August 19, 2019
Institut National de Recherche Biomédicale
Kinshasa, Democratic Republic of the Congo

MR. BABINGTON: All right.  So, let's get started.  Good afternoon, everyone.  My name is Tom Babington.  I'm the Press Director for the U.S. Agency for International Development.  I'm traveling with Administrator Green here in DRC.  We got here yesterday.  We had several meetings with different donors to the Ebola crisis, UN agencies, NGOs, and then, this afternoon, we met with President Tshisekedi.  And here we are, waiting for Dr. Muyembe Just to arrive.  And Administrator Green and Ambassador Hammer are going to meet with him later.

So, with that, I'm going to turn it over to Administrator Green.  He'll say a few words about what he's doing here, about the Ebola crisis.  And then we'll turn it over to questions and answers.
 
ADMINISTRATOR GREEN: Good afternoon.  It is good to be here.  Thank you to all of you for coming.  Let me begin by thanking you for what you do.  When challenges like Ebola emerge, one of the most important aspects to battling Ebola is good coverage by the media.  It helps to raise awareness.  It helps your listeners, your viewers, and your readers understand the challenges that are there, and also helps them to understand precautions that they can take.  And so, I thank you sincerely for the role that you are all playing.
 
This is my second visit to DRC.  I was here six weeks ago, but that visit was entirely in Eastern DRC.  I felt it was important for me to go to Butembo, to go to Goma, to see the work in the field, to meet with community leaders, NGOs, to meet with the healthcare workers, Congolese healthcare workers, so I knew a little bit more before I came, this time, to meet with government leaders.
 
As you have heard, we have had even a meeting today with President Tshisekedi himself, as well as Dr. Muyembe Just's team, and we will meet with him shortly.  In my last visit here, one of the things that I said is that fighting Ebola is not just a medical crisis; it is a development crisis.  And I said that, in my view, as the top development official for the U.S. Government, that I saw it as a public international development crisis in the Eastern Congo.
 
So, as many of you know, there have been years of development challenges and conflict.  There have been problems of corruption, and sometimes weak governance.  All of those things make life difficult for everyday cities in Eastern Congo.  And then, this thing called Ebola suddenly pops up.  It suddenly emerges.  And so, all of these challenges come together, and it makes the work of Dr. Muyembe Just, and his team, and the World Health Organization especially difficult. 
 
So, USAID -- the U.S. Agency for International Development -- part of what we aim to do is to try to help President Tshisekedi and others to begin to address some of the development challenges so that there is more community trust, better community communication.  And that will make the work of fighting the disease -- the virus -- simpler.
 
Earlier today, when Ambassador Hammer and I met with President Tshisekedi, he made very clear to me that this was his highest priority, and I believe him.  He was very clear that he knows how important this is.  And so, he told me that, and we had conversations about making sure that the response to Ebola is effective, it is targeted to areas in need, it is transparent, and that it is always communicating with the good people of DRC on the ground.  And so, I came away impressed with his level of commitment.  And so, we look forward to working with the President and Dr. Muyembe Just -- and the timing is perfect -- (laughter) -- to assist in fighting the outbreak.  

Let me emphasize: the response to the outbreak is led by your government.  We want to be helpful as friends, and we believe we are friends of DRC.  And we will walk by your side.  But, we want to help President Tshisekedi and the good doctor in not just defeating Ebola for the moment but addressing the conditions that we all hope will prevent it from coming back again.
 
MR. BABINGTON: With that, we can go into questions.  Before you say your question, please just say your name and which outlet you work for.
 
QUESTION: My name is Saleh Nasibu.  I'm working for VOA and the Associated (inaudible) in Congo.  How the Ebola can be controlled?  And what can the U.S. do to help?
 
ADMINISTRATOR GREEN: So, I am sometimes asked about the current outbreak, compared to a famous outbreak just a few years ago in West Africa.  And I will let Dr. Muyembe Just answer more of this, but we have tools that we did not have then.  We have vaccine.  And we have some promising treatments.  Again, I am not a doctor, so I do not want to go out too far, but we have new tools.  From the development side, I think what we can do is, we can look at small ways to help with projects that strengthen community communications, create some opportunities for people, help to meet some humanitarian needs.  I said to an earlier group I was in politics a long time myself.  And a wise politician once said, "The people need to know that you care before they care what you know."  What we hope to be able to do is show that we care by making some investments and working closely with the good leaders here to increase communication.
 
On the medical side, the public health side, I would defer to Dr. Muyembe Just.
 
DR. MUYEMBE JUST: So, thank you very much.  To come here, I took an ambulance. (laughter)
 
ADMINISTRATOR GREEN: It is good when you could take an ambulance, and come away, and smile. (laughter)

DR. MUYEMBE JUST: So, I think we must take this response to Ebola -- must be seen as an opportunity to strengthen our health system.  We will start with the provinces of North Kivu and Ituri -- and after that, all the country.  We must be able now to detect early, any new diseases or epidemics in the country.  And to us, a response to the current outbreak, as you know, it is now a multi-sectoral approach.  It is not only the Minister of Health, but we must include other ministers, like Minister Interior, and so on and so on.  And even the Minister of Finance and Budget -- because to fight Ebola, you need money.  And we must collaborate with all these different ministers. 
 
And so, I think the first thing is to have a community engagement.  Until now, there is a lack of community engagement.  That cannot permit us to win the war against Ebola.  And for that, we are -- we will use the local people there, local people who speak the Northern language, who can go into the community and give the information for vaccination, and also for surveillance, and so on and so on.  So, it is our most important strategy.  And it works; I think in three or four months, the outbreak will be over.
 
MR. BABINGTON: Any questions there --
  
AMBASSADOR HAMMER: If I might -- an even broader perspective, to reinforce what the Administrator has said.  On behalf of the United States Government, this is an extremely high priority.  We have weekly -- if not twice weekly -- conversations with the White House and our whole of government -- our interagency.  That's why we have collaborators here from the Centers for Disease Control, who are technical experts, who are going to be working with Dr. Muyembe Just's team -- and have two decades plus of a relationship with Congolese health authorities because we know full-well how much experience you have, you have the technical know-how, you have the capacity, we want to just support that.  We also have, as you know, from the National Institutes of Health, embedded here, staff that is working with you on the clinical studies that are shown to -- very effective treatments.
 
And so, from -- again -- the United States' perspective -- the largest, perhaps, contributor to this effort, we see this partnership with Congo as very important, not just for Congo -- not just for Congo and the American people, but for the world.  The work that's being done now to address this outbreak is going to be impactful going forward, and that's why the Administrator is here on his second visit.  That's why Dr. Redfield has come on a couple of occasions.  And in a month's time, we'll have our Minister of Health, Secretary Azar, coming as well with the White House delegation.  So, this is very important, and it indicates the very close partnership we have with President Tshisekedi and the rest of his team.
 
MR. BABINGTON: Yes, ma'am, in the back?
 
QUESTION: Anasthasie Tudieshe, Voice of America.  Dr. Muyembe Just said that we could get rid of the disease of Ebola in three to four months.  These are exciting news, but how can you be so sure?
 
DR. MUYEMBE JUST: Okay.  I am not so sure, but I am ambitious.
 
Yes.  So, this is essential.  And also, I asked my people in the field.  So, I said, "Do you think that we can stop this outbreak in three or four months?"  All of them agreed, saying, "Yes, we'll do that."  So, these kinds of people, I like.
 
Yes.  We can do that, I think.  We have the possibility, we have the skills, we have the experience, we have the expertise.  And now, the problem is the security -- problem there, and also, the engagement of the population.
 
ADMINISTRATOR GREEN: If I may just add, myself, I have lived in Africa a few times in my life, and I have been very involved in battles against malaria and other infectious diseases.  And we also think that it is very important, while we have the aspirational goal that we must push forward to, we must never give up.  And so, we must keep going, even after three or four months, to make sure that everything is done.  Because a danger -- again, I know from my work on malaria -- is that we declare victory before it occurs, and then, it can come back. 
 
So, under the good doctor's leadership, we will all push very, very hard.  But it is our view that we must keep going and never let up, and keep going to the final case, because we know that Ebola has occurred a number of times in the region, and we know that we can never take our eyes away from the challenge that it presents.  

DR. MUYEMBE JUST: Yes.
 
MR. BABINGTON: Yes, sir.
 
QUESTION: Gaius Kowene; I work for the BBC.  I have a question for Mr. Green and Professor Muyembe Just -- so, we know that -- in DRC, for example, one of the main problems is there is a lack of a strong, basic health system, and that's why we had problems with early detection, for example.  How is the USAID going to have -- into building a strong health system -- completely -- that's -- my question to you.  And to Professor Muyembe Just, my question was, is there a plan in changing the vaccination strategy?  Because right now, we've been using the ring vaccination strategy, but still, the virus is spreading very fast.  Are we planning to, like, deploy the vaccine to everybody, and start the vaccination chain?
 
ADMINISTRATOR GREEN: I will answer what I think is the easier of the two questions.
 
So, we certainly agree that while we take on Ebola, this outbreak, that it is important to strengthen health systems overall.  In terms of what we can do, I think the first step is what Ambassador Hammer and I heard today from President Tshisekedi, who told us he believes that the system needs to be strengthened over the long run.  At USAID, it is not our role to lead; it is our role to assist and to support your leaders as they make commitments and try to build things up.  And so, when I hear, from President Tshisekedi, his dedication to this, to me, that is the first step, and that tells me that these things can be done.

DR. MUYEMBE JUST: Yes.  This problem of vaccine -- yes.  Yesterday, I worked with the Minister for Health of Rwanda.  Rwanda decided to vaccinate all the traders that are crossing the borders every day.  So, Rwanda ordered 100,000 doses of J and J vaccine.  You see?  So, Uganda also is using J and J vaccine, and J and J vaccine is still in use in Guinea.  I think DRC will also take this opportunity to vaccine more than every day.  More than 64,000 people are crossing the border by -- petite barrier, you know, in Goma, going to Rwanda, everyday -- a lot of people.  So, I think we can combine these vaccinations between Rwanda and DRC.  And after that, I think more would vaccinate, willing to do vaccination in South Kivu, because there is a high risk of transmission of the virus there. 
 
Okay, so, I think, in addition to Merck vaccine, we need a second vaccine that is preventive.  And according to our -- to SAGE -- SAGE is the advisors -- a group of advisors to WHO, concerning vaccinations.  SAGE made a recommendation to the countries to use a second vaccine that is preventive, because Merck is not a preventive vaccine, only to stop the transmission between the infected case and contact -- after contact.
 
So, to vaccinate a lot of people, we need this kind of vaccine.  And also, the importance of this vaccine is to conduct the research, which means that we can see if this vaccine is effective or not, and so on, during this outbreak.  It was the same with the Merck vaccine that was used in Kenya -- in Liberia, Guinea, and so on.  So, we take profit of these experiences made in West Africa, and we have introduced this here in DRC.
 
MR. BABINGTON: Great.  Yes, sir, in the front?  I'm sorry, it's --
 
QUESTION: My name is Steve Wembi for the New York Times.  I have two questions.  The question -- the first question is to Mr. Green.  I'd like to know in terms of budgets, the Ebola outbreak (inaudible)?  And the second question is to Dr. Muyembe Just -- you know, in the history of selecting (inaudible) and there are some areas which are under control of the militia, so, what do you (inaudible) end this outbreak in three months?  And there are a serious problem -- how to deliver the vaccinations in the area which are under control of the militia, especially in (inaudible).
 
ADMINISTRATOR GREEN: On the first part, USAID has already provided over $136 million towards the Ebola response in DRC and some of the immediate countries.  Of course, the World Bank has provided a very significant contribution just a few weeks ago, and some of our partners -- partners of DRC and the U.S., both -- the Brits, Canadians, other Europeans are also providing assistance.  So, we have provided assistance, and we will continue to walk with DRC in this journey.  And we are looking for ways to also make some modest investments that can help on the community level, as I had mentioned earlier, to get at some community development, which we think will strengthen communications that were perhaps pushed down on mistrust.
 
DR. MUYEMBE JUST: Yes, yes.  So, yes.  I agree with you that security is the bottleneck of these outbreaks.  But I think we will receive the support of UN system.  So, now, we have David Gressly, who is in charge of establishing -- to improve the condition of work, security in Katwa and (inaudible).  So, David is in charge of security, and for that public health issue, we have WHO.  WHO is in charge of public health issues.  All the problem of surveillance and so on -- it is in charge by WHO.  And the problem of the policy, security, and so on is taken -- in charge by David Gressly.  It is the Special Envoy of the UN Secretary General.  So, I think we'll improve the situation of security.  And as I said, we have the experience, we have the skill, we have the expertise.  I think it is possible to stop Ebola outbreak as soon as possible.
 
MR. BABINGTON: Great.  I think we have time for one more question.  Yes, ma'am?
 
QUESTION: (off-mike).
 
ADMINISTRATOR GREEN: Between --
 
QUESTION: (off-mike).

ADMINISTRATOR GREEN: I think the level of communication is very good, is very strong.  We are communicating all the time, sharing information.  So, I would assess the working partnership to be very, very good.  And I will also point back to something that Dr. Muyembe Just said, we are also all coordinating with David Gressly, who I met with earlier on this trip, as well, and met with on the last trip.  And he is helping to pull together communications so that we are all working from the same numbers and that we all see the same challenges.  So, I think the level of coordination right now is quite good.