-
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 items were
kicked around and were discussed,
-
but nobody suggested
this one that you see here today
-
and 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
(Doctors Without Borders)
-
and the treatment center there,
-
they 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 the communities,
to the children, to the 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 chiefs,
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 health care
workers who had come,
-
the heroes who come to try and help save
and 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, Peter,
they 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,
-
tody, loafer County is nearly eight weeks
without seeing a single case of ebola.
-
(Applause)
-
Now this doesn't mean that
the job is done obviously.
-
There still are huge risk that
there will 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 health care 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,
-
evaded the detection for 3 or 4 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 they make it
even more complicated,
-
the virus itself was causing a symptom,
is a type of a presentation
-
that wasn't classical of the disease.
-
So people didn't even recognize
a disease, people who knew ebola
-
For that reason it evaded a detection
for some time,
-
But contrary to public belief
sometimes these days,
-
once the virus was detected,
there was a rapid surge in up support.
-
MSF rep relief set up
the ebola treatment center
-
as many of you know, in the area
the World Health Organization
-
and the partners that worked
with deplored
-
and eventually hundreds of people
over the next two months
-
to be able to help track the virus.
-
The problem is, 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
toward ebola outbreak.
-
By the middle of the year,
not just Guinea
-
but now Sierra Leone and Liberia
were also infected.
-
And 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 to try and help the people,
-
the health care workers, the other
responders
-
were also sick and dying by the dozens.
-
The presidents of these countries
recognized 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,
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 teemy metropolis of Legos
-
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 expectations would be
that there be a huge outpouring of
-
international assistance to help these
countries which were in so much trouble
-
and concerns at that time.
-
But what we saw was
something very different.
-
There was some great response.
-
A number of countries came to assist,
many many NGOs and others as you know,
-
but at the same time, the opposite
happened in many places.
-
Alarm through -- alarm escalated and
very soon these countries found themselves
-
not receiving the support they needed
but increasingly isolated.
-
What we saw with 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 cause 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
-
they could not get
people on airplanes,
-
they couldn't get in to 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 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, and
many of you saw, again,
-
on the televisions, 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 started,
-
no longer functioned the way
that they should in these countries.
-
We saw the misinformation and
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 the space suits,
-
as they call them,
would 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
forty years since it first popped up
-
in Central Africa, 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
the 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 at
-
it then causes in humans
where we see this disease cause
-
severe fevers, diarrhea, vomiting,
and then
-
unfortunately, in 70% of the cases
or probably 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.
-
This 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
a system that could find every single case
-
every contact of those cases and
begin to track to transmission chains
-
so that you can stop transmission.
-
We have to have treatment center
specialized ebola treatment centers,
-
where the workers can be protected
as they try to provide support
-
to these add 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 kinda exponential growth
that you saw.
-
That was a 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 incredible group of NGOs and
governments, of local leaders,
-
of UN agencies and many humanitarian
and other organizations
-
that came and joined the fight,
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 and community engagement
the case finding, contact tracing, etc.
-
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 so that they specialized
-
treatment centers so that they could
control, they could prevent the disease
-
from spreading from those were infected.
-
They would rapidly build out
many many burial teams so that
-
they could safely
deal with the dead.
-
With that, they were trying to slow
this outbreakts see if it could
-
actually then be controlled using
the classic approach
-
of case finding in 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 in champion
-
this surge of international support
to try and stop this disease.
-
We saw military's from within
those countries in 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
Programme build a tremendous
-
air bridge that could get responders
to every single corner at 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 just incredible work by the government
by the leaders in these countries
-
with the communities to try insure people
understood this disease,
-
understood the extraordinary things they
would 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 the first of December.
-
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 is that
many people are asking even when
-
they saw this curve, they said,
"hang on a minute, that's great
-
you can slow it down, but can you
actually drive it down to zero?"
-
Now we already answered that question
at right back the beginning of this talk
-
when I spoke about Lofa county
in Liberia,
-
we told you the story haw Lofa county
got to a situation where they have
-
not seen ebola for eight weeks.
But this similar stories
-
from the other countries as well,
from GuĂŠckĂŠdou 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 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,
they 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 epidemiologist,
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 had the support that they need.
-
Ladies and gentleman, 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
Csaba Lóki
At 8:03 there is a confusing mistake in the original trascript, saying "started" instead of "startled". Please post-edit it in order to prevent misunderstandings for other languages!
Brian Greene
Two corrections were made to this transcript on March 9, 2016.
The subtitle beginning at 8:03 was changed to:
What we saw was commercial airlines
[stopped] flying into these countries
The subtitle beginning at 8:12 was changed to:
This caused not only problems, obviously,
for the countries themselves,