WASHINGTON — As the rate of new Ebola infections in Liberia has slowed, American and Liberian officials are debating whether to build all 17 planned Ebola treatment centers in the country or to shift money from the Obama administration that was planned for the centers into other programs to combat future outbreaks.
The United States announced Monday that it had completed the first of the 100-bed centers, some 40 miles outside Monrovia, in Tubmanburg, and turned over its operation to the International Organization for Migration, which will staff and run the center.
Two other treatment units, in Sinje, to the north of Monrovia, and Buchanan, to the south, will be completed by the end of November, American military officials said. Seven additional treatment units across the country are in various stages of construction.
A 25-bed hospital recently opened outside Monrovia, and American and Liberian military officials are clearing the land for two more units. If all of them go ahead as planned, that would bring the total units built by the American and Liberian militaries working together on the project to 13, or four short of the units promised by President Obama on Sept. 16.
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But Mr. Obama’s promise came at the height of the epidemic, when new cases were increasing at a brisk rate. Since then, the rate of new infections in Liberia has come down and several treatment units around the country have for more than a month reported empty beds. The World Health Organization said Wednesday that there had been a stabilization in the decline of new infections in Liberia, which reported 97 new cases last week.
Everyone involved, from the W.H.O. to the Liberian government to the Obama administration, has warned against complacency in international efforts to fight the disease. But both American and Liberian officials say that if the numbers continue to decline, it may be wiser to shift the funds toward other needs in the country.
“They would be fools to spend all that money on E.T.U.s,” said Stephen D. Cashin, chief executive of the Pan African Capital Group and an adviser to President Ellen Johnson Sirleaf of Liberia, speaking of the Ebola treatment units. “They’re better to spend the money on putting in place the expertise and skill sets and county medical clinics and health care to provide care to the masses of people of Liberia, and to create a system of movable clinics and testing centers and hot spots.”
Capt. Robert C. Langston, a public affairs officer with the United States Army in Monrovia, said the Liberian government was taking the lead on deciding where and when the units would be built. But he said the American military, which has 2,100 troops in Liberia, “will remain agile and flexible to respond quickly to needs on the ground as they change.”
American military officials say they now think that fewer American troops will deploy to West Africa to build units and train health workers than originally planned — perhaps 3,000 instead of 4,000.
Brig. Gen. Daniel D. Ziankahn, chief of staff of the Armed Forces of Liberia, said in a telephone interview that a decision would be made soon on whether to go ahead with all of the planned treatment units. “There’s going to be some decision point as to whether we have to shift our efforts to something else,” he said.
Mr. Obama has asked Congress for $6 billion to fight Ebola in the United States and West Africa, a request that administration officials defended before the Senate Appropriations Committee on Wednesday.
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“We believe we have the right strategy in place both at home and abroad,” Sylvia Mathews Burwell, the secretary of the Department of Health and Human Services, said at the hearing. “Additional funding is needed, and that’s what we’re here to talk about today.”
If the full Congress approves the funding, it would be the single largest sum to combat Ebola from any country or international organization.
The request seemed to gain bipartisan support. The hearing had none of the contentiousness of one in the House last month in which officials were grilled for hours about the initial flawed federal response to Ebola cases in the United States. Senator Barbara A. Mikulski, Democrat of Maryland and chairwoman of the committee, said she hoped the request would be granted, adding that it was similar to when President George W. Bush asked for emergency funding to fight bird flu in 2009.
“We’ve done this before,” she said.
Under the request, the Department of Health and Human Services would receive about $3 billion, a third of which would be spent in the United States on items such as personal protective equipment and monitoring travelers at American airports.
In the hardest hit countries in Africa, the money would go to bolstering infection control, including support for laboratories and to help develop a local health care work force trained in identifying outbreaks.
The State Department and the United States Agency for International Development would together receive nearly $3 billion to go toward supplies, logistics networks, burial teams and education to prevent the spread of the disease.
About $1.5 billion of the total $6 billion the federal agencies are asking for would go to a so-called contingency fund to be spread among federal agencies to meet unexpected and sudden needs, such as a vaccination campaign for health workers, should a vaccine become available.
About $250 million would go to the National Institutes of Health and the Food and Drug Administration to speed the development of vaccines and other therapies.