As Ebola Retreats, Obama Urges Vigilance and Preparation in West Africa

Now that the Ebola crisis in West Africa finally appears to be petering out, President Obama on Wednesday called for renewed international efforts to rebuild the shattered health systems in Liberia, Guinea and Sierra Leone, to shore up the response to future pandemics in the region.

Appearing at the White House alongside the presidents of the three countries, the hardest hit by the latest outbreak, Mr. Obama said the global response must continue, even as the number of new Ebola cases has dropped to zero in Liberia and about 30 in Guinea and Sierra Leone.

“We have to be vigilant, and the international community has to remain fully engaged in a partnership with these three countries until there are no cases of Ebola,” Mr. Obama said. “Health systems also have to be rebuilt to meet daily needs — vaccines for measles, delivering babies safely, treating H.I.V./AIDS and malaria.”

Mr. Obama made his remarks while flanked by Presidents Ellen Johnson Sirleaf of Liberia, Ernest Bai Koroma of Sierra Leone and Alpha Condé of Guinea, in a scene that was far different from the widespread panic seven months ago amid calls for the United States to close its borders to travelers from the affected countries.

Anxieties have settled down since then. In Liberia, there have been no new Ebola cases since March 20; if that number remains at zero, the country will be declared Ebola-free at the beginning of next month. The United Nations Mission for Ebola Emergency Response reported that as of April 10, there were 21 confirmed new cases in Guinea, compared with 52 the previous week, and nine new cases in Sierra Leone, which had 25 the week before.

Since the outbreak began more than a year ago, there have been 26,611 confirmed, probable and suspected cases of Ebola, with 10,611 reported deaths, the agency said.

Even though the threat of further infection has declined significantly, all three presidents and their entourages were issued temporary cellphones and thermometers upon arrival in the United States and, like all visitors from their countries, must take their temperatures daily while in the United States and report them to American authorities. Mr. Obama shook hands with all three presidents, aides said.

About 3,000 American troops went to Liberia as part of the American effort to combat the disease, and about 100 remain. The United States military officially ended a mission to build treatment facilities in February, months earlier than expected.

The race to get to zero cases is crucial, Obama administration officials said on Wednesday, because the porous borders between the three worst affected countries means that all three would remain at risk until the virus was gone from neighboring countries. A health official in Liberia said Wednesday that the authorities there were focused on providing care and help for survivors who need chronic care services for post-Ebola syndrome, which includes vision loss, joint pain and psychological trauma.

The World Health Organization has been urging Ebola survivors to have protected sex, with condoms, until global health officials can figure out just how long the virus remains in semen, after a case in Liberia in which a man’s semen tested positive for the virus six months after he was considered free of Ebola.

An Obama administration official said Wednesday that efforts were underway to revamp the struggling health systems in the three countries so that any future outbreaks would not spiral out of control. Even before Ebola, all three countries had struggled with a host of public health maladies common in the developing world, including malaria and measles. The challenge now, administration officials said, is to figure out how to retool the massive Ebola response infrastructure to adapt to other health concerns.