WEBVTT

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When I was invited to give this talk 
a couple of months ago,

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we discussed a number 
of titles with the organizers,

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and a lot of different items were 
kicked around and were discussed.

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But nobody suggested this one,

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and the reason for that
was two months ago,

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Ebola was escalating exponentially

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and spreading over wider geographic areas
than we had ever seen,

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and the world was terrified, 
concerned and alarmed

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by this disease, in a way we've not 
seen in recent history.

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But today, I can stand here 
and I can talk to you about beating Ebola

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because of people 
whom you've never heard of,

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people like Peter Clement, a Liberian 
doctor who's working in Lofa County,

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a place that many of you have 
never heard of, probably, in Liberia.

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The reason that Lofa County 
is so important

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is because about five months ago,

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when the epidemic was 
just starting to escalate,

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Lofa County was right at the center, 
the epicenter of this epidemic.

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At that time, MSF
and the treatment center there,

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they were seeing dozens of patients 
every single day,

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and these patients, these communities
were becoming more and more terrified

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as time went by, with this disease 
and what it was doing to their families,

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to their communities, 
to their children, to their relatives.

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And so Peter Clement was charged with 
driving that 12-hour-long rough road

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from Monrovia, the capital,
up to Lofa County,

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to try and help bring control
to the escalating epidemic there.

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And what Peter found when he arrived was
the terror that I just mentioned to you.

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So he sat down with the local chiefs, 
and he listened.

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And what he heard was heartbreaking.

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He heard about the devastation 
and the desperation

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of people affected by this disease.

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He heard the heartbreaking stories

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about not just the damage
that Ebola did to people,

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but what it did to families 
and what it did to communities.

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And he listened to the local chiefs there
and what they told him --

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They said, "When our children are sick, 
when our children are dying,

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we can't hold them at a time when 
we want to be closest to them.

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When our relatives die, we can't take care
of them as our tradition demands.

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We are not allowed to wash 
the bodies to bury them

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the way our communities and 
our rituals demand.

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And for this reason, they were
deeply disturbed, deeply alarmed

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and the entire epidemic 
was unraveling in front of them.

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People were turning on the healthcare 
workers who had come,

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the heroes who had come to try 
and help save the community,

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to help work with the community,
and they were unable to access them.

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And what happened then was 
Peter explained to the leaders.

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The leaders listened. 
They turned the tables.

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And Peter explained what Ebola was.
He explained what the disease was.

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He explained what it did
to their communities.

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And he explained that Ebola threatened 
everything that made us human.

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Ebola means you can't hold your children
the way you would in this situation.

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You can't bury your dead 
the way that you would.

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You have to trust these people 
in these space suits to do that for you.

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And ladies and gentlemen, what 
happened then was rather extraordinary:

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The community and the health workers, 
Peter, they sat down together

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and they put together a new plan 
for controlling Ebola in Lofa County.

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And the reason that this is such 
an important story, ladies and gentlemen,

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is because today, this county, which is 
right at the center of this epidemic

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you've been watching, 
you've been seeing in the newspapers,

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you've been seeing on 
the television screens,

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today Lofa County is nearly eight weeks
without seeing a single case of Ebola.

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(Applause)

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Now, this doesn't mean that 
the job is done, obviously.

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There's still a huge risk
that there will be additional cases there.

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But what it does teach us 
is that Ebola can be beaten.

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That's the key thing.

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Even on this scale,

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even with the rapid kind of growth
that we saw in this environment here,

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we now know Ebola can be beaten.

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When communities come together 
with health care workers, work together,

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that's when this disease can be stopped.

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But how did Ebola end up
in Lofa County in the first place?

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Well, for that, we have to go back 
12 months, to the start of this epidemic.

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And as many of you know, 
this virus went undetected,

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it evaded detection for three 
or four months when it began.

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That's because this is not 
a disease of West Africa,

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it's a disease of Central Africa, 
half a continent away.

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People hadn't seen the disease before;

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health workers hadn't seen 
the disease before.

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They didn't know what 
they were dealing with,

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and to make it 
even more complicated,

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the virus itself was causing a symptom,
a type of a presentation

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that wasn't classical of the disease.

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So people didn't even recognize 
the disease, people who knew Ebola.

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For that reason it evaded detection 
for some time,

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But contrary to public belief 
sometimes these days,

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once the virus was detected, 
there was a rapid surge in of support.

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MSF rapidly set up an Ebola treatment 
center, as many of you know, in the area.

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The World Health Organization
and the partners that it works with

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deployed eventually hundreds of people 
over the next two months

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to be able to help track the virus.

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The problem, ladies and gentlemen,
is by then, this virus,

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well known now as Ebola, 
had spread too far.

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It had already outstripped what was 
one of the largest responses

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that had been mounted so far
to an Ebola outbreak.

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By the middle of the year,
not just Guinea

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but now Sierra Leone and Liberia
were also infected.

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And the virus was spreading geographically
the numbers were increasing

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and at this time, not only were 
hundreds of people infected

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and dying of the disease,
but as importantly,

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the front line responders,

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the people who had gone 
to try and help the people,

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the health care workers, the other 
responders

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were also sick and dying by the dozens.

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The presidents of these countries 
recognized the emergencies

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they met right around that time, 
they agreed on common action

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and they put together an emergency 
joint operation center in Conakry

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to try and work together to finish this
disease and get it stopped,

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to implement the strategies
we talked about.

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But what happened then was something 
we had never seen before with Ebola.

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What happened then was the virus, 
or someone sick with the virus,

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boarded an airplane, 
flew to another country,

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and for the first time,
we saw in another distant country

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the virus pop up again.

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This time it was in Nigeria,
in the teeming metropolis of Legos,

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21 million people.

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Now the virus was in that environment.

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And as you can anticipate, 
there was international alarm,

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international concern on a scale that 
we hadn't seen in recent years

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caused by a disease like this.

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The World Health Organization immediately 
called together an expert panel,

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looked at the situation, 
declared an international emergency.

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And in doing so, the expectations would be
that there be a huge outpouring

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of international assistance to help these 
countries which were in so much trouble

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and concern at that time.

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But what we saw was 
something very different.

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There was some great response.

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A number of countries came to assist,
many many NGOs and others as you know,

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but at the same time, the opposite 
happened in many places.

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Alarm escalated and very soon 
these countries found themselves

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not receiving the support they needed
but increasingly isolated.

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What we saw with commercial airlines
started flying into these countries

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and people who hadn't even been
exposed to the virus

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were no longer allowed to travel.

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This cause not only problems, obviously, 
for the countries themselves,

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but also for the response.

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Those organizations that were trying to
bring people in,

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to try and help them
respond to the outbreak

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they could not get 
people on airplanes,

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they could not get them in to the 
countries to be able to respond.

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In that situation,
ladies and gentleman,

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a virus like Ebola takes advantage.

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And what we saw then was something 
also we hadn't seen before.

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Not only did this virus 
continue in the places

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where they'd already become infected,
but then it started to escalate

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and we saw the case numbers that you 
see here,

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something we'd never seen before 
on such a scale

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and exponential increase of Ebola cases

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not just in these countries or the areas 
already infected in these countries

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but also spreading further and 
deeper into these countries.

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Ladies and gentleman, this was one of the

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most concerning international emergencies 
in public health we've ever seen.

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And what happened in these 
countries then, many of you saw, again,

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on the televisions, read about in 
the newspapers,

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we saw the health system start to collapse
under the weight of this epidemic.

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We saw the schools begin to close, 
markets no longer started,

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no longer functioned the way 
that they should in these countries.

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We saw the misinformation and 
the misperceptions started to spread

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even faster through the communities 
which became even more alarmed

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about the situation.

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They started to recoil from those people 
that you saw in the space suits,

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as they call them, 
would come to help them.

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And then the situation deteriorated 
even further.

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The countries had to declare a state of
emergency.

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Large populations needed to 
be quarantined in some areas

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and then riots broke out. 
It was a very very terrifying situation

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And the world many people began to ask

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can we ever stop Ebola 
when it starts to spread like this

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and they started to ask, how well 
do we really know this virus.

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The reality is we don't know 
Ebola extremely well.

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It's a relatively modern disease 
in terms of what we know about it

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we've known the disease only for 
forty years since it first popped up

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in Central Africa in 1976.

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But despite that we do know many things,

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we know that this virus probably survives
in a type of a bat,

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we know that it probably enters 
a human population

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when we come in contact with
a wild animal that has been

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infected with the virus 
and probably sickened by it.

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Then we know that the
virus spreads from person to person

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through contaminated body fluids.

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And as you've all seen we know 
the horrific disease,

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that it then causes in humans
where we see this disease cause

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severe fevers, diarrhea, vomiting, 
and then

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unfortunately, in 70% of the cases 
or often more, death.

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This is a very dangerous, debilitating, 
and deadly disease.

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But despite the fact that we've not known
this disease for a particularly long time,

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and we don't know everything about it,
we do know how to stop this disease.

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There are four things that are critical to 
stopping Ebola.

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First and foremost, the communities 
have got to understand this disease,

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they've got to understand 
how it spreads and how to stop it.

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And then we've got to be able to have 
systems that can find every single case,

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every contact of those cases and 
begin to track to transmission chains

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so that you can stop transmission.

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We have to have treatment center
specialized Ebola treatment centers,

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where the workers can be protected
as they try to provide support

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to the people who are infected,

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so that they might survive the disease.

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And then for those who do die, 
we have to ensure

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there is a safe, but at the same time, 
dignified burial process,

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so that there is no spread 
at that time as well.

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So we do know how to stop Ebola and these
strategies work, ladies and gentlemen,

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the virus was stopped in Nigeria 
by these four strategies

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and the people implementing them 
obviously.

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It was stopped in Senegal where it had
spread, and also in the other countries

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that were affected by this virus, 
in this outbreak.

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So there's no question that 
these strategies actually work.

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The big question, ladies and gentlemen,
was whether these strategies could work

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on this scale, in this situation, with 
so many countries affected with

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the kinda exponential growth 
that you saw.

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That was a big question that we were 
facing just two or three months ago.

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Today, we know 
the answer to that question.

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We know that answer because of 
the extraordinary work

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of an incredible group of NGOs and 
governments, of local leaders,

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of UN agencies and many humanitarian 
and other organizations

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that came and joined the fight, 
to try and stop Ebola in West Africa.

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But what had to be done there 
was slightly different.

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These countries took those strategies 
I just showed you;

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the communities and community engagement
the case finding, contact tracing, etc.

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and they turn them on their head.

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There was so much disease 
they approached it differently.

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What they decided to do was they would 
first try and slow down this epidemic

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by rapidly building as many beds 
as possible so that they specialized

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treatment centers so that they could 
control, they could prevent the disease

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from spreading from those were infected.

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They would rapidly build out
many many burial teams so that

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they could safely deal with the dead,

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and with that, they would try and slow 
this outbreak

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to see if it could actually then 
be controlled using the classic approach

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of case finding in contact tracing.

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And when I went to West Africa about 
three months ago when I was there,

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what I saw was extraordinary.

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I saw presidents opening emergency
operation centers themselves against Ebola

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so that they could personally coordinate 
and oversee in champion

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this surge of international support 
to try and stop this disease.

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We saw militaries from within 
those countries in from far beyond

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coming in to help build 
Ebola treatment centers

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that could be used to isolate 
those who were sick.

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to help train the community 
so that they could actually

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We saw the Red Cross movement working with
its partner agencies on the ground there

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safely bury their dead
in a dignified manner themselves,

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and we saw the UN agencies the World Food 
Program build a tremendous

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air bridge that could get responders 
to every single corner of these countries

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rapidly to be able to implement 
the strategies that we just talked about.

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What we saw, ladies and gentlemen, 
which is probably most impressive

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was this incredible work by the governments,
by the leaders in these countries

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with the communities to try 
to ensure people understood this disease,

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understood the extraordinary things they 
would have to do to try and stop Ebola.

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And as a result, ladies and gentlemen,
we saw something that we did not know

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only two or three months earlier,
whether or not it would be possible.

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What we saw was what you see now 
in this graph,

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when we took stock 
on the first of December.

00:15:17.118 --> 00:15:20.560
what we saw was we could bend that curve, 
so to speak,

00:15:20.560 --> 00:15:24.334
change this exponential growth
and bring some hope back

00:15:24.334 --> 00:15:27.163
to the ability to control this outbreak.

00:15:27.163 --> 00:15:29.197
And for this reason, ladies and gentlemen,

00:15:29.197 --> 00:15:33.368
there's absolutely no question now 
that we can catch up with this outbreak

00:15:33.368 --> 00:15:37.785
in West Africa, and we can beat Ebola.

00:15:37.785 --> 00:15:39.578
The big question though is,

00:15:39.578 --> 00:15:42.941
that many people are asking even when
they saw this curve, they said,

00:15:42.941 --> 00:15:45.485
"hang on a minute, that's great
you can slow it down,

00:15:45.485 --> 00:15:47.656
but can you actually drive it down 
to zero?"

00:15:47.656 --> 00:15:51.057
Now we already answered that question 
back at the beginning of this talk

00:15:51.057 --> 00:15:55.590
when I spoke about Lofa county 
in Liberia,

00:15:55.590 --> 00:15:59.526
we told you the story haw Lofa county 
got to a situation where they have

00:15:59.526 --> 00:16:01.829
not seen Ebola for eight weeks.

00:16:01.829 --> 00:16:05.205
But there are similar stories from 
the other countries as well.

00:16:05.205 --> 00:16:07.451
From Gueckedou in Guinea,

00:16:07.451 --> 00:16:11.959
the first area where the first case was
actually diagnosed.

00:16:11.959 --> 00:16:15.373
We've seen very very few cases
in the last couple of months,

00:16:15.373 --> 00:16:19.800
and here in Kenema, in Sierra Leone, 
another area in the epicenter,

00:16:19.800 --> 00:16:23.061
we have not seen the virus for more than 
a couple of weeks --

00:16:23.061 --> 00:16:27.980
way too early to declare victory obviously
but evidence, ladies and gentlemen,

00:16:27.980 --> 00:16:32.346
not only can the response catch up 
to the disease but this disease

00:16:32.346 --> 00:16:34.722
can be driven to zero.

00:16:34.722 --> 00:16:38.878
The challenge now, of course, is doing this 
on the scale needed

00:16:38.878 --> 00:16:44.244
right across these three countries,
and that is a huge challenge.

00:16:44.244 --> 00:16:46.579
Because when you've been at something

00:16:46.579 --> 00:16:52.949
for this long, on this scale, two other 
big threats come in to join the virus.

00:16:52.949 --> 00:16:57.701
The first of those is complacency. 
The risk that as this disease

00:16:57.701 --> 00:17:02.739
curve starts to bend, the media look 
elsewhere, the world looks elsewhere.

00:17:02.739 --> 00:17:05.521
Complacency always a risk. 
And the other risk of course

00:17:05.521 --> 00:17:09.964
is when you've been working so hard 
for so long and slept so few hours

00:17:09.964 --> 00:17:15.510
over the past months, people are tired, 
people become fatigued and these new risks

00:17:15.510 --> 00:17:18.660
start to creep into the response.

00:17:18.660 --> 00:17:20.830
Ladies and gentlemen, I can tell you today

00:17:20.830 --> 00:17:25.150
I've just come back from West Africa. 
The people of this countries,

00:17:25.150 --> 00:17:27.936
the leaders of these countries, 
they are not complacent.

00:17:27.936 --> 00:17:31.879
They want to drive Ebola to zero 
in their countries.

00:17:31.879 --> 00:17:35.664
And these people, yes they're tired, 
but they are not fatigued.

00:17:35.664 --> 00:17:37.869
They have an energy, they have a courage,

00:17:37.869 --> 00:17:40.399
they have the strength 
to get this finished.

00:17:40.399 --> 00:17:45.113
What they need, ladies and gentlemen, 
at this point, is the unwavering support

00:17:45.113 --> 00:17:49.437
of the international community, to stand 
with them, to bolster and bring even more

00:17:49.437 --> 00:17:54.727
support at this time, to get the 
job finished. Because finishing Ebola

00:17:54.727 --> 00:17:59.835
right now means turning the tables 
on this virus, and beginning to hunt it.

00:17:59.835 --> 00:18:05.124
Remember, this virus, this whole crisis, 
rather, started with one case,

00:18:05.124 --> 00:18:10.353
and is going to finish with one case. 
But it will only finish if those countries

00:18:10.353 --> 00:18:14.207
have got enough epidemiologists, 
enough health workers, enough logisticians

00:18:14.207 --> 00:18:17.594
and enough other people working with them
to be able to find every one of

00:18:17.594 --> 00:18:22.636
those cases track their contacts and make
sure that this disease stops

00:18:22.636 --> 00:18:24.220
once and for all.

00:18:24.220 --> 00:18:27.557
Ladies and gentleman, Ebola can be beaten.

00:18:27.557 --> 00:18:32.245
Now we need you to take this story out
to tell it to the people who will listen

00:18:32.245 --> 00:18:35.457
and educate them on what it means
to beat Ebola,

00:18:35.457 --> 00:18:39.189
and more importantly,
we need you to advocate with the people

00:18:39.189 --> 00:18:42.743
who can help us bring the resources we
need to these countries,

00:18:42.743 --> 00:18:44.517
to beat this disease.

00:18:44.517 --> 00:18:48.699
There are a lot of people out there 
who will survive and will thrive,

00:18:48.699 --> 00:18:52.101
in part, because of 
what you do to help us beat Ebola.

00:18:52.101 --> 00:18:53.587
Thank you.

00:18:53.587 --> 00:18:57.474
(Applause)