June 18, 2019
Sheraton Four Points
Nairobi, Kenya

MR. BABINGTON: So, we'll kick things off. Thanks, first of all, everyone, for joining us this morning. We're kind of in the middle of our Africa trip. The Administrator's been to Eastern DRC, Rwanda -- yesterday, we returned from Somalia, and later today, we're off to Mozambique. But, wanted to use this time to just chat a little bit about some of his observations in the Eastern DRC, where he was over the weekend, and then, open it up for Q and A. So, maybe before we do that, if you just want to tell us who you are and what outlet you're working for.

REPORTER: Sure. My name's Sara Jerving; I'm a reporter with Devex.

REPORTER: My name is Omar Mohammed. I'm with Reuters here, in Nairobi.

REPORTER: My name is Moses, I'm with AP.

REPORTER: My name is Khalil, I'm with AP.

ADMINISTRATOR GREEN: Thanks. Thanks for taking time, thanks for coming this morning. As Tom just mentioned, we're in the middle of an extensive Africa trip. Kenya's always particularly fun for me to visit. I lived here at one time; 30 years ago, I was a teacher in western Kenya. It's changed a little bit in 30 years, but nonetheless, it's always enjoyable to come back and have a chance to reconnect with the wonderful people of Kenya. This past weekend, I visited the cities of Goma, Butembo, and Katwa, in North Kivu province of the DRC. I had a chance to meet with healthcare workers at an Ebola Treatment Unit in Katwa, community and local leaders at the Emergency Operations Center in Butembo, and representatives of the NGO community.

Additionally, I have with me here today one of my staff, Sonali Korde, who -- this is actually her second trip to the region in a rather short period of time. She visited Butembo about a month ago. And so, she brought the additional perspective of time and change.

From our perspective, even though the WHO has not declared a public health emergency, it is very clear to me that this is a development emergency. As we all know, a deadly virus has struck a region of Africa that was already besieged over the years by a number of failures -- failures in development, a failure of democracy, and a failure of governance. And, this is a combustible, deadly mix. And I think, going forward, a number of things will need to happen.

First, I'm very pleased that the UN has responded to the donor community's call for a reset, and appointed David Gressly, a veteran of many crises, to lead the Ebola response in DRC. One of the most important things that we've heard from him, and had a very good discussion with him -- he said that, given all that he has seen in DRC and seen in other crises zones, there was nothing that he saw that was insurmountable. And, I agree with that optimistic assessment. And, I believe that as we move forward, when more order is brought to what has been a chaotic situation, I think that we will see progress. Steps need to be taken, but I believe they are steps that we can take.

Second, with over 2,168 cases and over 1,400 deaths, we need to turn distrust in the community, which has been well-reported by many of you, into an asset. We need to turn it into a community-based response. We need a response that engages all parts of the community not only to tackle the virus, but to rebuild the institutions that will be necessary so as not to leave the area vulnerable again for the next shock which could come its way. This includes a commitment to transparently communicating to the community all aspects of the response, from testing and treatment to finances and hiring.

And, there is no reason for information to be withheld from the community at all. We want to see a continued and deepening engagement, and utilization of the NGO and faith-based community actors who, as they pointed out to us -- they have been there for years, and they will continue to be there, partnering with local leaders, long after everybody else has left.

We need to see vaccines deployed more broadly, and we need to see an application of the latest recommendations in that regard. And, we need to see an effective approach to addressing security concerns in the region, and that needs to be done without militarizing the response, which will only further alienate the local community.

It was interesting to me that almost everyone that we spoke to, when they asked -- when we asked them what the biggest problem was, they would say, "security." And, you realized that "security" was a very broad term in their minds, that covered the obvious: the prevention of violence and conflict, to also taking steps towards eliminating distrust. They saw that as questions of security as well.

Third, the cases in Uganda clearly heightened the urgency to bolster Ebola preparedness efforts regionally and in Goma. There is room for improvement in real-time communication, coordination, and data-sharing, not just in DRC, but regionally. We have -- the United States government made a number of investments, along with other partners, in building preparedness systems. Those investments have been sound investments, and those investments need to continue.

Obviously, the crisis is far from over. I will have a few more announcements in coming weeks, as it relates to USAID's response efforts. But, this is obviously an important matter, and I am truly grateful to have had the opportunity to visit the places that I did. So, in summary, I agree with David Gressly when he said that with all of the challenges -- and there are many -- there is nothing that is insurmountable. But, in order to take advantage of the openings that are there, to make real progress towards containing and eliminating the outbreak, there are steps that we need to do in close coordination with local actors from all parts of the community. And, I'm confident that those steps will be taken. And again, we will have some more concrete announcements in coming days, as early as next week. So, with that, I'd be happy to address any questions that you might have.

MR. BABINGTON: Sarah.

REPORTER: Yeah, actually, I'm wanting to start off first with a question about the move of the permanent Mission to Mogadishu. So, the Somali central government has been criticized for its kind of dismissive attitude towards other member states, including concerns on how foreign aid is spent and allocated. So, the U.S. government is considered a supporter of a strong, centralized approach in Somalia. There are concerns that moving the USAID office to Mogadishu, as kind of a symbolic act, will encourage this dismissive attitude, and give it more control -- give the central government more control over allocation of U.S. funds. Can you respond to these concerns, and --

ADMINISTRATOR GREEN: Sure.

REPORTER: -- will the U.S. be putting effort into mending the ties between the central government and (inaudible) member states?

ADMINISTRATOR GREEN: First off, no foreign government controls the allocation of U.S. funds -- first and foremost. Secondly, I am thrilled that we've reopened a Mission after nearly 30 years away. We took that step because we are seeing signs of a real commitment by the new government in Somalia, to undertake the kinds of reforms that we believe will be necessary in the long run to achieve the progress that we all want to see. And, first and foremost, that's why we've taken that step.

Secondly, we've made clear a key step towards self-reliance and realizing Somalia's potential is for the government to achieve the reforms it needs to achieve to receive debt relief. And, a big part of that is making sure that they are connected with, working with, listening to, and partnering with, the external governments. So, that it is not simply something managed from Mogadishu, but there is ongoing communication and partnership and coordination. So, that we have a government that represents not really one part of the country, but the entire country. And, the Prime Minister made very clear to us that he is committed to that, and we spoke with one of his Ministers who has been, as he put it, "always in motion." And so, I think that that's very important. We agree with that, that it is very important.

But Somalia has, we think, a good opportunity, and we look forward to walking shoulder-to-shoulder with them to help them achieve those reforms that will be necessary to rise and undo, obviously, years of challenge and violence and distrust.

REPORTER: Hi, I have a question about the level of preparedness in some of the countries that you went to, with regards to Ebola. If a situation, like what happened in Uganda last week, were to have been, let's say, in South Sudan. How prepared is USAID, do you think, to deal with that challenge?

ADMINISTRATOR GREEN: Well, first, a few thoughts -- I'm not sure I can comment on the details of preparation in any given country other than where I've visited. However, what I can say is that the U.S. Government, USAID, CDC -- all of us who are involved in helping to strengthen health systems -- we have been working with local government leaders on preparedness not just for Ebola, but for other health challenges. In our model of assistance, we hope to help countries undertake the reforms and build the institutions needed to take on their own health challenges, all the while walking with them along the way.

We all recognize that the scourge of Ebola, a deadly virus -- when it emerges in a setting that has had years of conflict, distrust, lack of citizen responsiveness, and fragmentation, is an extraordinary challenge. And, we must remember that this recent outbreak in DRC is not the only outbreak of Ebola, but it is a virus that emerged in a very complicated setting at a very complicated point in the country's history. All of those forces combined, I think, to bring us to the terrible situation that we're in, in terms of loss of life and damage.

But, those are things that can be fixed, they must be fixed, and I am pleased to hear from David Gressly and others who have been responding to U.S. Government calls for a reset -- U.S. Government, as well as our partners, particularly the British -- those are encouraging. Again, we are a long way away from saying that this outbreak is entirely contained, but there are some positive signs. And again, I think the appointment of David Gressly is a positive sign, and Sonali can comment more to it, but in the roughly 30 days in between her visits, she saw that as signs of some progress.

MS. KORDE: Yes, that's correct. I think the appointment of David Gressly as the head -- definitely has been a very positive development. And, what we heard from others in the community and from the NGOs seemed to reflect that fact, as well. I'll also just say that USAID has been investing, and we've been working with partners in South Sudan, on Ebola preparedness efforts, as well. Those have been ongoing.

REPORTER: I'm wondering if you can further elaborate on kind of what the difference between the global emergency and the development emergency is, kind of, from your perspective? And kind of, how would the declaration of a global emergency have changed USAID's work on the ground, and at what point should the WHO --

ADMINISTRATOR GREEN: Hold on. I'm not a medical doctor. I'm the son of a medical doctor. That doesn't give me much qualification. Again, what I can comment on is -- as a development guy who started off in East Africa 30 years ago -- it is very clear in DRC that decades of damage have been done. You have people who are impoverished, who have lost faith in institutions, who see outsiders coming in as -- in some cases, they see them as being more concerned about the virus than they are about them. Those are bad things. The way that you defeat this deadly virus is to harness the strength, the connections, and the spirit of every part of the community. Every part of the community is affected, every part of the community must be in the response, and that is, to me, the most important thing.

In DRC, we have work to do. We have to undo some of the damage and distrust that has built up over the years. I think we need to make the kinds of investments that make clear that there is hope, from a development perspective. And, I think we also have to redouble our efforts to demystify Ebola. One thing that I saw at the emergency treatment unit, which I was pleased with -- and understand, I've not been to an Ebola treatment unit before, so I have limited comparisons. But, in every step in the process, the tarped-off area that they were using, they used clear panels, so that people saw those who were in, from being tested to -- at least, in one case that I saw, a gentleman who had tested positive, which is, obviously, a difficult thing. And yet, the community and his family could at least come and see that he was being cared for respectfully, and as comfortably as possible.

Those kinds of steps, which may be small from a technical standpoint, are extraordinarily important from a community standpoint. Remember that in the earliest days of this outbreak, we all heard of rumors running around the place about Ebola, and other terms were tossed in. And a lack of information, a lack of trust, in those settings, is combustible. And, my opinion is that there should be completely transparent, regular reporting constantly, as to where resources are going, as to facilities that are enhanced or created, and the progress that is being made. There is no reason not to be sharing that information.

I know that when an outbreak occurs, it is a chaotic time often. And people are, sometimes, not so much panicked as harried and hurried. And you know, some of that is understandable, from a human nature perspective. But, turning to everyone in the community -- turning to elders, turning to institutions that are trusted, and being completely open and transparent is a step not to be bypassed. You know, we've seen, in taking on challenges from the AIDS pandemic, to even the more, quite frankly, common challenges of Malaria -- and I come from a Malaria background -- that progress was made, and success occurred, when it was completely transparent and everybody was involved. And, that needs to be the case here.

REPORTER: How can all of this be managed with also protecting aid workers on the ground, and what are the top concerns in terms of protection, as well as kind of what steps will USAID take?

ADMINISTRATOR GREEN: Well, again, I -- the facilities that I visited -- and I'll stick to those, because I have first-hand knowledge of those -- I was actually quite impressed with the steps that were -- had been taken. You know, the -- again, I sound like a broken record, but the most important part of that is being very open with people as to how Ebola is spread.

When someone who is confirmed to have Ebola, when they are contagious, being very clear on those steps, again, helps to demystify the response, and then the steps, the obvious steps, of disinfectant and such become more effective, because people understand why those steps are taken and when they're taken. So, as you can tell, I'm a big believer in taking a broad approach to an outbreak of Ebola. We know what to do medically.

We know precisely what to do medically. We have vaccines, and while it remains a deadly disease, we've also seen progress. When people report early, their chances of survival are better and better. People are often prevented from reporting early. Anger, distrust, lack of knowledge, conflict -- you have to take those problems on to allow this to be addressed effectively medically, and that's why we believe it is a development emergency certainly.

REPORTER: I'm sorry. I actually meant security in terms of armed militia.

ADMINISTRATOR GREEN: Oh. Well, there are a number of steps that need to be taken. I'm not fully qualified to answer all of that. But, again, when I take a look at insecurity, I think part of it does come from distrust, a distrust as to where resources are going and institutions who are being partnered with. Yes, clearly there are -- and I've heard various terms used, spoilers, and, again, these are terms that are used specifically in that setting. And, those are things to be concerned about. Anytime that healthcare facilities, in particular, are targeted, that obviously has -- any violence is bad. Any violence against individuals is bad, but when healthcare facilities are targeted such that a disruption in surveillance and treatment occurs, that is obviously exponentially worse.

MR. BABINGTON: We probably have time for one more question.

REPORTER: You talked about the reset with the UN. Is there any other areas that you think need to be reset in the Ebola response besides (inaudible) this issue of transparency?

ADMINISTRATOR GREEN: We'll have more announcements next week.

REPORTER: Okay.

ADMINISTRATOR GREEN: For me, the most important step that I've seen to date was the appointment of Gressly so that you have a focal point which is always the most important step. I think that was an enormously important step. I'd like to think that my visit and meeting with NGO leaders, elected and community leaders, as well as families that that, too, is an important part of building a comprehensive response. You know, at USAID we have a DART as we call it, Disaster Assistance Response Team, that has been deployed for a number of months. It may be deployed by USAID, but it is a cross U.S. Government team. Our close partners, the Centers for Disease Control, are a critical part of this in bringing to bear medical knowledge and experience, and that obviously will be a key part of the response as well.