United States – Nigeria Foreign Policy Regarding Spread of Disease

Nigeria is a country in Africa that has been through financial turmoil for many years.  The United States has developed many international agencies charged with protecting the health of citizens of other poor countries, particularly many nations in Africa.  Protecting the health of individuals in Africa and preventing and stopping epidemics from spreading, ultimately saves lives globally, including in the United States.  Epidemic infections in one place in the world can travel to many countries around the world due to the relative ease and affordability of international travel.

Outbreaks of communicable diseases occur on a daily basis all over the world.  The United States’ Global Disease Detection Program, a program of the Center for Disease Control and Prevention goal is to locate and stop global epidemic disease outbreaks.  The Global Disease Detection Program has offices in several countries around the world staffed with expert healthcare workers to monitor international health in real time, especially in countries that cannot or will not report such health emergencies, and assist by providing financial support for international health emergencies (Christian et al.). 

            Salmonella infections are a severe health problem in West Africa.  Although salmonella is a common bacterial infection in many countries around the world that usually only results in mild diarrhea, the invasive nontyphoidal salmonella causes fever and can lead to death if the infection is not treated (Uche et al.).  Nontyphoidal salmonella gastroenteritis comes from contact with animal or animal products, such as: eggs, chicken and other animals, contaminated produce and water, as well as contact with live animals and their habitats.  On the other hand, typhi and salmonella paratyphi are transmitted from person to person (Uche et al.).  Unfortunately, many Africans have risk factors that make them especially susceptible to salmonella infections, including HIV and malaria infections, malnutrition, anemia, as well as being young and/or living in a rural area (Uche et al.).  The vulnerable and weak in society in Nigeria are often dealt a second blow with salmonella or other infections on top of other pre-existing conditions.

            HIV and AIDS in Africa is a widely known problem that has affected many individuals and families in Nigeria.  In 2003, President George W. Bush enacted the President’s Emergency Plan for AIDS Relief, which gave $18 billion dollars to combat the AIDS epidemic, with a significant portion of support given to Africa (Katito).  The President’s Plan for AIDS Relief is noted as being the “ . . . largest international health initiative in history dedicated to a single disease . . . “, providing prevention and treatment services alike (Katito).  Unfortunately, the attention and resources dedicated to AIDS left the prevention of other diseases to become less of a priority (McCollum et al.). 

            West Africa militaries are an extremely important resource in diagnosing and treating communicable diseases to stop the spread of epidemics for military and civilians alike (McCollum et al.).  United States Africa Command was established to protect United States relations with 42 countries in Africa (Katito).  The United States Africa Command, United States Armed Forces, United States Department of Defense and United States Agency for International Development, along with military and health officials from Europe and Africa work together to stop the spread of deadly malaria in civilian and military populations (McCollum et al.).  While militaries use microscopes and other health testing to identify contagious diseases, many health agencies in Africa don’t have funds to purchase microscopes, pay for medical experts, nor necessarily have the basic electricity infrastructure needed to complete crucial testing (McCollum et al.)  This leaves many populations in Africa underserved and more susceptible to dangerous and possibly deadly infections.  Properly trained, staffed and supplied militaries can help alleviate this gap in medical care for the most needy.

According to an article in Military Medicine, there were approximately 627,000 deaths from malaria in 2012, a majority of which were children in Africa (McCollum et al.).  The United States President’s Malaria Initiative offers financial aid to militaries in other countries and is paramount for the effort to eradicate malaria in West Africa (McCollum et al.).  Recent preventative measures, including mosquito nets for beds, insecticides, and preventative healthcare for high risk individuals, including pregnant women and children have greatly decreased the casualty rate (McCollum et al.).  Military from the United States as well as other countries represent a unique high risk from contagious diseases, due to the nature of military travel, living conditions and lack of local immunity to malaria, and other disease as well as different strands of diseases (McCollum et al.). 

            The United States funded Preparedness and Response Project is geared to help other countries prevent and respond to disease outbreaks.  A priority of the United States Agency for International Development Preparedness and Response Project is to catch contagious diseases in animal populations before they can reach humans (Holton).  This tactic leads to many possible outbreaks of communicable diseases that are prevented before large scale outbreaks can occur (Holton).  The general public may never hear about these cases due to the fact that the epidemics are stopped before they could ever occur occurr, since they were eradicated in animals before they could reach human populations.

            When Ronald Reagan was president, he instituted what became known as the Global Gag Rule, which did not allow any United States Funding to go to any international agency or organization that performs, offers, or even mentions abortions in any way or for any reason (Flipovic), leaving desperate women in other nations that depend on United States financial support to obtain unsafe and often deadly abortions.  President Bill Clinton rescinded the Global Gag Rule when he was president and many Africans were able to receive appropriate medical care with United States assisting with funds.  When George W. Bush became president, he reinstated the Global Gag Rule.  President Barack Obama rescinded the Global Gag Rule a second time.  Women in Africa were again able to use family planning services and obtain legal and safe abortions.  On the fourth Day of President Donald Trump’s term, he not only reinstated the Global Gag Rule, but made it even more restrictive, essentially leaving millions of Africans without access to basic healthcare, including reproductive planning, HIV/AIDS care, and other healthcare that reduces deaths of mothers and young children, and others (Flipovic).  With millions of dollars of financial aid from the United States being stripped away from desperate healthcare facilities in Africa, many people in Africa will be more likely to contract contagious diseases, suffer, and die as a result of lack of treatment.  This Global Gag Rule needs to be permanently rescinded as it affects the mortality of countless Africans, which in turn affects all people of the world when it comes to contagious diseases and their spread.

The Obama administration promised over $175 million dollars, as well as about 3,000 United States military forces to help control, contain, and stop the ebola crisis in West Africa (“Fact”).  The United States Africa Command provided infrastructure in Africa to treat ebola, including providing transportation, needed supplies and workers (“Facts”).  There is even a special Department of Defense hospital designed specifically to help workers in the field of healthcare who become exposed or infected with diseases and need treatment (“Facts”).  The United States Agency for International Development partnered with Departments of State and Health and Human Services, the Centers for Control, the Department of Defense, and non-profits, as well as the United Nations, the World Health Organizations and many international organizations to get citizens in the community trained and to offer protection kits to families to help spread ebola (“Facts”).  The response to this communicable disease outbreak is the “largest international response in [the Centers for Disease Control] history” (“Facts”).

            A major problem in preventing the spread of disease, especially in remote and poor areas of West Africa is the amount of time it takes for an outbreak to occur, be discovered by medical professionals, and then to be communicated to the general public was an average of about 32 days total (Kluberg et al.).  Africa clearly needs more international assistance, as it has the highest number of disease outbreaks, takes the most time to discover illness, and also has the longest number of days (43) to communicate to the public (Kluberg).  Much more work needs to be done to help Nigeria strengthen the healthcare responses of disease outbreaks to keep them from becoming an international epidemic.

  

Works Cited

Christian, Kira A., et al. "What we are watching *five top global infectious disease threats, 2012: a perspective from CDC’s Global Disease Detection Operations Center." Emerging Health Threats, vol. 6, 2013, pp. 1-8. Academic Search Complete, doi:10.3402/ehtj.v6i0.20632. Accessed 1 July 2017.

"Fact Sheet: U.S. Response to the Ebola Epidemic in West Africa." Obama White House, The White House, 16 Sept. 2014, obamawhitehouse.archives.gov/the-press-office/2014/09/16/fact-sheet-us-response-ebola-epidemic-west-africa. Accessed 1 July 2017.

Filipovic, Jill. "Sin of Omission." Foreign Policy, no. 223, Mar.-Apr. 2017, pp. 50-61. Academic Search Complete, dcccd.idm.oclc.org/login?url=http://search.ebscohost.com.dcccd.idm.oclc.org/login.aspx?direct=true&db=a9h&AN=121697712&site=ehost-live. Accessed 3 July 2017.

Holton, Elizabeth. "Before the Spread: How the U.S. is Working to Stop the Next Ebola." U.S. Global Leadership Coalition, 7 Apr. 2017, www.usglc.org/2017/04/07/before-the-spread-how-the-u-s-is-working-to-stop-the-next-ebola/. Accessed 1 July 2017.

Katito, George. "Continuity, little change?: US-Africa policy under the Obama administration." OASIS - Observatorio de Análisis de los Sistemas Internacionales, no. 14, 2009, pp. 145-57. Academic Search Complete, dcccd.idm.oclc.org/login?url=http://search.ebscohost.com.dcccd.idm.oclc.org/login.aspx?direct=true&db=a9h&AN=60072453&site=ehost-live. Accessed 1 July 2017.

Kluberg, Sheryl A., et al. "Global Capacity for Emerging Infectious Disease Detection, 1996-2014." Emerging Infectious Diseases, vol. 22, no. 10, Oct. 2016, pp. e1-e9. Academic Search Complete, doi:10.3201/eid2210.151956. Accessed 1 July 2017.

McCollum, Jeffrey T., et al. "Strengthening Malaria Prevention and Control: Integrating West African Militaries’ Malaria Control Efforts. The Inaugural Meeting of the West African Malaria Task Force, April 24-26, 2013, Accra, Ghana." Military Medicine, vol. 180, no. 1, Jan. 2015, pp. 7-11. Academic Search Complete, doi:10.7205/MILMED-D-14-00406. Accessed 1 July 2017.

Uche, Ifeanyi Valentine, et al. "A Systematic Review of the Incidence, Risk Factors and Case Fatality Rates of Invasive Nontyphoidal Salmonella (iNTS) Disease in Africa (1966 to 2014)." PLoS Neglected Tropical Diseases, vol. 11, no. 1, 5 Jan. 2017, pp. 1-28. Academic Search Complete, doi:10.1371/journal.pntd.0005118. Accessed 3 July 2017.