Shadow Government

Three Lessons the White House Should Learn from the Ebola Outbreak

We are pleased to welcome Michael Miller to the Shadow Government team -- and just in time.  With the headlines talking about pandemic scares and health screening of VIPs visiting the White House, it is obvious that health matters have profound implications for foreign policy and vice-versa.  Michael has just the right background and perspective to make sense of these issues and to help our leaders manage them more wisely. Welcome aboard.

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The news coverage of the Ebola outbreak in West Africa has left Americans reasonably unsure whether the threat is real or hype. In fact, it is both. The outbreak's startling spread and high mortality rate is indeed a real crisis, but it is unlikely to pose a serious threat to Americans at home. Stark differences in natural, cultural, and capacity factors between West Africa and the United States, and the way the virus is transmitted among humans make it extremely unlikely that the United States will face the kind of crisis that has swept through Guinea, Sierra Leone, and Liberia.

The low likelihood of a serious threat to us from Ebola, however, does not mean we should be unconcerned. Though the story is becoming part of a hype-and-fizzle news cycle that contributes to dangerous complacency and even cynicism about the very real threat of a global pandemic, such as from H5N1 influenza ("bird flu" or "avian flu") that could mutate and become readily transmissible among humans, it still carries important lessons.

Like bird flu, Ebola is an animal virus whose novelty among humans makes it highly pathogenic. But Ebola is spread only through direct contact with body fluids of an infected person, and a person directly exposed to Ebola is not contagious if he or she shows no symptoms, which makes travel possible and screening and response relatively straightforward, if admittedly challenging, for competent authorities.

By contrast, a traveler infected with a mutated bird flu could be asymptomatic yet contagious for days, giving no indication of the acute public-health threat they represent and rendering global point-of-entry-focused security measures dangerously ineffective. This scenario is the most common one discussed regarding a potential global pandemic -- it's not far-fetched and should be added to the growing list of things that keep a president up at night.

For its part, the Obama administration has responded to Ebola appropriately thus far, and has not treated the situation as a crisis it shouldn't waste. That said, a bit of "good crisis" thinking is perhaps in order to improve our ability to prepare for and respond to a future pandemic threat. Instead of allowing the "lessons learned" process around Ebola to default to a recommendation to simply spend more money -- a typical Washington impulse -- this crisis should be an opportunity to also honestly examine potential systemic weaknesses and advance policies that could be the difference between life and death for millions of people.

First, the White House should provide clarity about roles and responsibilities among U.S. government departments and agencies involved in health-security, both at home and abroad. Earlier this year the administration unveiled a Global Health Security agenda that sets the right tone and goals, but at least publicly is unclear about authorities, responsibilities, and accountability. In this case, the National Security Council (NSC) process of interagency refereeing and policy development cannot suffice for clearly established authorities and responsibilities at the department and agency level. A lack of clarity in this case can be dangerous, and someone has to be in charge and accountable to the public. There is no room for considerations of fairness or equity among agencies, and parochial rivalries should be dealt with forcefully.

Second, if ever there's an area in which the United Nations system should work, it is to address global public-health threats. The World Health Organization (WHO) is bloated, politicized, and inconsistent in fulfilling its essential role. It is impossible to see how the necessary reforms could ever happen in the absence of forceful U.S. leadership. The president and his new secretary of health and human services have a sometimes-willing reform partner in current WHO leadership, and they should exploit the opening as fully as possible.

Third, the president should use this opening to champion the International Health Regulations (IHRs) and explain importance of these un-sexy, "one world"-sounding commitments that spell out countries' obligations to each other on health-security. Adoption and adherence is voluntary, and the entire system is only as strong as the weakest links. It should be no surprise that three of those weak links are now battling Ebola. Now that the agenda for this week's U.S.-Africa Leaders Summit has been overshadowed by Ebola, the president should direct the discussion toward an honest assessment of the failures around the outbreak, why adherence to the IHRs could make a difference, and how and under what circumstance we can help.

In cases of "lessons learned," the default course for government tends to be one that leads only to a plea for more spending -- doing something different will take a commitment of effort and discipline that seem in short supply in Washington these days. By using the Ebola crisis as an opening for honest evaluation and real reforms, the president has the chance to address some critical deficiencies in our government and the weak global health-security system upon which we all depend.

Michael Miller is a Washington, D.C.-based consultant and an adjunct associate professor at the Duke Global Health Institute. Previously, he was Republican Policy Director at the Senate Foreign Relations Committee, and served as senior advisor in the office of the secretary of health and human services, deputy assistant administrator for global health at USAID, and director for Africa at the National Security Council.

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Shadow Government

Obama's Faulty Logic on Gaza Is Going to Hurt U.S. Standing All Across the Middle East

As Israel seeks to end Hamas's latest war against it, the Obama administration flounders. In fact, the response of the president and his secretary of state has made the situation positively worse with regard to every relationship we have in the region. Opponents of terrorism and supporters of Israel struggle to understand the administration's approach. Is it incompetence, or a continuation of this president's determination always to be above the fray -- as though the United States' only legitimate role is to midwife peace at any price rather than pursue policies that benefit it and its allies while defeating our enemies? A brief look at the actions in this conflict clarifies the question, even if it doesn't answer it.

Start with the facts: Whatever one thinks about Israel's overall actions vis-à-vis the Palestinians over the decades, Hamas has chosen to launch yet another illegal war by attacking Israeli citizens. No credible case in international law can be made for Hamas's rocket attacks on Tel Aviv and other Israeli cities. Hamas is in the position it is in now because, unlike the Palestinian Authority in the West Bank under Mahmoud Abbas, it remains a terrorist organization supported by Iran. Having gained some political power via the ballot box in 2006, it then launched a coup in 2007 to get all of the power in Gaza and keep it forever. Its refusal to recognize Israel and lay down its weapons (at the insistence of every legitimate actor in the world) makes it a pariah, an enemy of the peace. In short, it is an outlaw regime and organization.

Israel, on the other hand, is a democratic nation-state, a member of the United Nations (for all the good that does Israel), and a willing participant in countless efforts to establish peace. It not only has acceded to the Abbas government's political authority over the West Bank but it has even aided and supported it. In short, it is a member of the community of democratic states and a highly successful economic power even though it has to fight every day for its existence, surrounded as it is by hostile states and groups who would eliminate it from the map.

It should not be difficult for any U.S. administration to tell the good guys from the bad guys, nor to understand who our allies are and where our interests lie.

In fact, it is so clear to others that the Egyptian, Saudi, and Jordanian governments are in a de facto alliance with Israel in this current conflict, working to oppose Hamas and its supporter, Iran, even if they are not thrilled to be in this position. On the other side are Iran, Turkey, and the Qatari regime that has actively aided Hamas for years.

But tragically, the Obama administration's actions and assertions reveal it does not understand where U.S. interests lie or how to achieve them. Secretary Kerry and the president have repeated ad nauseam a non sequitur that amounts to the following: "Israel's civilians are being attacked by Hamas and Israel has a right to defend itself; therefore, both sides should show restraint and agree to a cease fire so that civilian lives can be saved." Some form of this mantra is repeated so often that we tend to overlook how meaningless it is because the assumptions that underlie the first clause make the last clause absurd.

We know from the context of this assertion that the administration, in its desire to end the killing, is acknowledging that Israel did not start the fight and that Hamas's actions are war crimes (no proper casus belli, targeting Israeli civilians and using Gazan civilians as shields). But by the end of the assertion the administration is treating both combatants as equally to blame for the war generally and for the deaths of civilians specifically, as though they each have to stop doing a bad thing and start doing a good thing so that the right state of affairs can be produced. But the right state of affairs the United States should seek is not for Hamas yet again to get away with an attack on Israeli civilians and to create conditions for Palestinian civilians to be killed. The right state of affairs is that Hamas is punished to the point of being militarily neutered, Israeli civilians are no longer threatened by tunnels and rockets, and Palestinian civilians are no longer human shields for Hamas. And that state of affairs is not achieved by the administration's call for a ceasefire, which is simply a punt. And we've had too many of those over the decades.

Last weekend, the illogical position fell to pieces when Hamas broke the fifth ceasefire by using tunnels and rockets to continue attacking Israel before the ceasefire was even two hours old. It was cringe-inducing to watch Dan Shapiro, U.S. Ambassador to Israel, tell Wolf Blitzer on Sunday that the U.S. call for a ceasefire had been a way stop the tunnel and rocket attacks. Even if one accepts the U.S. position that the terms of the U.S.-backed ceasefire meant Israel could continue to destroy the tunnels, it does not follow that Hamas's rocket caches were no longer an issue; rocket caches do not disappear at the declaration of a ceasefire. That was made clear when Hamas used them 90 minutes into last weekend's truce. At that point, Prime Minister Benjamin Netanyahu told the Obama administration "not to ever second-guess me again" on Hamas, having had all the illogical diplomacy he could stomach.

Why does the administration do this? To remain in favor with polite opinion in Europe and at the U.N.? To desperately reach an accord and be the hero? To prove that the United States' proper role is mediator and diplomatic grandee? Or is the administration in thrall to some misguided notion that to save its negotiations with Iran over its nuclear weapons program the United States can't help deliver a deathblow to Iran's proxy in Gaza? It certainly does not follow its chosen path if it is trying to support our allies and defeat our enemies. Maybe it thinks that U.S. interests are found in reprising the British role of "perfidious Albion," but the world doesn't work that way anymore. The Obama administration is wrong; the world needs a leader who pursues peace by supporting the good guys and defeating, or at least vexing, the bad guys. It does not need policies and diplomacy that amount to a boon for Iran and other U.S. enemies while discouraging friends and harming our alliances.

Even the Washington Post, loathe to criticize the president, sees blundering in the administration's efforts. And in the U.S. government, only the Congress is getting it right, in bipartisan fashion. It has chosen sides clearly. Thank heaven it can achieve unity and pursue U.S. interests in this, even if it can't on other issues.

GIL COHEN MAGEN/AFP/Getty Images