As epidemic escalates, can U.S. aid for Ebola be deployed quickly enough?

(or a better title would be: 'How to handle Ebola by experts from the CFR and Georgetown University')*

September 16, 2014 at 6:10 PM EDT

How effective will new U.S. aid and military support be in fighting Ebola? Laurie Garrett of the Council on Foreign Relations and Lawrence Gostin of Georgetown Law School join Judy Woodruff for a deep dive into the plan. Then special correspondent Fred de Sam Lazaro offers an update from Nigeria, a country that has been relatively successful in controlling the deadly virus.

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TRANSCRIPT

JUDY WOODRUFF: Let’s dive deeper now into the president’s plan to ramp up the response to the Ebola outbreak and to try preventing a humanitarian catastrophe.

It comes amid prior criticism of the administration, along with the WHO and of other countries, for not doing more and for not getting it done faster.

We turn back to two who have been closely watching this and speaking with government officials in recent days.

Laurie Garrett of the Council on Foreign Relations, she has written widely about Ebola, including the books “Betrayal of Trust” and “The Coming Plague,”and Lawrence Gostin of Georgetown University. He’s the director of the O’Neill Institute for National and Global Health Law.

And we welcome you — welcome both of you back to the program.

Laurie Garrett, to you first. What is your assessment of the president’s plan that he outlined today?

LAURIE GARRETT, Council on Foreign Relations: Well, it’s a bold step forward. I’m delighted it’s actually taking place.

But I think everything depends on the haste with which we can mobilize. And I am afraid a lot of people don’t understand that committing troops and saying you’re going to build a hospital are all very good steeps, but it takes weeks to execute these things. And, in the meantime, the epidemic is doubling every 10 to 20 days. We don’t have a lot of time. We’re racing against a clock.

JUDY WOODRUFF: Lawrence Gostin, do you have the same concerns? What’s your assessment?

LAWRENCE GOSTIN, Georgetown Law: I think Laurie is right about timing.

First of all, I am very proud of my country. I mean, we have stepped forward when no one else would or could. But there are major unanswered questions. It’s not just timing, but also command-and-control. There’s chaos on the ground. It’s uncoordinated.

I was very pleased to see the president say that we have a command post, but how are we going to command Chinese or Cuban workers? I do think we need a U.N. Security Council resolution to actually have the kind of international legitimacy that we need.

JUDY WOODRUFF: So going beyond what the U.S…

LAWRENCE GOSTIN: Yes, the U.S. can’t do it alone.

JUDY WOODRUFF: Well, let me just go further here with what the U.S. is doing. You said you’re proud of your country. What specifically do you think is going to make the most difference here?

LAWRENCE GOSTIN: Well, I think the most difference will be training health workers, although — and building health facilities in the community, contact tracing. All of those things are very important.

JUDY WOODRUFF: Meaning going back and finding out where…

LAWRENCE GOSTIN: Meaning going back, finding out who has been in contact with whom, and quickly isolating them in safe conditions.

One of the big problems, though, is, is that even once we have built these treatment facilities, it’s going to be handed over eventually to the Ministry of Health in Liberia. And they just don’t have the health workers. The doctors and the nurses have been decimated. And so we really do have a huge infrastructure task.

JUDY WOODRUFF: Laurie Garrett, you laid out your concerns, but of what has been announced, how do you see this unfolding and making any difference?

LAURIE GARRETT: Well, first of all, we don’t have any commercial flights landing in the area now. And so just getting doctors on the ground, getting medical supplies, keeping stocks in place of such simple things as latex gloves to protect you from infection have all proven daunting, in the absence of real solidarity from neighboring countries and the willingness to have planes land and commercial flights.

So one huge role for the U.S. military is going to be helping Ghana, which has very kindly and generously agreed to be the air bridge for all supplies and human movement into the area, to extend their runway, build their airport up, have logistic and supply operations in place, and then to have smaller flights go from Ghana into specific targeted areas carrying supplies with them as needed.

But Larry points out a crucial problem with all of this. We don’t have a central command, which means we don’t even have a centralized list of what’s needed. Who needs latex gloves where? Is the situation more dire in this county in Sierra Leone or in this county in Liberia? Where do we need to deploy people first?

We don’t have that kind of operation in place. And our U.S. military is not going to play that role. We will have a central command, but it will be commanding U.S. military personnel, not people from other countries and certainly not the Liberians themselves.

And we also see that the response is not a regional one. We are, unfortunately, dividing our response according to kind of old colonial ties. So the French are focusing on Guinea, which used to be a French colony. The United Kingdom is focused on Sierra Leone, which is settled by the descendants of British slaves who came from the Caribbean, and we’re focused on Liberia, which is settled by former American slaves.

And so there’s this sort of distasteful neocolonial feel to things, and it means that the responses are not unified. They are very divided by country. So you have heard of 165 Cuban responders and 59 Chinese. They’re all going to Sierra Leone, where they will be under we don’t know what kind of command, loosely coordinated by the Sierra Leone government.

JUDY WOODRUFF: And, Lawrence Gostin, this is sounding like a very complicated effort, which we already knew, but it sounds even more complicated listening to the two of you.

What about the timing of this? How long is it going to take to begin to make a difference, to begin to get to the people who need treatment and are not receiving it?

LAWRENCE GOSTIN: Well, first of all, we are very late to the game. The fire has nearly burned the house down, and we have arrived. The cavalry has arrived.

It will take a long time, I think, to build the kind of facilities that we want. I mean, the whole idea, for example, that we’re sending 500,000 home kits suggests that we can’t get people into hospitals quick enough to treat them and isolate them, and people who…

JUDY WOODRUFF: These are self-testing kits?

LAWRENCE GOSTIN: These are self-testing kits or self-protecting kits. I’m not sure the community will know what to do with them when they get them.

And so this is a — this is a makeshift response to a huge humanitarian crisis. I don’t think it had to come to this, but now that we’re there, I’m really glad the see the United States military involved.

JUDY WOODRUFF: So, Laurie Garrett, should we be pleased that this is happening or more worried because it’s not the holistic response that I heard you describing that’s necessary?


“…if we can’t get a response on the ground immediately, effectively, across the region … then we’re talking about something equivalent to the Black Death’s impact on Tuscany and Florence in 1346. “

LAURIE GARRETT: Look, I’m delighted, like Larry, to see my country step up to the plate and play a role. And I’m hoping that we can save lots and lots and lots of lives and bring this epidemic under control.

But I agree completely we’re late to the game. And if you just do the math, based on the statement made today by WHO, a doubling time every 10 to 21 days, and you take the number of actually identified and suspected cases existing now and do your math, you can see that if we can’t get a response on the ground immediately, effectively, across the region, we will be looking at a quarter of a million cases by Thanksgiving, and 400,000 by Christmas if this is not abated and brought under control.

And then we’re talking about something equivalent to the Black Death’s impact on Tuscany and Florence in 1346.

JUDY WOODRUFF: Sobering, sobering any which way you look at it. We appreciate both of you joining us.

Laurie Garrett, Lawrence Gostin, thank you.

LAWRENCE GOSTIN: Thank you.

JUDY WOODRUFF: And one country in West Africa that has had relative success in controlling this virus so far is Nigeria.

While this nation has had 21 confirmed and suspected cases of the Ebola virus, including seven deaths, it has not had an explosive surge and spread since its first victim was reported in late July.

Our special correspondent, Fred de Sam Lazaro, is on assignment in Lagos, and he checked in with us earlier today.

FRED DE SAM LAZARO: Nigeria is Africa’s most populous country. It has the largest economy on the continent and its commercial capital, Lagos, has 20 million inhabitants, all of which have raised concerns that an Ebola outbreak would be catastrophic.

But that hasn’t happened, in part due to an early break, and in large part due the a good public health response, experts say. The virus was first brought to Nigeria by a Liberian traveler who fell ill at the airport, and, in a peculiar twist of fate, medical doctors were on strike when he was taken in for health care.

That exposed far fewer health workers to the virus, and health care workers have been especially hard-hit during this epidemic. They have contracted the virus and they have passed it on to their patients. Despite its reputation for chaos and dysfunction, Nigeria has launched a very sophisticated response to Ebola.

Everyone entering the country, including this reporter when we arrived yesterday at the airport, is screened for any symptoms. Those with an elevated fever, for example, are taken in for secondary screening to make sure it’s not related to Ebola.

There’s a call center where people can report suspected cases, and a concerted public awareness campaign that has kept fear from turning into panic. And a sophisticated surveillance system has enabled this country to trace and keep track of all cases and people with whom they came into contact.

All of these cases have been directly traced to that original index case, the Liberian traveler. This is reassuring, but at a time when there’s so much travel and when the virus is running amuck in other parts of West Africa, Nigeria is nowhere near being able to declare victory. A lot of fingers are still crossed tightly here.

JUDY WOODRUFF: And we will have more of Fred’s reporting from Nigeria in the coming days.


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How retired Supreme Court Justice Stevens would amend the constitution

April 21, 2014 at 6:25 PM EDT






Former Supreme Court Justice John Paul Stevens talks to Judy Woodruff about his new book, “Six Amendments: How and Why We Should Change the Constitution.” In his book, the 94-year-old liberal justice calls for major changes to the Constitution on issues such as the death penalty, firearms, redistricting and campaign finance.


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TRANSCRIPT

JUDY WOODRUFF: Now: A former Supreme Court justice takes on the U.S. Constitution and the court he stepped away from.

John Paul Stevens was known in his 35 years in office for views that evolved from the time he was appointed by Republican President Gerald Ford to one of the court’s most outspoken liberal voices.

Today, four years after retiring, the 94-year-old continues to make waves with an ambitious new book. It’s titled “Six Amendments: How and Why We Should Change the Constitution.”

I talked to him last week in his chambers at the Supreme Court.

Justice John Paul Stevens, thank you for talking with us.

FMR. JUSTICE JOHN PAUL STEVENS, U.S. Supreme Court: Well, I’m happy to be here.

JUDY WOODRUFF: You’re asking to amend the Constitution six different ways. How practical is that?

FMR. JUSTICE JOHN PAUL STEVENS: Well, it certainly would take time to do that job completely, but there’s no reason why — one or two amount amendments might be adopted before the others.

And I think the issues in each of the ones I discussed are sufficiently important that it’s worth spending time debating them and thinking about it.

JUDY WOODRUFF: You single out rules, Justice Stevens, that were handed down, as you point out, by a slim majority of the court over the last 40 years that you say — and I’m quoting you now — “have had such a profound and unfortunate impact on our basic law, that resort to the process of amendment is warranted.”

You’re essentially taking on the modern Supreme Court.

FMR. JUSTICE JOHN PAUL STEVENS: Well, because I have been trying to do that for a good many years.

But I think there were incorrect — incorrect decisions that were profoundly unwise, and really contrary to a lot of things that our country stands for. And I think they should be changed.

JUDY WOODRUFF: You’re speaking in a mild mannered way, Justice Stevens, but I can tell you feel pretty strongly about this.

FMR. JUSTICE JOHN PAUL STEVENS: Well, I do.

(LAUGHTER)

FMR. JUSTICE JOHN PAUL STEVENS: There’s no doubt about that.

JUDY WOODRUFF: Let’s talk about some of the ways that you would like to see the Constitution changed.

Among other things, you want an amendment that would require the states not to draw legislative or congressional districts in a way to increase partisan strength. We know, clearly, there is partisan redistricting. But most redistricting is done around where populations live, whether it’s an urban area, a suburban area. Why isn’t this something that is better left to the political process?

FMR. JUSTICE JOHN PAUL STEVENS: Well, because the political process has misfired.

And in a number of states, the dominant party has redistricted with its own objective of strengthening its control of the state in the future and of its congressional delegation at the time by drawing bizarre districts that have no purpose whatsoever, other than to enhance the political strength of the party in power.

Now, it’s my very profound view that a person in public office has a primary duty to follow — to make impartial decisions, not motivated by personal profit or personal gain or advantage just to the political party of whom — of which he is a member.

JUDY WOODRUFF: So you’re saying take it out of politics?

FMR. JUSTICE JOHN PAUL STEVENS: Well, not entirely. But don’t allow districts to be drawn for no reason other than political advantage.

There are times when political — political considerations can be taken into account in making certain minor adjustments such as that.

But the examples that I talked about in the book are examples of districts that are bizarre in shape and have absolutely — obviously no justification, other than the impermissible justification of partisan advantage to those who drafted the districts.

JUDY WOODRUFF: You also want to amend the Constitution to abolish the death penalty. People who have always opposed the death penalty lament how long they say it took you to change your mind, from the time you came on the court in 1975 until 2008.

Why do you think it took you as long as it did to change your mind? And was it for humane reasons or constitutional reasons?

FMR. JUSTICE JOHN PAUL STEVENS: Well, I think that what has happened in the period that I have been on the court is that the court has used death penalty litigation to develop rules that make conviction more likely than it should be, the rules governing the selection of the jury, for example, rules governing the admissibility of victim-impact evidence at the penalty phase of the trial.

Those rules have slanted the opportunity for justice in favor of the prosecutor. And I think it’s particularly incorrect to do it in the capital context, because the cost is so high. If you make a mistake in a capital case, there is no way to take care of it later on.

And the risk of an incorrect execution in any case to me is really intolerable. And the system shouldn’t permit that possibility to exist.

JUDY WOODRUFF: Another controversy you’re jumping right into is campaign finance. You believe Congress should be able to put limits on the amount of money candidates spend on their campaigns…

FMR. JUSTICE JOHN PAUL STEVENS: Yes.

JUDY WOODRUFF: … and that the Supreme Court has made mistakes in several decisions, allowing corporations, labor unions to advocate and spend money on candidates.

Considering all the court has done, Justice Stevens, to open the door for huge money to pour into American politics, including the recent McCutcheon decision, what effect does all this have on American politics?

FMR. JUSTICE JOHN PAUL STEVENS: Well, I don’t think it’s a healthy effect.

And I think it’s a change from what the people who direct — framed our basic government envisioned. For the — as the chief justice said, I think, in the first sentence of his opinion in the McCutcheon case the other day, there is nothing more important than participation in electing our representatives.

But the law that developed in that case and in a number of other cases involved not electing the representatives of the people who voted for them, but electing representatives of — in other jurisdictions where the financing is used. In other words, that was a case that involved the right of the — of an individual to spend as much of its money as he wanted to elect representatives of other people. He didn’t use any of that money to elect his own representatives.

And I think that’s a distortion of the concept that we started with many, many years ago.

JUDY WOODRUFF: The last area that I want to ask you about is what this country should do about guns. You would change the wording of the Second Amendment to the Constitution to say the right of people to bear arms to own a gun should apply only when serving in the militia.

Is it your ultimate hope that there would be no right to own a gun for self-defense?

FMR. JUSTICE JOHN PAUL STEVENS: Well, it would be my ultimate hope that legislatures would decide the issues, and not be hampered by constitutional restrictions, because, clearly, legislators are in a much better position than judges are to decide what could be permissible in different contexts.

And the effect of the Second Amendment as it is now construed is to make federal judges the final arbiters of gun policy, which is quite, quite wrong, I think, and quite contrary to what the framers intended when they drafted the Second Amendment, to protect states from the danger that a strong federal armed force would have been able to the states of their own militias.

JUDY WOODRUFF: When you look at all of these changes that you would like to see in the Constitution, and whether it’s campaign finance, redistricting or something else, do you believe the more conservative members of the Supreme Court have a partisan agenda? Do you think they are actually trying to get conservatives elected to office?

FMR. JUSTICE JOHN PAUL STEVENS: No, I don’t think so. I wouldn’t question their motives at all.

I think they have come to the incorrect conclusion, but I do think they have — where they have had chances to take a different tack, I think they have acted incorrectly. But I wouldn’t suggest that any of them were improperly motivated.

JUDY WOODRUFF: Do you think you should have stayed on the court longer?

FMR. JUSTICE JOHN PAUL STEVENS: Should I have stayed on — no.

(LAUGHTER)

FMR. JUSTICE JOHN PAUL STEVENS: If anything, I stayed on too long.

JUDY WOODRUFF: How does a justice know when it is the right time to retire? What do you think?

FMR. JUSTICE JOHN PAUL STEVENS: Well, in my case, the time — I can remember the events that triggered the specific decision.

I announced my dissent in the Citizens United orally, and I stumbled in my announcement. I had a little difficulty expressing myself. And that was out of character. And I used to have no problem at all being articulate and coherent.

And I took that as a warning sign that maybe I had been around longer than I should.

JUDY WOODRUFF: Justice John Paul Stevens, thank you very much for talking with us.

The book is “Six Amendments: How and Why We Should Change the Constitution.”

FMR. JUSTICE JOHN PAUL STEVENS: Thank you. It’s been a pleasure being here.
 

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