-
When I was asked to, invited, rather,
to give this talk a couple of months ago
-
we discussed a number
of titles with the organizers
-
and a lot of different titles
were kicked around and were discussed,
-
but nobody suggested
this one that you see here today.
-
The reason for that was, two months ago,
-
Ebola was escalating exponentially
-
and spreading over wider geographic areas
than we had ever seen
-
and the world was terrified, concerned,
and alarmed by this disease
-
in a way we've not seen in recent history.
-
But today, I can stand here
and I can talk to you about beating Ebola
-
because of people
whom you've never heard of,
-
people like Peter Clement,
-
a Liberian doctor,
who's working in Lofa County,
-
a place that many of you
have never heard of, probably, in Liberia.
-
The reason that Lofa County
is so important
-
is because about five months ago,
-
when the epidemic
was just starting to escalate,
-
Lofa County was right at the center,
the epicenter of this epidemic.
-
At that time,
MSF and the treatment center there,
-
were seeing dozens of patients
every single day,
-
and these patients, these communities,
were becoming more and more terrified
-
as time went by, with this disease
and what it was doing to their families,
-
to their communities,
to their children, to their relatives.
-
And so Peter Clement was charged with
driving that 12-hour-long rough road
-
from Monrovia, the capital,
up to Lofa County
-
to try and help bring control
to the escalating epidemic there.
-
And what Peter found when he arrived
was a terror that I just mentioned to you.
-
So he sat down with the local chiefs,
and he listened.
-
And what he heard was heartbreaking.
-
He heard about the devastation
and the desperation of people
-
affected by this disease.
-
He heard the heartbreaking stories
-
about not just the damage
that Ebola did to people,
-
but what it did to families,
and what it did to communities.
-
And he listened to the local chiefs
there, and what they told him --
-
They said: "When our children are sick,
when our children are dying,
-
we can't hold them at a time
when we want to be closest to them.
-
When our relatives die, we can't take care
of them as our tradition demands.
-
We are not allowed to wash
the bodies to bury them
-
the way our communities
and our rituals demand.
-
And for this reason,
-
they were deeply disturbed,
deeply alarmed
-
and the entire epidemic
was unraveling in front of them.
-
People were turning on
the healthcare workers who had come,
-
the heroes who come to try
and help save the community,
-
to help work with the community,
and they were unable to access them.
-
And what happened then was
Peter explained to the leaders.
-
The leaders listened.
They turned the tables.
-
And Peter explained what Ebola was.
He explained what the disease was.
-
He explained what it did
to their communities,
-
and he explained that Ebola threatened
everything that made us human:
-
Ebola means you can't hold your children
the way you would in this situation,
-
you can't bury your dead
the way that you would,
-
you have to trust these people
in the space suits to do that for you.
-
And ladies and gentlemen,
-
what happened then
was rather extraordinary:
-
the community, health workers,
and Peter sat down together
-
and they put together a new plan
for controlling Ebola in that Lofa County.
-
And the reason that this is
such an important story,
-
ladies and gentlemen,
-
is because today, this County,
-
which is right at the center
of this epidemic you've been watching,
-
you've been seeing on the newspapers,
-
you've been seeing
on the television screens,
-
today, Lofa County is nearly eight weeks
without seeing a single case of Ebola.
-
(Applause)
-
This doesn't mean
that the job is done, obviously;
-
there's still a huge risk
that there'll be additional cases there,
-
but what it does teach us
is that Ebola can be beaten.
-
That's the key thing.
-
Even on the scale,
-
even with the rapid kind of growth
that we saw in this environment here,
-
we now know Ebola can be beaten.
-
When communities come together
with healthcare workers, work together,
-
that's when this disease can be stopped.
-
But how did Ebola end up
in Lofa County in the first place?
-
Well, for that, we have to go back
12 months, to the start of this epidemic.
-
And as many you know,
this virus went undetected,
-
it evaded detection
for three or four months when it began.
-
That's because this is not
a disease of West Africa,
-
it's a disease of Central Africa,
half a continent away.
-
People hadn't seen the disease before;
-
health workers hadn't seen
the disease before.
-
They didn't know
what they were dealing with.
-
And to make it
even more complicated,
-
the virus itself was causing a symptom,
a type of a presentation
-
that wasn't classical of the disease,
-
so people didn't even recognize
the disease, people who knew Ebola.
-
For that reason it evaded
detection for some time,
-
but contrary to public belief
sometimes these days,
-
once the virus was detected,
there was a rapid surge in of support.
-
MSF rapidly set up an Ebola treatment
center as many of you know, in the area.
-
The World Health Organization
and the partners it works with deployed
-
eventually hundreds of people
over the next two months
-
to be able to help track the virus.
-
The problem, ladies and gentlemen, is
-
by then, this virus, well known
now as Ebola, had spread too far.
-
It had already outstripped
what was one of the largest responses
-
that had been mounted so far
to an Ebola outbreak.
-
By the middle of the year,
-
not just Guinea but now Sierra Leone
and Liberia were also infected.
-
The virus was spreading geographically,
the numbers were increasing,
-
and at this time,
-
not only were hundreds of people
infected and dying of the disease
-
but as importantly,
-
the front line responders, the people
who had gone to try and help,
-
the healthcare workers,
the other responders
-
were also sick and dying by the dozens.
-
The presidents of these countries
recognized the emergencies.
-
They met right around that time,
-
they agreed on common action,
and they put together
-
an emergency joint operation center
in Conakry
-
to try and work together to finish
this disease and get it stopped,
-
to implement the strategies
we talked about.
-
But what happened then was something
we had never seen before with Ebola.
-
What happened then was the virus,
or someone sick with the virus,
-
boarded an airplane,
flew to another country,
-
and for the first time,
-
we saw in another distant country
the virus pop up again.
-
This time it was in Nigeria,
-
in the teeming metropolis
of Lagos, 21 million people;
-
now the virus was in that environment.
-
And as you can anticipate, there was
international alarm, international concern
-
on a scale that we haven't seen
in recent years
-
caused by a disease like this.
-
The World Health Organization immediately
called together an expert panel,
-
looked at the situation,
declared an international emergency.
-
And in doing so, the expectation would be
-
that there be a huge outpouring
of international assistance
-
to help these countries which were in
so much trouble and concern at that time.
-
But what we saw
was something very different.
-
There was some great response.
-
A number of countries came to assist
- many NGOs and others, as you know -
-
but at the same time,
the opposite happened in many places.
-
Alarm escalated, and very soon,
-
these countries found themselves
-
not receiving the support they needed
but increasingly isolated.
-
What we saw was commercial airlines
started flying into these countries,
-
and people who hadn't even been
exposed to the virus
-
were no longer allowed to travel.
-
This caused not only problems,
obviously, for the countries themselves
-
but also for the response.
-
Those organizations
that we're trying to bring people in,
-
to try and help them
respond to the outbreak,
-
could not get people on airplanes,
-
couldn't get them into the countries
to be able to respond.
-
In that situation, ladies and gentleman,
a virus like Ebola takes advantage.
-
And what we saw then was something
also we hadn't seen before:
-
not only did this virus
continue in the places
-
where they'd already become infected
but then it started to escalate
-
and we saw the case numbers
that you see here,
-
something we never seen
before on such a scale,
-
and exponential increase of Ebola cases
-
not just in these countries or the areas
already infected in these countries
-
but also spreading further
and deeper into these countries.
-
Ladies and gentleman,
-
this was one of the most concerning,
international emergencies in public health
-
we've ever seen.
-
And what happened
in these countries then,
-
many of you saw, again, on the television,
read about in the newspapers,
-
we saw the health system start to collapse
under the weight of this epidemic.
-
We saw the schools begin to close,
-
markets no longer functioned the way
that they should in these countries.
-
We saw the misinformation,
the misperceptions, started to spread
-
even faster through the communities
-
which became even more alarmed
about the situation.
-
They started to recoil
-
from those people that you saw
in those space suits, as they call them,
-
who had come to help them.
-
And then the situation
deteriorated even further:
-
the countries had to declare
a state of emergency,
-
large populations need to be quarantined
in some areas, and then riots broke out.
-
It was a very, very terrifying situation.
-
And the world, many people began to ask:
-
"Can we ever stop Ebola
when it starts to spread like this?"
-
And they started to ask: "How well
do we really know this virus?"
-
The reality is we don't know
Ebola extremely well.
-
It's a relatively modern disease
in terms of what we know about it
-
we've known the disease only for 40 years
-
since it first popped up
in Central Africa in 1976.
-
But despite that, we do know many things:
-
we know that this virus probably
survives in a type of a bat,
-
we know that it probably enters
a human population
-
when we come in contact with a wild animal
-
that has been infected with the virus
and probably sickened by it.
-
Then we know that the virus
spreads from person to person
-
through contaminated body fluids.
-
And as you've all seen,
-
we know the horrific disease
that it then causes in humans,
-
where we see this disease caused
severe fevers, diarrhea, vomiting,
-
and then, unfortunately, and in 70%
of the cases or often more, death.
-
This is a very dangerous,
debilitating, and deadly disease.
-
But despite the fact that we've not known
this disease for a particularly long time,
-
and we don't know everything about it,
we do know how to stop this disease.
-
There are four things
that are critical to stopping Ebola.
-
First and foremost, the communities
have got to understand this disease,
-
they've got to understand
how it spreads and how to stop it.
-
And then we've got
to be able to have systems
-
that could find every single case,
every contact of those cases,
-
and begin to track the transmission chain
so that you can stop transmission.
-
We have to have treatment centers,
specialized Ebola treatment centers,
-
where the workers can be protected
-
as they try to provide support
to the people who are infected,
-
so that they might survive the disease
-
And then, for those who do die,
-
we have to ensure there is a safe but at
the same time dignified burial process,
-
so that there is no spread
at that time as well.
-
So we do know how to stop Ebola,
-
and these strategies work,
ladies and gentlemen.
-
The virus was stopped in Nigeria
by these four strategies,
-
and the people
implementing them, obviously.
-
It was stopped in Senegal
where it had spread,
-
and also in the other countries
-
that were affected by this virus,
in this outbreak.
-
So there's no question
that these strategies actually work.
-
The big question, ladies and gentlemen,
-
was whether these strategies could work
on this scale, in this situation,
-
with so many countries affected
with the exponential growth that you saw.
-
That was the big question that we were
facing just two for three months ago.
-
Today, we know the answer
to that question.
-
We know that answer
because of the extraordinary work
-
of an incredible group of NGOs,
of governments, of local leaders,
-
of UN agencies, and many humanitarian
and other organizations
-
that came and joined the fight
to try and stop Ebola in West Africa.
-
But what had to be done
there was slightly different.
-
These countries took
those strategies I just showed you;
-
the communities, the community engagement,
the case finding and contact tracing,
-
and they turn them on their head.
-
There was so much disease,
they approached it differently.
-
What they decided to do was
-
they would first try
and slow down this epidemic
-
by rapidly building
as many beds as possible
-
in specialized treatment centers,
-
so that they could prevent the disease
from spreading from those were infected.
-
They would rapidly build out
many many burial teams
-
so they could safely deal
with the dead,
-
and with that, they would try
and slow this outbreak to see
-
if it could actually then be controlled
-
using the classic approach
of case finding and contact tracing.
-
And when I went to West Africa
about three months ago, when I was there,
-
what I saw was extraordinary.
-
I saw presidents
-
opening emergency operation centers
themselves against Ebola
-
so that they could personally coordinate,
and oversee, and champion
-
this surge of international support
to try and stop this disease.
-
We saw militaries
-
from within those countries
and from far beyond,
-
coming in to help build
Ebola treatment centers
-
that could be used to isolate
those who are sick.
-
We saw the Red Cross Movement
-
working with its partner agencies
on the ground there
-
to help train the community so that they
could actually safely bury their dead
-
in a dignified manner themselves.
-
And we saw the UN agencies,
the World Food Program,
-
build a tremendous air bridge
that could get responders
-
to every single corner
of these countries rapidly
-
to be able to implement the strategies
that we just talked about.
-
What we saw, ladies and gentlemen,
which is probably most impressive,
-
was this incredible work
by the governments,
-
by the leaders in these countries,
with the communities,
-
to try insure
people understood this disease,
-
understood the extraordinary things
they'd have to do to try and stop Ebola.
-
And as a result, ladies and gentlemen,
-
we saw something that we did not know
only two or three months earlier,
-
whether or not it would be possible.
-
What we saw was
-
what you see now in this graph
when we took stock on December 1.
-
What we saw was
we could bend that curve, so to speak,
-
change this exponential growth,
-
and bring some hope back
to the ability to control this outbreak.
-
And for this reason, ladies and gentlemen,
there's absolutely no question now
-
that we can catch up with this outbreak
in West Africa, and we can beat Ebola.
-
The big question though,
that many people are asking,
-
even when they saw this curve, [is]:
-
"Well, hang on a minute;
that's great, you can slow it down,
-
but can you actually
drive it down to zero?"
-
We've already answered that question
right back at the beginning of this talk,
-
when I spoke about Lofa County in Liberia.
-
We told you the story
how Lofa County got to a situation
-
where they have not seen Ebola
for eight weeks.
-
But there are similar stories
from the other countries as well.
-
From Guéckédou in Guinea,
-
the first area where the first case
was actually diagnosed.
-
We've seen very, very few cases
in the last couple of months,
-
and here in Kenema, in Sierra Leone
- another area in the epicenter -
-
we have not seen the virus
for more than a couple of weeks.
-
Way too early to declare
victory, obviously,
-
but evidence, ladies and gentlemen,
-
not only can the response
catch up to the disease
-
but this disease can be driven to zero.
-
The challenge now, of course,
is doing this on the scale needed
-
right across these three countries,
and that is a huge challenge.
-
Because when you've been at
something for this long, on this scale,
-
two other big threats
come in to join the virus.
-
The first of those is complacency,
-
the risk that as this disease curve
starts to bend,
-
the media look elsewhere,
the world looks elsewhere.
-
Complacency's always a risk.
-
And the other risk, of course, is
when you've been working so hard
-
for so long and slept so few hours
over the past months,
-
people are tired, people become fatigued,
-
and these new risks
start to creep into the response.
-
Ladies and gentlemen, I can tell you today
I've just come back from West Africa.
-
The people of this countries,
the leaders of these countries,
-
are not complacent.
-
They want to drive Ebola
to zero in their countries.
-
And these people, yes they're tired,
but they are not fatigued.
-
They have an energy, they have a courage,
-
they have the strength
to get this finished.
-
What they need,
ladies and gentlemen, at this point,
-
is the unwavering support
of the international community,
-
to stand with them, to bolster,
-
and bring even more support
at this time, to get the job finished.
-
Because finishing Ebola right now means
-
turning the tables on this virus
and beginning to hunt it.
-
Remember, this virus, this whole crisis,
rather, started with one case,
-
and is going to finish with one case.
-
But it will only finish if those countries
have got enough epidemiologists,
-
enough health workers, enough logisticians
and enough other people working with them
-
to be able to find every one
of those cases, track their contacts,
-
and make sure that this disease
stops once and for all.
-
I can tell you just having come back,
-
they are not complacent,
they are not fatigued,
-
and they will finish the job,
if they have the support that they need.
-
Ladies and gentlemen,
you know the story of Ebola,
-
we just told you the story
of Ebola, Ebola can be beaten.
-
Now, we need you to take this story out
-
to tell it to the people who will listen
-
and educate them
on what it means to beat Ebola,
-
and more importantly,
we need you to advocate with the people
-
who can help us bring the resources
we need to these countries,
-
to beat this disease.
-
Ladies and gentleman,
-
there are a lot of people out there
who will survive and will thrive
-
in part because of what you do
to help us beat Ebola.
-
Thank you.
-
(Applause)
closed TED
