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Humanity vs. Ebola. How we could win a terrifying war
-
0:01 - 0:04When I was asked to -
invited, rather, -
0:04 - 0:06to give this talk
a couple of months ago -
0:06 - 0:10we discussed a number
of titles with the organizers -
0:10 - 0:13and a lot of different items were
kicked around and were discussed, -
0:13 - 0:17but nobody suggested
this one that you see here today -
0:17 - 0:20and the reason for that was,
two months ago -
0:20 - 0:23ebola was escalating exponentially
-
0:23 - 0:26and spreading over wider geographic areas
than we had ever seen -
0:26 - 0:30and the world was terrified,
concerned and alarmed -
0:30 - 0:35by this disease, in a way we've not
seen in recent history. -
0:35 - 0:39But today, I can stand here
and I can talk to you -
0:39 - 0:42about beating ebola,
-
0:42 - 0:45because of people
whom you've never heard of, -
0:45 - 0:48people like Peter Clement,
-
0:50 - 0:55a Liberian doctor,
who's working in Lofa county, -
0:55 - 1:01a place that many of you have
never heard of, probably, in Liberia. -
1:02 - 1:04The reason that Lofa county
is so important -
1:04 - 1:07is because
about five months ago, -
1:07 - 1:11when the epidemic was
just starting to escalate, -
1:11 - 1:16Lofa county was right at the center,
the epicenter of this epidemic. -
1:16 - 1:18At that time, MSF
(Doctors Without Borders) -
1:18 - 1:20and the treatment center there,
-
1:20 - 1:22they were seeing dozens of patients
every single day, -
1:22 - 1:27and these patients, these communities
were becoming more and more terrified -
1:27 - 1:31as time went by, with this disease
and what it was doing to their families, -
1:31 - 1:35to the communities,
to the children, to the relatives. -
1:35 - 1:40And so Peter Clement was charged with
driving that 12 hour long rough road, -
1:40 - 1:43from Monrovia, the capital,
up to Lofa county, -
1:43 - 1:48to try and help bring control
to the escalating epidemic there. -
1:48 - 1:54And what Peter found when he arrived
was a terror that I just mentioned to you. -
1:54 - 1:57So he sat down with the local chiefs,
and he listened. -
1:58 - 2:02And what he heard was heartbreaking.
-
2:02 - 2:06He heard about the devastation
and the desperation -
2:06 - 2:09of people affected by this disease.
-
2:09 - 2:12He heard the heartbreaking stories about
-
2:12 - 2:15not just the damage that
ebola did to people, -
2:15 - 2:18but what it did to families
and what it did to communities. -
2:19 - 2:23And he listened to the chiefs,
the local chiefs there -
2:23 - 2:25and what they told him - they said
-
2:25 - 2:28"When our children are sick,
when our children are dying, -
2:28 - 2:31we can't hold them at a time when
we want to be closest to them. -
2:31 - 2:36When our relatives die, we can't
take care of them as our tradition demands -
2:36 - 2:38we are not allowed to wash
the bodies to bury them -
2:38 - 2:41the way our communities and
our rituals demand. -
2:41 - 2:45And for this reason,
they were deeply disturbed, deeply alarmed -
2:45 - 2:49and the entire epidemic
was unraveling in front of them. -
2:49 - 2:52People were turning on the health care
workers who had come, -
2:52 - 2:55the heroes who come to try and help save
and the community -
2:55 - 2:59to help work with the community,
And they were unable to access them. -
3:00 - 3:06And what happened then was
Peter explained to the leaders, -
3:06 - 3:09the leaders listened.
They turned the tables. -
3:09 - 3:13And Peter explained what ebola was.
He explained what the disease was, -
3:13 - 3:15he explained what it did
to their communities. -
3:15 - 3:20And he explained that ebola threatened
everything that made us human. -
3:20 - 3:24Ebola means you can't hold your children
the way you would in this situation. -
3:24 - 3:27You can't bury your dead
the way that you would. -
3:27 - 3:31You have to trust these people
in the space suits to do that for you. -
3:31 - 3:35And ladies and gentlemen, what
happened then was rather extraordinary; -
3:35 - 3:38the community, health workers, Peter,
they sat down together -
3:38 - 3:43and they put together a new plan
for controlling ebola in that Lofa county. -
3:43 - 3:47And the reason that this is such
an important story, ladies and gentlemen, -
3:47 - 3:53is because today, this County, which is
right at the center of this epidemic -
3:53 - 3:56you've been watching,
you've been seeing on the newspapers, -
3:56 - 3:59you've been seeing on
the television screens, -
3:59 - 4:05tody, loafer County is nearly eight weeks
without seeing a single case of ebola. -
4:05 - 4:12(Applause)
-
4:12 - 4:15Now this doesn't mean that
the job is done obviously. -
4:15 - 4:19There still are huge risk that
there will be additional cases there. -
4:19 - 4:22But what it does teach us is that
ebola can be beaten. -
4:22 - 4:24That's the key thing.
-
4:24 - 4:27Even on the scale, even with the rapid
kind of growth that we saw -
4:27 - 4:32in this environment here,
we now know ebola can be beaten. -
4:32 - 4:36When communities come together
with health care workers work together, -
4:36 - 4:39that's when this disease can be stopped.
-
4:39 - 4:42But how did ebola end up in Lofa county
in the first place? -
4:42 - 4:47Well, for that, we have to go back
12 months, to the start of this epidemic. -
4:47 - 4:51And as many you know,
this virus went undetected, -
4:51 - 4:55evaded the detection for 3 or 4 months
when it began. -
4:55 - 4:57That's because this is not
a disease of West Africa, -
4:57 - 5:01it's a disease of Central Africa,
half a continent away. -
5:01 - 5:03People hadn't seen the disease before,
-
5:03 - 5:05health workers hadn't seen
the disease before -- -
5:05 - 5:07they didn't know what
they were dealing with, -
5:07 - 5:09and they make it
even more complicated, -
5:09 - 5:14the virus itself was causing a symptom,
is a type of a presentation -
5:14 - 5:16that wasn't classical of the disease.
-
5:16 - 5:20So people didn't even recognize
a disease, people who knew ebola -
5:20 - 5:24For that reason it evaded a detection
for some time, -
5:24 - 5:27But contrary to public belief
sometimes these days, -
5:27 - 5:33once the virus was detected,
there was a rapid surge in up support. -
5:33 - 5:37MSF rep relief set up
the ebola treatment center -
5:37 - 5:40as many of you know, in the area
the World Health Organization -
5:40 - 5:42and the partners that worked
with deplored -
5:42 - 5:45and eventually hundreds of people
over the next two months -
5:45 - 5:48to be able to help track the virus.
-
5:48 - 5:51The problem is, ladies and gentlemen,
is by then, this virus, -
5:51 - 5:54well known now as ebola,
had spread too far. -
5:54 - 5:58It had already outstripped what was
one of the largest responses -
5:58 - 6:02that had been mounted so far
toward ebola outbreak. -
6:02 - 6:04By the middle of the year,
not just Guinea -
6:04 - 6:08but now Sierra Leone and Liberia
were also infected. -
6:08 - 6:13And the virus was spreading geographically
the numbers were increasing -
6:13 - 6:18and at this time, not only were
hundreds of people infected -
6:18 - 6:21and dying of the disease,
but as importantly, -
6:21 - 6:23the front line responders,
-
6:23 - 6:26the people who to try and help the people,
-
6:26 - 6:29the health care workers, the other
responders -
6:29 - 6:32were also sick and dying by the dozens.
-
6:32 - 6:35The presidents of these countries
recognized emergencies -
6:35 - 6:38they met right around that time,
they agreed on common action -
6:38 - 6:42and they put together an emergency
joint operation center in Conakry -
6:42 - 6:47to try and work together to finish this
disease and get it stopped, -
6:47 - 6:50to implement the strategies
we talked about. -
6:50 - 6:54But what happened then was something
we had never seen before with ebola. -
6:54 - 6:58What happened then was the virus,
someone sick with the virus, -
6:58 - 7:01boarded an airplane,
flew to another country, -
7:01 - 7:05and for the first time,
we saw in another distant country -
7:05 - 7:08the virus pop up again.
-
7:08 - 7:12This time it was in Nigeria
in the teemy metropolis of Legos -
7:12 - 7:1421 million people.
-
7:14 - 7:17Now the virus was in that environment.
-
7:17 - 7:21And as you can anticipate,
there was international alarm, -
7:21 - 7:24international concern on a scale that
we haven't seen in recent years -
7:24 - 7:27caused by a disease like this.
-
7:27 - 7:31The World Health Organization immediately
called together an expert panel, -
7:31 - 7:34looked at the situation,
declared an international emergency. -
7:34 - 7:40And in doing so, the expectations would be
that there be a huge outpouring of -
7:40 - 7:45international assistance to help these
countries which were in so much trouble -
7:45 - 7:48and concerns at that time.
-
7:48 - 7:50But what we saw was
something very different. -
7:50 - 7:54There was some great response.
-
7:54 - 7:58A number of countries came to assist,
many many NGOs and others as you know, -
7:58 - 8:02but at the same time, the opposite
happened in many places. -
8:02 - 8:08Alarm through -- alarm escalated and
very soon these countries found themselves -
8:08 - 8:12not receiving the support they needed
but increasingly isolated. -
8:12 - 8:17What we saw with commercial airlines
started flying into these countries -
8:17 - 8:20and people who hadn't even been
exposed to the virus -
8:20 - 8:22were no longer allowed to travel.
-
8:22 - 8:26This cause not only problems, obviously,
for the countries themselves, -
8:26 - 8:28but also for the response.
-
8:28 - 8:31Those organizations that we're trying to
bring people in, -
8:31 - 8:33to try and help them
respond to the outbreak -
8:33 - 8:35they could not get
people on airplanes, -
8:35 - 8:38they couldn't get in to the countries
to be able to respond. -
8:38 - 8:41In that situation,
ladies and gentleman, -
8:41 - 8:44a virus like ebola takes advantage.
-
8:44 - 8:49And what we saw then was something
also we hadn't seen before. -
8:49 - 8:51Not only did this virus
continue in the places -
8:51 - 8:55where they'd already become infected,
but then it started to escalate -
8:55 - 8:58and we saw the case numbers that you
see here, -
8:58 - 9:01something we never seen before
on such a scale -
9:01 - 9:04and exponential increase ebola cases
-
9:04 - 9:08not just in these countries or the areas
already infected in these countries -
9:08 - 9:12but also spreading further and
deeper into these countries. -
9:12 - 9:14Ladies and gentleman, this was one of the
-
9:14 - 9:20most concerning international emergencies
in public health we've ever seen. -
9:20 - 9:24And what happened in these countries, and
many of you saw, again, -
9:24 - 9:26on the televisions, read about in
the newspapers, -
9:26 - 9:32we saw the health system start to collapse
under the weight of this epidemic. -
9:32 - 9:37We saw the schools begin to close,
markets no longer started, -
9:37 - 9:40no longer functioned the way
that they should in these countries. -
9:40 - 9:44We saw the misinformation and
the misperceptions started to spread -
9:44 - 9:48even faster through the communities
which became even more alarmed -
9:48 - 9:49about the situation.
-
9:49 - 9:53They started to recoil from those people
that you saw in the space suits, -
9:53 - 9:55as they call them,
would come to help them. -
9:55 - 9:58And then the situation deteriorated
even further. -
9:58 - 10:01The countries had to declare a state of
emergency. -
10:01 - 10:04Large populations need to
be quarantined in some areas -
10:04 - 10:10and then riots broke out.
It was a very very terrifying situation -
10:10 - 10:13And the world many people began to ask
-
10:13 - 10:17can we ever stop ebola
when it starts to spread like this -
10:17 - 10:21and they started to ask how well
do we really know this virus. -
10:22 - 10:24The reality is we don't know
ebola extremely well. -
10:25 - 10:29It's a relatively modern disease
in terms of what we know about it -
10:29 - 10:32we've known the disease only for
forty years since it first popped up -
10:32 - 10:35in Central Africa, 1976.
-
10:35 - 10:38But despite that we do know many things,
-
10:38 - 10:42we know that this virus probably survives
in a type of a bat, -
10:42 - 10:45we know that it probably enters
a human population -
10:45 - 10:48when we come in contact with
the wild animal that has been -
10:48 - 10:51infected with the virus
and probably sickened by it. -
10:52 - 10:55Then we know that the
virus spreads from person to person -
10:55 - 10:57through contaminated body fluids.
-
10:57 - 11:00And as you've all seen we know
the horrific disease at -
11:00 - 11:03it then causes in humans
where we see this disease cause -
11:04 - 11:06severe fevers, diarrhea, vomiting,
and then -
11:06 - 11:12unfortunately, in 70% of the cases
or probably more, death. -
11:12 - 11:18This is a very dangerous, debilitating,
and deadly disease. -
11:18 - 11:22But despite the fact that we've not known
this disease for a particularly long time, -
11:22 - 11:27and we don't know everything about it,
we do know how to stop this disease. -
11:27 - 11:30This four things that are critical to
stopping ebola. -
11:30 - 11:35First and foremost, the communities
have got to understand this disease, -
11:35 - 11:39they've got to understand
how it spreads and how to stop it. -
11:39 - 11:43And then we've got to be able to have
a system that could find every single case -
11:43 - 11:47every contact of those cases and
begin to track to transmission chains -
11:47 - 11:49so that you can stop transmission.
-
11:49 - 11:52We have to have treatment center
specialized ebola treatment centers, -
11:52 - 11:57where the workers can be protected
as they try to provide support -
11:57 - 12:00to these add to the people
who are infected, -
12:00 - 12:02so that they might survive the disease
-
12:02 - 12:06and then for those who do die,
we have to ensure -
12:06 - 12:10there is a safe, but at the same time,
dignified burial process, -
12:10 - 12:13so that there is no spread
at that time as well. -
12:13 - 12:19So we do know how to stop ebola and these
strategies work, ladies and gentlemen, -
12:19 - 12:23the virus was stopped in Nigeria
by these four strategies -
12:23 - 12:26and the people implementing them
obviously, -
12:26 - 12:29it was stopped in Senegal where it had
spread, and also in the other countries -
12:29 - 12:33that were affected by this virus,
in this outbreak. -
12:33 - 12:37So there's no question that
these strategies actually work. -
12:37 - 12:43The big question, ladies and gentlemen,
was whether these strategies could work -
12:43 - 12:47on this scale, in this situation, with
so many countries affected with -
12:47 - 12:50the kinda exponential growth
that you saw. -
12:50 - 12:55That was a big question that we were
facing just two for three months ago. -
12:55 - 12:59Today, we know
the answer to that question. -
12:59 - 13:03We know that answer because of
the extraordinary work -
13:03 - 13:07of incredible group of NGOs and
governments, of local leaders, -
13:07 - 13:11of UN agencies and many humanitarian
and other organizations -
13:11 - 13:15that came and joined the fight,
try and stop ebola in West Africa. -
13:16 - 13:19But what had to be done there
was slightly different. -
13:19 - 13:22These countries took those strategies
I just showed you; -
13:22 - 13:26the communities and community engagement
the case finding, contact tracing, etc. -
13:26 - 13:29and they turn them on their head.
-
13:29 - 13:32There was so much disease
they approached it differently. -
13:32 - 13:37What they decided to do was they would
first try and slow down this epidemic -
13:37 - 13:42by rapidly building as many beds
as possible so that they specialized -
13:42 - 13:46treatment centers so that they could
control, they could prevent the disease -
13:46 - 13:47from spreading from those were infected.
-
13:47 - 13:50They would rapidly build out
many many burial teams so that -
13:50 - 13:52they could safely
deal with the dead. -
13:52 - 13:55With that, they were trying to slow
this outbreakts see if it could -
13:55 - 13:59actually then be controlled using
the classic approach -
13:59 - 14:01of case finding in contact tracing.
-
14:01 - 14:06And when I went to West Africa about
three months ago when I was there, -
14:06 - 14:08what I saw was extraordinary
-
14:08 - 14:13I saw presidents opening emergency
operation centers themselves against ebola -
14:13 - 14:17so that they could personally coordinate
and oversee in champion -
14:17 - 14:21this surge of international support
to try and stop this disease. -
14:21 - 14:25We saw military's from within
those countries in from far beyond -
14:25 - 14:27coming in to help build
ebola treatment centers -
14:27 - 14:30that could be used to isolate
those who are sick. -
14:30 - 14:35We saw the Red Cross movement working with
its partner agencies on the ground there -
14:35 - 14:38to help train the community
so that they could actually -
14:38 - 14:43safely bury their dead
in a dignified manner themselves, -
14:43 - 14:47and we saw the UN agencies the World Food
Programme build a tremendous -
14:47 - 14:51air bridge that could get responders
to every single corner at these countries -
14:51 - 14:55rapidly to be able to implement
the strategies that we just talked about. -
14:55 - 14:59What we saw, ladies and gentlemen,
which is probably most impressive -
14:59 - 15:03was just incredible work by the government
by the leaders in these countries -
15:03 - 15:08with the communities to try insure people
understood this disease, -
15:08 - 15:13understood the extraordinary things they
would have to do to try and stop ebola. -
15:13 - 15:18And as a result, ladies and gentlemen,
we saw something that we did not know -
15:18 - 15:22only two or three months earlier
whether or not it would be possible. -
15:22 - 15:26What we saw was what you see now
in this graph, -
15:26 - 15:28when we took stock
on the first of December. -
15:28 - 15:32what we saw was we could bend that curve,
so to speak, -
15:32 - 15:35change this exponential growth
and bring some hope back -
15:35 - 15:38to the ability to control this outbreak.
-
15:38 - 15:40And for this reason, ladies and gentlemen,
-
15:40 - 15:44there's absolutely no question now
that we can catch up with this outbreak -
15:44 - 15:48in West Africa, and we can beat ebola.
-
15:48 - 15:52The big question though is that
many people are asking even when -
15:52 - 15:55they saw this curve, they said,
"hang on a minute, that's great -
15:55 - 15:58you can slow it down, but can you
actually drive it down to zero?" -
15:58 - 16:02Now we already answered that question
at right back the beginning of this talk -
16:02 - 16:09when I spoke about Lofa county
in Liberia, -
16:09 - 16:13we told you the story haw Lofa county
got to a situation where they have -
16:13 - 16:16not seen ebola for eight weeks.
But this similar stories -
16:16 - 16:21from the other countries as well,
from GuĂŠckĂŠdou in Guinea, -
16:21 - 16:25the first area where the first case was
actually diagnosed. -
16:25 - 16:29We've seen very very few cases
in the last couple of months, -
16:29 - 16:34and here in Kenema, in Sierra Leone,
another area in the epicenter, -
16:34 - 16:38we have not seen the virus for more than
a couple of weeks -- -
16:38 - 16:42way too early to declare victory obviously
but evidence, ladies and gentlemen, -
16:42 - 16:47not only can the response catch up
to the disease but this disease -
16:47 - 16:52can be driven to zero. The challenge now,
of course, is doing this -
16:52 - 16:57on the scale needed right across these
three countries, -
16:57 - 17:02and that is a huge challenge. Because
when you've been at something -
17:02 - 17:08for this long, on this scale, two other
big threats come in to join the virus. -
17:08 - 17:13The first of those is complacency.
The risk that as this disease -
17:13 - 17:17curve starts to bend, the media look
elsewhere, the world looks elsewhere. -
17:17 - 17:21Complacency always a risk.
And the other risk of course is -
17:21 - 17:25when you've been working so hard
for so long and slept so few hours -
17:25 - 17:30over the past months, people are tired,
people become fatigued and these new risks -
17:30 - 17:35start to creep into the response.
Ladies and gentlemen, I can tell you today -
17:35 - 17:40I've just come back from West Africa.
The people of this countries, -
17:40 - 17:43the leaders of these countries,
they are not complacent. -
17:43 - 17:47They want to drive ebola to zero
in their countries. -
17:47 - 17:50And these people, yes they're tired,
but they are not fatigued. -
17:50 - 17:53They have an energy, they have a courage,
-
17:53 - 17:56they have the strength
to get this finished. -
17:56 - 18:00What they need, ladies and gentlemen,
at this point, is the unwavering support -
18:00 - 18:04of the international community, to stand
with them, to bolster and bring even more -
18:04 - 18:09support at this time, to get the
job finished. Because finishing ebola -
18:09 - 18:14right now means turning the tables
on this virus, and beginning to hunt it. -
18:14 - 18:19Remember, this virus, this whole crisis,
rather, started with one case, -
18:19 - 18:25and is going to finish with one case.
But it will only finish if those countries -
18:25 - 18:29have got enough epidemiologist,
enough health workers, enough logisticians -
18:29 - 18:32and enough other people working with them
to be able to find every one of -
18:32 - 18:37those cases track their contacts and make
sure that this disease stops -
18:37 - 18:40once and for all.
I can tell you just having come back, -
18:40 - 18:45they are not complacent, they are not
fatigued, and they will finish the job, -
18:45 - 18:48if they had the support that they need.
-
18:48 - 18:52Ladies and gentleman, you know the story
of ebola, we just told you the story -
18:52 - 18:57of ebola, ebola can be beaten.
Now we need you to take this story out -
18:57 - 19:01to tell it to the people who will listen
and educate them on what it means -
19:01 - 19:06to beat ebola, and more importantly,
we need you to advocate with the people -
19:06 - 19:10who can help us bring the resources we
need to these countries, -
19:10 - 19:12to beat this disease.
-
19:12 - 19:16Ladies and gentleman, there are a lot of
people out there who will survive and -
19:16 - 19:20will thrive, in part, because of
what you do to help us beat ebola. -
19:20 - 19:22Thank you.
-
19:22 - 19:26(Applause)
- Title:
- Humanity vs. Ebola. How we could win a terrifying war
- Speaker:
- Bruce Aylward
- Description:
-
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 19:11
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Amara Bot
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,