—born in Hawaii, raised there and, for four years, in Indonesia—and he is fixated on turning America’s attention to Asia
  • For Obama, Asia represents the future. Africa and Latin America, in his view, deserve far more U.S. attention than they receive. Europe, about which he is unromantic, is a source of global stability that requires, to his occasional annoyance, American hand-holding. And the Middle East is a region to be avoided—one that, thanks to America’s energy revolution, will soon be of negligible relevance to the U.S. economy.
  • Advisers recall that Obama would cite a pivotal moment in The Dark Knight, the 2008 Batman movie, to help explain not only how he understood the role of isis, but how he understood the larger ecosystem in which it grew. “There’s a scene in the beginning in which the gang leaders of Gotham are meeting,” the president would say. “These are men who had the city divided up. They were thugs, but there was a kind of order. Everyone had his turf. And then the Joker comes in and lights the whole city on fire. isil is the Joker. It has the capacity to set the whole region on fire. That’s why we have to fight it.”
  • The rise of the Islamic State deepened Obama’s conviction that the Middle East could not be fixed—not on his watch, and not for a generation to come.
  • The traveling White House press corps was unrelenting: “Isn’t it time for your strategy to change?” one reporter asked. This was followed by “Could I ask you to address your critics who say that your reluctance to enter another Middle East war, and your preference of diplomacy over using the military, makes the United States weaker and emboldens our enemies?” And then came this imperishable question, from a CNN reporter: “If you’ll forgive the language—why can’t we take out these bastards?” Which was followed by “Do you think you really understand this enemy well enough to defeat them and to protect the homeland?”
  • This rhetoric appeared to frustrate Obama immensely. “When I hear folks say that, well, maybe we should just admit the Christians but not the Muslims; when I hear political leaders suggesting that there would be a religious test for which person who’s fleeing from a war-torn country is admitted,” Obama told the assembled reporters, “that’s not American. That’s not who we are. We don’t have religious tests to our compassion.”
  • he has never believed that terrorism poses a threat to America commensurate with the fear it generates. Even during the period in 2014 when isis was executing its American captives in Syria, his emotions were in check. Valerie Jarrett, Obama’s closest adviser, told him people were worried that the group would soon take its beheading campaign to the U.S. “They’re not coming here to chop our heads off,” he reassured her.
  • Obama frequently reminds his staff that terrorism takes far fewer lives in America than handguns, car accidents, and falls in bathtubs do
  • Several years ago, he expressed to me his admiration for Israelis’ “resilience” in the face of constant terrorism, and it is clear that he would like to see resilience replace panic in American society. Nevertheless, his advisers are fighting a constant rearguard action to keep Obama from placing terrorism in what he considers its “proper” perspective, out of concern that he will seem insensitive to the fears of the American people.
  • When I noted to Kerry that the president’s rhetoric doesn’t match his, he said, “President Obama sees all of this, but he doesn’t gin it up into this kind of—he thinks we are on track. He has escalated his efforts. But he’s not trying to create hysteria … I think the president is always inclined to try to keep things on an appropriate equilibrium. I respect that.”
  • Obama modulates his discussion of terrorism for several reasons: He is, by nature, Spockian. And he believes that a misplaced word, or a frightened look, or an ill-considered hyperbolic claim, could tip the country into panic. The sort of panic he worries about most is the type that would manifest itself in anti-Muslim xenophobia or in a challenge to American openness and to the constitutional order.
  • The president also gets frustrated that terrorism keeps swamping his larger agenda, particularly as it relates to rebalancing America’s global priorities. For years, the “pivot to Asia” has been a paramount priority of his. America’s economic future lies in Asia, he believes, and the challenge posed by China’s rise requires constant attention. From his earliest days in office, Obama has been focused on rebuilding the sometimes-threadbare ties between the U.S. and its Asian treaty partners, and he is perpetually on the hunt for opportunities to draw other Asian nations into the U.S. orbit. His dramatic opening to Burma was one such opportunity; Vietnam and the entire constellation of Southeast Asian countries fearful of Chinese domination presented others.
  • Obama believes, Carter said, that Asia “is the part of the world of greatest consequence to the American future, and that no president can take his eye off of this.” He added, “He consistently asks, even in the midst of everything else that’s going on, ‘Where are we in the Asia-Pacific rebalance? Where are we in terms of resources?’ He’s been extremely consistent about that, even in times of Middle East tension.”
  • “Right now, I don’t think that anybody can be feeling good about the situation in the Middle East,” he said. “You have countries that are failing to provide prosperity and opportunity for their people. You’ve got a violent, extremist ideology, or ideologies, that are turbocharged through social media. You’ve got countries that have very few civic traditions, so that as autocratic regimes start fraying, the only organizing principles are sectarian.”
  • He went on, “Contrast that with Southeast Asia, which still has huge problems—enormous poverty, corruption—but is filled with striving, ambitious, energetic people who are every single day scratching and clawing to build businesses and get education and find jobs and build infrastructure. The contrast is pretty stark.”
  • In Asia, as well as in Latin America and Africa, Obama says, he sees young people yearning for self-improvement, modernity, education, and material wealth.“They are not thinking about how to kill Americans,” he says. “What they’re thinking about is How do I get a better education? How do I create something of value?”
  • He then made an observation that I came to realize was representative of his bleakest, most visceral understanding of the Middle East today—not the sort of understanding that a White House still oriented around themes of hope and change might choose to advertise. “If we’re not talking to them,” he said, referring to young Asians and Africans and Latin Americans, “because the only thing we’re doing is figuring out how to destroy or cordon off or control the malicious, nihilistic, violent parts of humanity, then we’re missing the boat.
  • He does resist refracting radical Islam through the “clash of civilizations” prism popularized by the late political scientist Samuel Huntington. But this is because, he and his advisers argue, he does not want to enlarge the ranks of the enemy. “The goal is not to force a Huntington template onto this conflict,” said John Brennan, the CIA director.
  • “It is very clear what I mean,” he told me, “which is that there is a violent, radical, fanatical, nihilistic interpretation of Islam by a faction—a tiny faction—within the Muslim community that is our enemy, and that has to be defeated.”
  • “There is also the need for Islam as a whole to challenge that interpretation of Islam, to isolate it, and to undergo a vigorous discussion within their community about how Islam works as part of a peaceful, modern society,” he said. But he added, “I do not persuade peaceful, tolerant Muslims to engage in that debate if I’m not sensitive to their concern that they are being tagged with a broad brush.”
  • In private encounters with other world leaders, Obama has argued that there will be no comprehensive solution to Islamist terrorism until Islam reconciles itself to modernity and undergoes some of the reforms that have changed Christianity.
  • , Obama described how he has watched Indonesia gradually move from a relaxed, syncretistic Islam to a more fundamentalist, unforgiving interpretation; large numbers of Indonesian women, he observed, have now adopted the hijab, the Muslim head covering.
  • Why, Turnbull asked, was this happening?Because, Obama answered, the Saudis and other Gulf Arabs have funneled money, and large numbers of imams and teachers, into the country. In the 1990s, the Saudis heavily funded Wahhabist madrassas, seminaries that teach the fundamentalist version of Islam favored by the Saudi ruling family, Obama told Turnbull. Today, Islam in Indonesia is much more Arab in orientation than it was when he lived there, he said.
  • “Aren’t the Saudis your friends?,” Turnbull asked.Obama smiled. “It’s complicated,” he said.
  • But he went on to say that the Saudis need to “share” the Middle East with their Iranian foes. “The competition between the Saudis and the Iranians—which has helped to feed proxy wars and chaos in Syria and Iraq and Yemen—requires us to say to our friends as well as to the Iranians that they need to find an effective way to share the neighborhood and institute some sort of cold peace,”
  • “An approach that said to our friends ‘You are right, Iran is the source of all problems, and we will support you in dealing with Iran’ would essentially mean that as these sectarian conflicts continue to rage and our Gulf partners, our traditional friends, do not have the ability to put out the flames on their own or decisively win on their own, and would mean that we have to start coming in and using our military power to settle scores. And that would be in the interest neither of the United States nor of the Middle East.”
  • One of the most destructive forces in the Middle East, Obama believes, is tribalism—a force no president can neutralize. Tribalism, made manifest in the reversion to sect, creed, clan, and village by the desperate citizens of failing states, is the source of much of the Muslim Middle East’s problems, and it is another source of his fatalism. Obama has deep respect for the destructive resilience of tribalism—part of his memoir, Dreams From My Father, concerns the way in which tribalism in post-colonial Kenya helped ruin his father’s life—which goes some distance in explaining why he is so fastidious about avoiding entanglements in tribal conflicts.
  • “It is literally in my DNA to be suspicious of tribalism,” he told me. “I understand the tribal impulse, and acknowledge the power of tribal division. I’ve been navigating tribal divisions my whole life. In the end, it’s the source of a lot of destructive acts.”
  • “Look, I am not of the view that human beings are inherently evil,” he said. “I believe that there’s more good than bad in humanity. And if you look at the trajectory of history, I am optimistic.
  • “I believe that overall, humanity has become less violent, more tolerant, healthier, better fed, more empathetic, more able to manage difference. But it’s hugely uneven. And what has been clear throughout the 20th and 21st centuries is that the progress we make in social order and taming our baser impulses and steadying our fears can be reversed very quickly. Social order starts breaking down if people are under profound stress. Then the default position is tribe—us/them, a hostility toward the unfamiliar or the unknown.”
  • He continued, “Right now, across the globe, you’re seeing places that are undergoing severe stress because of globalization, because of the collision of cultures brought about by the Internet and social media, because of scarcities—some of which will be attributable to climate change over the next several decades—because of population growth. And in those places, the Middle East being Exhibit A, the default position for a lot of folks is to organize tightly in the tribe and to push back or strike out against those who are different.
  • “A group like isil is the distillation of every worst impulse along these lines. The notion that we are a small group that defines ourselves primarily by the degree to which we can kill others who are not like us, and attempting to impose a rigid orthodoxy that produces nothing, that celebrates nothing, that really is contrary to every bit of human progress—it indicates the degree to which that kind of mentality can still take root and gain adherents in the 21st century.”
  • “We have to determine the best tools to roll back those kinds of attitudes,” he said. “There are going to be times where either because it’s not a direct threat to us or because we just don’t have the tools in our toolkit to have a huge impact that, tragically, we have to refrain from jumping in with both feet.”
  • I asked Obama whether he would have sent the Marines to Rwanda in 1994 to stop the genocide as it was happening, had he been president at the time. “Given the speed with which the killing took place, and how long it takes to crank up the machinery of the U.S. government, I understand why we did not act fast enough,” he said. “Now, we should learn from tha
  • I actually think that Rwanda is an interesting test case because it’s possible—not guaranteed, but it’s possible—that this was a situation where the quick application of force might have been enough.
  • “Ironically, it’s probably easier to make an argument that a relatively small force inserted quickly with international support would have resulted in averting genocide [more successfully in Rwanda] than in Syria right now, where the degree to which the various groups are armed and hardened fighters and are supported by a whole host of external actors with a lot of resources requires a much larger commitment of forces.”
  • The Turkey press conference, I told him, “was a moment for you as a politician to say, ‘Yeah, I hate the bastards too, and by the way, I am taking out the bastards.’ ” The easy thing to do would have been to reassure Americans in visceral terms that he will kill the people who want to kill them. Does he fear a knee-jerk reaction in the direction of another Middle East invasion? Or is he just inalterably Spockian?
  • “Every president has strengths and weaknesses,” he answered. “And there is no doubt that there are times where I have not been attentive enough to feelings and emotions and politics in communicating what we’re doing and how we’re doing it.”
  • But for America to be successful in leading the world, he continued, “I believe that we have to avoid being simplistic. I think we have to build resilience and make sure that our political debates are grounded in reality. It’s not that I don’t appreciate the value of theater in political communications; it’s that the habits we—the media, politicians—have gotten into, and how we talk about these issues, are so detached so often from what we need to be doing that for me to satisfy the cable news hype-fest would lead to us making worse and worse decisions over time.”
  • “During the couple of months in which everybody was sure Ebola was going to destroy the Earth and there was 24/7 coverage of Ebola, if I had fed the panic or in any way strayed from ‘Here are the facts, here’s what needs to be done, here’s how we’re handling it, the likelihood of you getting Ebola is very slim, and here’s what we need to do both domestically and overseas to stamp out this epidemic,’ ” then “maybe people would have said ‘Obama is taking this as seriously as he needs to be.’ ” But feeding the panic by overreacting could have shut down travel to and from three African countries that were already cripplingly poor, in ways that might have destroyed their economies—which would likely have meant, among other things, a recurrence of Ebola. He added, “It would have also meant that we might have wasted a huge amount of resources in our public-health systems that need to be devoted to flu vaccinations and other things that actually kill people” in large numbers in America
  • “I have friends who have kids in Paris right now,” he said. “And you and I and a whole bunch of people who are writing about what happened in Paris have strolled along the same streets where people were gunned down. And it’s right to feel fearful. And it’s important for us not to ever get complacent. There’s a difference between resilience and complacency.” He went on to describe another difference—between making considered decisions and making rash, emotional ones. “What it means, actually, is that you care so much that you want to get it right and you’re not going to indulge in either impetuous or, in some cases, manufactured responses that make good sound bites but don’t produce results. The stakes are too high to play those games.”
  • The other meeting took place two months later, in the Oval Office, between Obama and the general secretary of the Vietnamese Communist Party, Nguyen Phu Trong. This meeting took place only because John Kerry had pushed the White House to violate protocol, since the general secretary was not a head of state. But the goals trumped decorum: Obama wanted to lobby the Vietnamese on the Trans-Pacific Partnership—his negotiators soon extracted a promise from the Vietnamese that they would legalize independent labor unions—and he wanted to deepen cooperation on strategic issues. Administration officials have repeatedly hinted to me that Vietnam may one day soon host a permanent U.S. military presence, to check the ambitions of the country it now fears most, China. The U.S. Navy’s return to Cam Ranh Bay would count as one of the more improbable developments in recent American history. “We just moved the Vietnamese Communist Party to recognize labor rights in a way that we could never do by bullying them or scaring them,” Obama told me, calling this a key victory in his campaign to replace stick-waving with diplomatic persuasion.
  • I noted that the 200 or so young Southeast Asians in the room earlier that day—including citizens of Communist-ruled countries—seemed to love America. “They do,” Obama said. “In Vietnam right now, America polls at 80 percent.”
  • The resurgent popularity of America throughout Southeast Asia means that “we can do really big, important stuff—which, by the way, then has ramifications across the board,” he said, “because when Malaysia joins the anti-isil campaign, that helps us leverage resources and credibility in our fight against terrorism. When we have strong relations with Indonesia, that helps us when we are going to Paris and trying to negotiate a climate treaty, where the temptation of a Russia or some of these other countries may be to skew the deal in a way that is unhelpful.
  • Obama then cited America’s increased influence in Latin America—increased, he said, in part by his removal of a region-wide stumbling block when he reestablished ties with Cuba—as proof that his deliberate, nonthreatening, diplomacy-centered approach to foreign relations is working. The alba movement, a group of Latin American governments oriented around anti-Americanism, has significantly weakened during his time as president. “When I came into office, at the first Summit of the Americas that I attended, Hugo Chávez”—the late anti-American Venezuelan dictator—“was still the dominant figure in the conversation,” he said. “We made a very strategic decision early on, which was, rather than blow him up as this 10-foot giant adversary, to right-size the problem and say, ‘We don’t like what’s going on in Venezuela, but it’s not a threat to the United States.’
  • Obama said that to achieve this rebalancing, the U.S. had to absorb the diatribes and insults of superannuated Castro manqués. “When I saw Chávez, I shook his hand and he handed me a Marxist critique of the U.S.–Latin America relationship,” Obama recalled. “And I had to sit there and listen to Ortega”—Daniel Ortega, the radical leftist president of Nicaragua—“make an hour-long rant against the United States. But us being there, not taking all that stuff seriously—because it really wasn’t a threat to us”—helped neutralize the region’s anti-Americanism.
  • “The truth is, actually, Putin, in all of our meetings, is scrupulously polite, very frank. Our meetings are very businesslike. He never keeps me waiting two hours like he does a bunch of these other folks.” Obama said that Putin believes his relationship with the U.S. is more important than Americans tend to think. “He’s constantly interested in being seen as our peer and as working with us, because he’s not completely stupid. He understands that Russia’s overall position in the world is significantly diminished. And the fact that he invades Crimea or is trying to prop up Assad doesn’t suddenly make him a player.
  • “The argument is made,” I said, “that Vladimir Putin watched you in Syria and thought, He’s too logical, he’s too rational, he’s too into retrenchment. I’m going to push him a little bit further in Ukraine.”
  • “Look, this theory is so easily disposed of that I’m always puzzled by how people make the argument. I don’t think anybody thought that George W. Bush was overly rational or cautious in his use of military force. And as I recall, because apparently nobody in this town does, Putin went into Georgia on Bush’s watch, right smack dab in the middle of us having over 100,000 troops deployed in Iraq.” Obama was referring to Putin’s 2008 invasion of Georgia, a former Soviet republic, which was undertaken for many of the same reasons Putin later invaded Ukraine—to keep an ex–Soviet republic in Russia’s sphere of influence.
  • “Putin acted in Ukraine in response to a client state that was about to slip out of his grasp. And he improvised in a way to hang on to his control there,” he said. “He’s done the exact same thing in Syria, at enormous cost to the well-being of his own country. And the notion that somehow Russia is in a stronger position now, in Syria or in Ukraine, than they were before they invaded Ukraine or before he had to deploy military forces to Syria is to fundamentally misunderstand the nature of power in foreign affairs or in the world generally. Real power means you can get what you want without having to exert violence. Russia was much more powerful when Ukraine looked like an independent country but was a kleptocracy that he could pull the strings on.”
  • Obama’s theory here is simple: Ukraine is a core Russian interest but not an American one, so Russia will always be able to maintain escalatory dominance there.“The fact is that Ukraine, which is a non-nato country, is going to be vulnerable to military domination by Russia no matter what we do,” he said.
  • “I think that the best argument you can make on the side of those who are critics of my foreign policy is that the president doesn’t exploit ambiguity enough. He doesn’t maybe react in ways that might cause people to think, Wow, this guy might be a little crazy.”“The ‘crazy Nixon’ approach,” I said: Confuse and frighten your enemies by making them think you’re capable of committing irrational acts.
  • “But let’s examine the Nixon theory,” he said. “So we dropped more ordnance on Cambodia and Laos than on Europe in World War II, and yet, ultimately, Nixon withdrew, Kissinger went to Paris, and all we left behind was chaos, slaughter, and authoritarian governments
  • “There is no evidence in modern American foreign policy that that’s how people respond. People respond based on what their imperatives are, and if it’s really important to somebody, and it’s not that important to us, they know that, and we know that,” he said. “There are ways to deter, but it requires you to be very clear ahead of time about what is worth going to war for and what is not.
  • Now, if there is somebody in this town that would claim that we would consider going to war with Russia over Crimea and eastern Ukraine, they should speak up and be very clear about it. The idea that talking tough or engaging in some military action that is tangential to that particular area is somehow going to influence the decision making of Russia or China is contrary to all the evidence we have seen over the last 50 years.”
  • “If you think about, let’s say, the Iran hostage crisis, there is a narrative that has been promoted today by some of the Republican candidates that the day Reagan was elected, because he looked tough, the Iranians decided, ‘We better turn over these hostages,’ ” he said. “In fact what had happened was that there was a long negotiation with the Iranians and because they so disliked Carter—even though the negotiations had been completed—they held those hostages until the day Reagan got elected
  • When you think of the military actions that Reagan took, you have Grenada—which is hard to argue helped our ability to shape world events, although it was good politics for him back home. You have the Iran-Contra affair, in which we supported right-wing paramilitaries and did nothing to enhance our image in Central America, and it wasn’t successful at all.” He reminded me that Reagan’s great foe, Daniel Ortega, is today the unrepentant president of Nicaragua.
  • Obama also cited Reagan’s decision to almost immediately pull U.S. forces from Lebanon after 241 servicemen were killed in a Hezbollah attack in 1983. “Apparently all these things really helped us gain credibility with the Russians and the Chinese,” because “that’s the narrative that is told,” he said sarcastically.
  • “Now, I actually think that Ronald Reagan had a great success in foreign policy, which was to recognize the opportunity that Gorbachev presented and to engage in extensive diplomacy—which was roundly criticized by some of the same people who now use Ronald Reagan to promote the notion that we should go around bombing people.”
  • “As I survey the next 20 years, climate change worries me profoundly because of the effects that it has on all the other problems that we face,” he said. “If you start seeing more severe drought; more significant famine; more displacement from the Indian subcontinent and coastal regions in Africa and Asia; the continuing problems of scarcity, refugees, poverty, disease—this makes every other problem we’ve got worse. That’s above and beyond just the existential issues of a planet that starts getting into a bad feedback loop.”
  • Terrorism, he said, is also a long-term problem “when combined with the problem of failed states.”
  • What country does he consider the greatest challenge to America in the coming decades? “In terms of traditional great-state relations, I do believe that the relationship between the United States and China is going to be the most critical,” he said. “If we get that right and China continues on a peaceful rise, then we have a partner that is growing in capability and sharing with us the burdens and responsibilities of maintaining an international order. If China fails; if it is not able to maintain a trajectory that satisfies its population and has to resort to nationalism as an organizing principle; if it feels so overwhelmed that it never takes on the responsibilities of a country its size in maintaining the international order; if it views the world only in terms of regional spheres of influence—then not only do we see the potential for conflict with China, but we will find ourselves having more difficulty dealing with these other challenges that are going to come.”
  • I’ve been very explicit in saying that we have more to fear from a weakened, threatened China than a successful, rising China,” Obama said. “I think we have to be firm where China’s actions are undermining international interests, and if you look at how we’ve operated in the South China Sea, we have been able to mobilize most of Asia to isolate China in ways that have surprised China, frankly, and have very much served our interest in strengthening our alliances.”
  • A weak, flailing Russia constitutes a threat as well, though not quite a top-tier threat. “Unlike China, they have demographic problems, economic structural problems, that would require not only vision but a generation to overcome,” Obama said. “The path that Putin is taking is not going to help them overcome those challenges. But in that environment, the temptation to project military force to show greatness is strong, and that’s what Putin’s inclination is. So I don’t underestimate the dangers there.”
  • “You know, the notion that diplomacy and technocrats and bureaucrats somehow are helping to keep America safe and secure, most people think, Eh, that’s nonsense. But it’s true. And by the way, it’s the element of American power that the rest of the world appreciates unambiguously
  • When we deploy troops, there’s always a sense on the part of other countries that, even where necessary, sovereignty is being violated.”
  • Administration officials have told me that Vice President Biden, too, has become frustrated with Kerry’s demands for action. He has said privately to the secretary of state, “John, remember Vietnam? Remember how that started?” At a National Security Council meeting held at the Pentagon in December, Obama announced that no one except the secretary of defense should bring him proposals for military action. Pentagon officials understood Obama’s announcement to be a brushback pitch directed at Kerry.
  • Obama’s caution on Syria has vexed those in the administration who have seen opportunities, at different moments over the past four years, to tilt the battlefield against Assad. Some thought that Putin’s decision to fight on behalf of Assad would prompt Obama to intensify American efforts to help anti-regime rebels. But Obama, at least as of this writing, would not be moved, in part because he believed that it was not his business to stop Russia from making what he thought was a terrible mistake. “They are overextended. They’re bleeding,” he told me. “And their economy has contracted for three years in a row, drastically.
  • Obama’s strategy was occasionally referred to as the “Tom Sawyer approach.” Obama’s view was that if Putin wanted to expend his regime’s resources by painting the fence in Syria, the U.S. should let him.
  • By late winter, though, when it appeared that Russia was making advances in its campaign to solidify Assad’s rule, the White House began discussing ways to deepen support for the rebels, though the president’s ambivalence about more-extensive engagement remained. In conversations I had with National Security Council officials over the past couple of months, I sensed a foreboding that an event—another San Bernardino–style attack, for instance—would compel the United States to take new and direct action in Syria. For Obama, this would be a nightmare.
  • If there had been no Iraq, no Afghanistan, and no Libya, Obama told me, he might be more apt to take risks in Syria. “A president does not make decisions in a vacuum. He does not have a blank slate. Any president who was thoughtful, I believe, would recognize that after over a decade of war, with obligations that are still to this day requiring great amounts of resources and attention in Afghanistan, with the experience of Iraq, with the strains that it’s placed on our military—any thoughtful president would hesitate about making a renewed commitment in the exact same region of the world with some of the exact same dynamics and the same probability of an unsatisfactory outcome.”
  • What has struck me is that, even as his secretary of state warns about a dire, Syria-fueled European apocalypse, Obama has not recategorized the country’s civil war as a top-tier security threat.
  • This critique frustrates the president. “Nobody remembers bin Laden anymore,” he says. “Nobody talks about me ordering 30,000 more troops into Afghanistan.” The red-line crisis, he said, “is the point of the inverted pyramid upon which all other theories rest.
  • “Was it a bluff?” I told him that few people now believe he actually would have attacked Iran to keep it from getting a nuclear weapon.“That’s interesting,” he said, noncommittally.I started to talk: “Do you—”He interrupted. “I actually would have,” he said, meaning that he would have struck Iran’s nuclear facilities. “If I saw them break out.”
  • “You were right to believe it,” the president said. And then he made his key point. “This was in the category of an American interest.”
  • I was reminded then of something Derek Chollet, a former National Security Council official, told me: “Obama is a gambler, not a bluffer.”
  • The president has placed some huge bets. Last May, as he was trying to move the Iran nuclear deal through Congress, I told him that the agreement was making me nervous. His response was telling. “Look, 20 years from now, I’m still going to be around, God willing. If Iran has a nuclear weapon, it’s my name on this,” he said. “I think it’s fair to say that in addition to our profound national-security interests, I have a personal interest in locking this down.”
  • In the matter of the Syrian regime and its Iranian and Russian sponsors, Obama has bet, and seems prepared to continue betting, that the price of direct U.S. action would be higher than the price of inaction. And he is sanguine enough to live with the perilous ambiguities of his decisions
  • Though in his Nobel Peace Prize speech in 2009, Obama said, “Inaction tears at our conscience and can lead to more costly intervention later,” today the opinions of humanitarian interventionists do not seem to move him, at least not publicly
  • As he comes to the end of his presidency, Obama believes he has done his country a large favor by keeping it out of the maelstrom—and he believes, I suspect, that historians will one day judge him wise for having done so
  • Inside the West Wing, officials say that Obama, as a president who inherited a financial crisis and two active wars from his predecessor, is keen to leave “a clean barn” to whoever succeeds him. This is why the fight against isis, a group he considers to be a direct, though not existential, threat to the U.S., is his most urgent priority for the remainder of his presidency; killing the so-called caliph of the Islamic State, Abu Bakr al-Baghdadi, is one of the top goals of the American national-security apparatus in Obama’s last year.
  • This is what is so controversial about the president’s approach, and what will be controversial for years to come—the standard he has used to define what, exactly, constitutes a direct threat.
  • Obama has come to a number of dovetailing conclusions about the world, and about America’s role in it. The first is that the Middle East is no longer terribly important to American interests. The second is that even if the Middle East were surpassingly important, there would still be little an American president could do to make it a better place. The third is that the innate American desire to fix the sorts of problems that manifest themselves most drastically in the Middle East inevitably leads to warfare, to the deaths of U.S. soldiers, and to the eventual hemorrhaging of U.S. credibility and power. The fourth is that the world cannot afford to see the diminishment of U.S. power. Just as the leaders of several American allies have found Obama’s leadership inadequate to the tasks before him, he himself has found world leadership wanting: global partners who often lack the vision and the will to spend political capital in pursuit of broad, progressive goals, and adversaries who are not, in his mind, as rational as he is. Obama believes that history has sides, and that America’s adversaries—and some of its putative allies—have situated themselves on the wrong one, a place where tribalism, fundamentalism, sectarianism, and militarism still flourish. What they don’t understand is that history is bending in his direction.
  • “The central argument is that by keeping America from immersing itself in the crises of the Middle East, the foreign-policy establishment believes that the president is precipitating our decline,” Ben Rhodes told me. “But the president himself takes the opposite view, which is that overextension in the Middle East will ultimately harm our economy, harm our ability to look for other opportunities and to deal with other challenges, and, most important, endanger the lives of American service members for reasons that are not in the direct American national-security interest.
  • George W. Bush was also a gambler, not a bluffer. He will be remembered harshly for the things he did in the Middle East. Barack Obama is gambling that he will be judged well for the things he didn’t do.
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How the U.S. Healthcare System Would Handle Ebola - 0 views

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    This article, written in second-person, outlines the steps that the U.S. healthcare system would take if you contracted Ebola. Many variables are involved in approving drug treatments. For example, neither the patient, the hospital, nor the government can decide whether or not to participate in experimental drug treatments, as drug companies decide who can receive the experimental treatments.
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NBC Cameraman Leaves Hospital After Beating Ebola - 0 views

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    American video journalist, Ashoka Mukpo, contracted Ebola during a business trip with NBC to Liberia. Both he and another patient, Rick Sacra, have recovered completely from the disease under the care of hospital workers at the University of Nebraska Medical Center. Mukpo recognizes his privilege, addressing the fact that "so many Liberians die [of ebola] alone with minimal care" every day.
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Drug mule left to die in airport over Ebola fears - The Local - 0 views

  • A Nigerian drug smuggler at Madrid's international airport who started shivering after the cocaine bags he was carrying inside his body burst was left to die after airport authorities activated an emergency Ebola alert
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A Deadly Coronavirus Was Inevitable. Why Was No One Ready? - WSJ - 0 views

  • When Disease X actually arrived, as Covid-19, governments, businesses, public-health officials and citizens soon found themselves in a state of chaos, battling an invisible enemy with few resources and little understanding—despite years of work that outlined almost exactly what the virus would look like and how to mitigate its impact.
  • Governments had ignored clear warnings and underfunded pandemic preparedness. They mostly reacted to outbreaks, instead of viewing new infectious diseases as major threats to national security. And they never developed a strong international system for managing epidemics, even though researchers said the nature of travel and trade would spread infection across borders.
  • Underlying it all was a failure that stretches back decades. Most everyone knew such an outcome was possible. And yet no one was prepared.
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  • Last year, a Chinese scientist he worked with published a specific forecast: “It is highly likely that future SARS- or MERS-like coronavirus outbreaks will originate from bats, and there is an increased probability that this will occur in China.”
  • Humans today are exposed to more deadly new pathogens than ever. They typically come from animals, as global travel, trade and economic development, such as meat production and deforestation, push people, livestock and wildlife closer together
  • Scientists knew infectious disease outbreaks were becoming more common, with 2010 having more than six times the outbreaks of pathogens from animal origins than in 1980, according to data in a study by Brown University researchers.
  • Yet plenty was left undone, in areas including funding, early-warning systems, the role of the WHO and coordination with China. A big chunk of U.S. funding went toward protecting Americans against a bioterror attack. Government funding for pandemics has come largely in emergency, one-time packages to stop an ongoing outbreak.
  • She said a better solution would be to fund public health more like national defense, with much more guaranteed money, year in, year out.
  • “Will there be another human influenza pandemic?” Dr. Webster asked in a paper presented at an NIH meeting in 1995. “The certainty is that there will be.”
  • Experts including Dr. Webster were particularly concerned about the potential for spillover in southern China, where large, densely populated cities were expanding rapidly into forests and agricultural lands, bringing people into closer contact with animals. Two of the three influenza pandemics of the 20th century are thought to have originated in China.
  • Dr. Webster and others warned it could re-emerge or mutate into something more contagious. With U.S. funding, he set up an animal influenza surveillance center in Hong Kong. The WHO, which hadn’t planned for pandemics before, started compiling protocols for a large-scale outbreak, including contingency plans for vaccines.
  • At a dinner back in the U.S., he remembers one guest saying, “Oh, you really needed to have someone in the U.S. to be impacted to really galvanize the government.”
  • That “drove home the reality in my own mind of globalization,” said Dr. Fukuda. SARS showed that viruses can crisscross the globe by plane in hours, making a local epidemic much more dangerous.
  • The WHO’s director-general, Gro Harlem Brundtland, publicly criticized China. The government under new leaders reversed course. It implemented draconian quarantines and sanitized cities, including a reported 80 million people enlisted to clean streets in Guangdong.
  • By May 2003, the number of new SARS cases was dwindling. It infected around 8,000 people world-wide, killing nearly 10%.
  • After SARS, China expanded epidemiologist training and increased budgets for new laboratories. It started working more closely in public health with the U.S., the world’s leader. The U.S. CDC opened an office in Beijing to share expertise and make sure coverups never happened again. U.S. CDC officials visiting a new China CDC campus planted a friendship tree.
  • In Washington in 2005, a powerful player started driving U.S. efforts to become more prepared. President George W. Bush had read author John M. Barry’s “The Great Influenza,” a history of the 1918 flu pandemic
  • Mr. Bush leaned toward the group of 10 or so officials and said, “I want to see a plan,” according to Dr. Venkayya. “He had been asking questions and not getting answers,” recalled Dr. Venkayya, now president of Takeda Pharmaceutical Co. ’s global vaccine business unit. “He wanted people to see this as a national threat.”
  • Mr. Bush launched the strategy in November, and Congress approved $6.1 billion in one-time funding.
  • The CDC began exercises enacting pandemic scenarios and expanded research. The government created the Biomedical Advanced Research and Development Authority to fund companies to develop diagnostics, drugs and vaccines.
  • A team of researchers also dug into archives of the 1918 pandemic to develop guidelines for mitigating the spread when vaccines aren’t available. The tactics included social distancing, canceling large public gatherings and closing schools—steps adopted this year when Covid-19 struck, though at the time they didn’t include wide-scale lockdowns.
  • A year after the plan was released, a progress report called for more real-time disease surveillance and preparations for a medical surge to care for large numbers of patients, and stressed strong, coordinated federal planning.
  • A European vaccine makers’ association said its members had spent around $4 billion on pandemic vaccine research and manufacturing adjustments by 2008.
  • The $6.1 billion Congress appropriated for Mr. Bush’s pandemic plan was spent mostly to make and stockpile medicines and flu vaccines and to train public-health department staff. The money wasn’t renewed. “The reality is that for any leader it’s really hard to maintain a focus on low-probability high-consequence events, particularly in the health arena,” Dr. Venkayya said.
  • In the U.S., President Barack Obama’s administration put Mr. Bush’s new plan into action for the first time. By mid-June, swine flu, as it was dubbed, had jumped to 74 countries. The WHO officially labeled it a pandemic, despite some evidence suggesting the sickness was pretty mild in most people.
  • That put in motion a host of measures, including some “sleeping” contracts with pharmaceutical companies to begin vaccine manufacturing—contracts that countries like the United Kingdom had negotiated ahead of time so they wouldn’t have to scramble during an outbreak.
  • In August, a panel of scientific advisers to Mr. Obama published a scenario in which as many as 120 million Americans, 40% of the population, could be infected that year, and up to 90,000 people could die.
  • H1N1 turned out to be much milder. Although it eventually infected more than 60 million Americans, it killed less than 13,000. In Europe, fewer than 5,000 deaths were reported.
  • The WHO came under fire for labeling the outbreak a pandemic too soon. European lawmakers, health professionals and others suggested the organization may have been pressured by the pharmaceutical industry.
  • France ordered 94 million doses, but had logged only 1,334 serious cases and 312 deaths as of April 2010. It managed to cancel 50 million doses and sell some to other countries, but it was still stuck with a €365 million tab, or about $520 million at the time, and 25 million extra doses.
  • The WHO had raised scares for SARS, mad-cow disease, bird flu and now swine flu, and it had been wrong each time, said Paul Flynn, a member of the Council of Europe’s Parliamentary Assembly and a British lawmaker, at a 2010 health committee hearing in Strasbourg.
  • Ultimately, an investigation by the council’s committee accused the WHO and public-health officials of jumping the gun, wasting money, provoking “unjustified fear” among Europeans and creating risks through vaccines and medications that might not have been sufficiently tested.
  • “I thought you might have uttered a word of regret or an apology,” Mr. Flynn told Dr. Fukuda, who as a representative of the WHO had been called to testify.
  • Back in Washington, scientist Dennis Carroll, at the U.S. Agency for International Development, was also convinced that flu wasn’t the only major pandemic threat. In early 2008, Dr. Carroll was intrigued by Dr. Daszak’s newly published research that said viruses from wildlife were a growing threat, and would emerge most frequently where development was bringing people closer to animals.
  • If most of these viruses spilled over to humans in just a few places, including southern China, USAID could more easily fund an early warning system.
  • “You didn’t have to look everywhere,” he said he realized. “You could target certain places.” He launched a new USAID effort focused on emerging pandemic threats. One program called Predict had funding of about $20 million a year to identify pathogens in wildlife that have the potential to infect people.
  • Drs. Daszak, Shi and Wang, supported by funds from Predict, the NIH and China, shifted their focus to Yunnan, a relatively wild and mountainous province that borders Myanmar, Laos and Vietnam.
  • One key discovery: a coronavirus resembling SARS that lab tests showed could infect human cells. It was the first proof that SARS-like coronaviruses circulating in southern China could hop from bats to people. The scientists warned of their findings in a study published in the journal Nature in 2013.
  • Evidence grew that showed people in the area were being exposed to coronaviruses. One survey turned up hundreds of villagers who said they recently showed symptoms such as trouble breathing and a fever, suggesting a possible viral infection.
  • Over the next several years, governments in the U.S. and elsewhere found themselves constantly on the defensive from global viral outbreaks. Time and again, preparedness plans proved insufficient. One, which started sickening people in Saudi Arabia and nearby
  • On a weekend morning in January 2013, more than a dozen senior Obama administration officials met in a basement family room in the suburban home of a senior National Security Council official. They were brainstorming how to help other countries upgrade their epidemic response capabilities, fueled by bagels and coffee. Emerging disease threats were growing, yet more than 80% of the world’s countries hadn’t met a 2012 International Health Regulations deadline to be able to detect and respond to epidemics.
  • The session led to the Global Health Security Agenda, launched by the U.S., the WHO and about 30 partners in early 2014, to help nations improve their capabilities within five years.
  • Money was tight. The U.S. was recovering from the 2008-09 financial crisis, and federal funding to help U.S. states and cities prepare and train for health emergencies was declining. Public-health departments had cut thousands of jobs, and outdated data systems weren’t replaced.
  • “It was a Hail Mary pass,” said Tom Frieden, who was director of the CDC from 2009 to 2017 and a force behind the creation of the GHSA. “We didn’t have any money.”
  • At the WHO, Dr. Fukuda was in charge of health security. When the Ebola outbreak was found in March 2014, he and his colleagues were already stretched, after budget cuts and amid other crises.
  • The United Nations created a special Ebola response mission that assumed the role normally played by the WHO. Mr. Obama sent the U.S. military to Liberia, underscoring the inability of international organizations to fully handle the problem.
  • It took the WHO until August to raise an international alarm about Ebola. By then, the epidemic was raging. It would become the largest Ebola epidemic in history, with at least 28,600 people infected, and more than 11,300 dead in 10 countries. The largest outbreak before that, in Uganda, had involved 425 cases.
  • Congress passed a $5.4 billion package in supplemental funds over five years, with about $1 billion going to the GHSA. The flood of money, along with aggressive contact tracing and other steps, helped bring the epidemic to a halt, though it took until mid-2016.
  • Global health experts and authorities called for changes at the WHO to strengthen epidemic response, and it created an emergencies program. The National Security Council warned that globalization and population growth “will lead to more pandemics,” and called for the U.S. to do more.
  • r. Carroll of USAID, who had visited West Africa during the crisis, and saw some health workers wrap themselves in garbage bags for protection, started conceiving of a Global Virome Project, to detect and sequence all the unknown viral species in mammals and avian populations on the planet.
  • Billionaire Bill Gates warned in a TED talk that an infectious disease pandemic posed a greater threat to the world than nuclear war, and urged world leaders to invest more in preparing for one. The Bill & Melinda Gates Foundation helped form a new initiative to finance vaccines for emerging infections, the Coalition for Epidemic Preparedness Innovations.
  • Congress established a permanent Infectious Diseases Rapid Response Fund for the CDC in fiscal 2019, with $50 million for that year and $85 million in fiscal 2020.
  • In May 2018, John Bolton, then President Trump’s national security adviser, dismantled an NSC unit that had focused on global health security and biodefense, with staff going to other units. The senior director of the unit left.
  • It pushed emerging disease threats down one level in the NSC hierarchy, making pandemics compete for attention with issues such as North Korea, said Beth Cameron, a previous senior director of the unit. She is now vice president for global biological policy and programs at the Nuclear Threat Initiative.
  • Deteriorating relations with China reduced Washington’s activities there just as researchers were becoming more certain of the threat from coronaviruses.
  • Dr. Carroll had earlier been ordered to suspend his emerging pandemic threats program in China.
  • Dr. Carroll pitched to USAID his Global Virome Project. USAID wasn’t interested, he said. He left USAID last year. A meeting that Dr. Carroll planned for last August with the Chinese CDC and Chinese Academy of Sciences to form a Chinese National Virome Project was postponed due to a bureaucratic hang-up. Plans to meet are now on hold, due to Covid-19.
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Newly Vigilant, U.S. Is to Screen Fliers for Ebola - 0 views

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    Health Officials have finally taken Ebola precautions by checking passengers for high temperatures before boarding the plane. If they have a temperature the person will be taken to a Center for Disease Control and Prevention and from there it will be up to the officials to decide whether or not to quarantined. However this has caused problems for health departments across the nation
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What the Ebola Crisis Reveals About Culture - NYTimes.com - 0 views

  • the critics misunderstand what’s going on here. Fear isn’t only a function of risk; it’s a function of isolation. We live in a society almost perfectly suited for contagions of hysteria and overreaction.
  • we’re living in a segmented society. Over the past few decades we’ve seen a pervasive increase in the gaps between different social classes. People are much less likely to marry across social class, or to join a club and befriend people across social class.
  • That means there are many more people who feel completely alienated from the leadership class of this country, whether it’s the political, cultural or scientific leadership. They don’t know people in authority. They perceive a vast status gap between themselves and people in authority. They may harbor feelings of intellectual inferiority toward people in authority. It becomes easy to wave away the whole lot of them,
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  • Second, you’ve got a large group of people who are bone-deep suspicious of globalization, what it does to their jobs and their communities.
  • You get the rise of the anti-science folks, who distrust the realm of far-off studies and prefer anecdotes from friends to data about populations.
  • So you get the rise of the anti-vaccine parents
  • Third, you’ve got the culture of instant news. It’s a weird phenomenon of the media age that, except in extreme circumstances, it is a lot scarier to follow an event on TV than it is to actually be there covering it.
  • Fourth, you’ve got our culture’s tendency to distance itself from death.
  • “In every calm and reasonable person there is a hidden second person scared witless about death.” In cultures where death is more present, or at least dealt with more commonly, people are more familiar with that second person, and people can think a bit more clearly about risks of death in any given moment.
  • The Ebola crisis has aroused its own flavor of fear.
  • It’s a sour, existential fear. It’s a fear you feel when the whole environment seems hostile, when the things that are supposed to keep you safe, like national borders and national authorities, seem porous and ineffective, when some menace is hard to understand.
  • In these circumstances, skepticism about authority turns into corrosive cynicism. People seek to build walls, to pull in the circle of trust. They become afraid. Fear, of course, breeds fear.
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Step One to Fighting Ebola? Start with Corruption - 0 views

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    The story of the current Ebola pandemic appears still in its opening chapter. Will the virus be contained, or will it spread its horror across Africa and beyond? The question is being raised around many family tables, including ours, particularly as my wife and I and our three small children, New Yorkers, live in Rwanda where I work in public health and she operates a job training program and a gourmet restaurant.
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Zika virus tied to birth defects is international emergency, WHO says | Reuters - 0 views

  • The World Health Organization on Monday declared the mosquito-borne Zika virus an international public health emergency due to its link to thousands of birth defects in Brazil, as the U.N. agency sought to build a global response to the threat.
  • WHO Director-General Margaret Chan told reporters that coordinated international action was needed to improve detection and expedite work on a vaccine and better diagnostics for the disease, but said curbs on travel or trade were not necessary.
  • The WHO said last week the Zika virus, transmitted by the bite of the Aedes aegypti mosquito, was "spreading explosively" and could infect as many as 4 million people in the Americas. The Pan American Health Organization says Zika has spread in 24 nations and territories in the Americas.
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  • Chan, whose agency was assailed as too slow in reacting to West Africa's Ebola epidemic that killed more than 10,000 people in the past two years, cited "first and foremost the big concern about microcephaly," the birth defect that causes babies to be born with abnormally small heads and improperly developed brains.
  • U.S. Centers for Disease Control and Prevention (CDC) head Thomas Frieden said the WHO emergency declaration "calls the world to action" on Zika. The CDC added four more countries and territories to its list of locales that pose a risk for Zika infection, advising pregnant women to consider avoiding travel to those areas.
  • Brazil is due to host the Olympics in Rio de Janeiro in August, and President Dilma Rousseff's chief of staff said on Monday there is no risk of cancelling the games due to Zika.
  • The emergency designation, recommended by a committee of independent experts following criticism of a hesitant response to Zika so far, should help fast-track international action and research priorities. The move lends official urgency to research funding and other steps to stem the spread of the virus.
  • This marks the fourth time the WHO has declared a global health emergency since such procedures were put in place in 2007, with the others arising from influenza, Ebola and polio.
  • The Zika virus has raised questions worldwide about whether pregnant women should avoid infected countries. Chan said delaying travel was something pregnant women "can consider" but added that if they needed to travel they should take protective measures by covering up and using mosquito repellent.
  • Brazil has reported some 3,700 suspected cases of microcephaly. Brazilian Health Minister Marcelo Castro told Reuters the epidemic was worse than believed because in 80 percent of cases the infected people had no symptoms.
  • As the virus spreads from Brazil, other countries in the Americas are also likely to see cases of babies with Zika-linked birth defects, experts believe. The clinical symptoms of Zika are usually mild and often similar to dengue, which is transmitted by the same mosquito, leading to fears that Zika will spread into all parts of the world where dengue is commonplace.
  • More than a third of the world’s population lives in areas at risk of dengue infection, in a band stretching through Africa, India, Southeast Asia and Latin America.Zika's rapid spread in Latin America is attributed to the prevalence of Aedes aegypti and a lack of immunity among the population.
  • A senior Obama administration official, speaking on condition of anonymity, said, "This is not an Ebola-type situation where you have to stop people at the border."
  • New York State Governor Andrew Cuomo said the state's health department would offer free tests for individuals with symptoms of infection who have traveled to countries impacted by Zika.
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Burkina Faso Begins 3 Days of Mourning After Al-Qaida Attack - The New York Times - 0 views

  • Burkina Faso Begins 3 Days of Mourning After Al-Qaida Attack
  • OUAGADOUGOU, Burkina Faso — Burkina Faso began three days of national mourning Sunday and the president said security would be stepped up in the capital and the country's borders after al-Qaida militants killed at least 28 people in an attack on a hotel and cafe popular with foreigners.
  • people of Burkina Faso must unite in the fight against terrorism. He also announced on the national broadcaster,
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  • "These truly barbaric criminal acts carried out against innocent people, claimed by the criminal organization al-Qaida in the Islamic Maghreb (AQIM) seek to destabilize our country and its republican institutions, and to undermine efforts to build a democratic, quiet and prosperous nation,"
  • The national mourning began Sunday, a day after Burkinabe and French forces ended a more than 12-hour siege at the upscale Splendid Hotel in downtown Ouagadougou
  • White House National Security Council Spokesperson Ned Price said Riddering "had devoted his life to working with the Burkinabe people" in a statement strongly condemning the recent terrorist attacks in Burkina Faso and mourning those killed "in these senseless acts of violence."
  • "During the Ebola crisis, when it was hard to find people to do the digging, Mike would go out and join them so they could continue doing the work,"
  • Swiss authorities said its two nationals who were killed were also in Burkina Faso for humanitarian reasons.
  • The al-Qaida group claiming responsibility for the carnage released an audio tape titled: "A Message Signed with Blood and Body Parts."
  • The attack, which began around 7:30 p.m. Friday, was the first of its kind in Burkina Faso, a largely Muslim country that had managed to avoid the kinds of jihadist attack
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