"MONROVIA, Liberia — As bodies littered the streets and the sick lay dying in front of overwhelmed clinics last year, President Obama ordered the largest American intervention ever in a global health crisis, hoping to stem the deadliest Ebola epidemic in history.
But after spending hundreds of millions of dollars and deploying nearly 3,000 troops to build Ebola treatment centers, the United States ended up creating facilities that have largely sat empty: Only 28 Ebola patients have been treated at the 11 treatment units built by the United States military, American officials now say.
Nine centers have never had a single Ebola patient.
“My task was to convince the international organizations, ‘You don’t need any more E.T.U.s,’ ” said Dr. Hans Rosling, a Swedish public health expert who advised Liberia’s health ministry, referring to Ebola treatment units.
“I warned them, ‘The only thing you’ll show is an empty E.T.U.,’ ” he added. “ ‘Don’t do it.’ ”
The American response, it turns out, was outpaced by the fast-moving and unpredictable disease.
Facing criticism that his reaction to the devastating epidemic had been slow and inadequate, Mr. Obama announced his signature plan in mid-September, focusing on Liberia, America’s historical ally.
But even before the first treatment center built by the American military opened there, the number of Ebola cases in Liberia had fallen drastically, casting doubt on the American strategy of building facilities that took months to complete.
The emphasis on constructing treatment centers — so widely championed last year — ended up having much less impact than the inexpensive, nimble measures taken by residents to halt the outbreak, many officials say.
Liberia could be declared free of Ebola as early as next month. But with health officials warning that it is only a matter of time before another outbreak erupts in this region, they are drawing important lessons from the successes and shortcomings of the response by international and West African leaders.
Had the Americans and other donors been more flexible, critics and some officials contend, the money could have been put toward rebuilding Liberia’s shattered health care system — or backing the efforts of local communities — instead of focusing on treatment centers that would scarcely be used.
“I knew that most of the E.T.U.s that were being built may not receive a single patient,” said Dr. Francis Kateh, who helped lead the response of the Liberian government, which decided with the Americans where to build the 11 centers.
“But at the same time, you couldn’t put a stop to that process,” he added. “The train was coming full force.”
The United States has spent $1.4 billion on its Ebola mission in West Africa, with most of it going to Liberia. Deploying the military cost $360 million, not including the construction, staffing and operating expenses at the treatment centers it built."