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Beating Ebola | Bruce Aylward | TEDxPlaceDesNations

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    When I was asked to, invited, rather,
    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 titles
    were kicked around and were discussed,
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    but nobody suggested
    this one that you see here today.
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    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 by this disease
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    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,
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    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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    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 a 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 of people
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    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,
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    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 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 the space suits to do that for you.
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    And ladies and gentlemen,
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    what happened then
    was rather extraordinary:
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    the community, health workers,
    and Peter sat down together
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    and they put together a new plan
    for controlling Ebola in that Lofa County.
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    And the reason that this is
    such an important story,
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    ladies and gentlemen,
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    is because today, this County,
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    which is right at the center
    of this epidemic you've been watching,
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    you've been seeing on 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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    This doesn't mean
    that the job is done, obviously;
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    there's still a huge risk
    that there'll 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 the 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 healthcare 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 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 it works with deployed
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    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
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    by then, this virus, 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,
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    not just Guinea but now Sierra Leone
    and Liberia were also infected.
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    The virus was spreading geographically,
    the numbers were increasing,
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    and at this time,
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    not only were hundreds of people
    infected and dying of the disease
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    but as importantly,
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    the front line responders, the people
    who had gone to try and help,
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    the healthcare 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,
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    they agreed on common action,
    and they put together
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    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,
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    we saw in another distant country
    the virus pop up again.
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    This time it was in Nigeria,
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    in the teeming metropolis
    of Lagos, 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, international concern
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    on a scale that we haven'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 expectation would be
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    that there be a huge outpouring
    of international assistance
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    to help these countries which were in
    so much trouble 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 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,
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    these countries found themselves
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    not receiving the support they needed
    but increasingly isolated.
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    What we saw was commercial airlines
    [stopped] 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 caused not only problems,
    obviously, for the countries themselves
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    but also for the response.
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    Those organizations
    that we're trying to bring people in,
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    to try and help them
    respond to the outbreak,
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    could not get people on airplanes,
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    couldn't get them into the countries
    to be able to respond.
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    In that situation, ladies and gentleman,
    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 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,
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    this was one of the most concerning,
    international emergencies in public health
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    we've ever seen.
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    And what happened
    in these countries then,
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    many of you saw, again, on the television,
    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,
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    markets no longer functioned the way
    that they should in these countries.
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    We saw the misinformation,
    the misperceptions, started to spread
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    even faster through the communities
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    which became even more alarmed
    about the situation.
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    They started to recoil
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    from those people that you saw
    in those space suits, as they call them,
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    who had 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 need to be quarantined
    in some areas, and then riots broke out.
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    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 40 years
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    since it first popped up
    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
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    that has been 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,
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    we know the horrific disease
    that it then causes in humans,
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    where we see this disease caused
    severe fevers, diarrhea, vomiting,
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    and then, unfortunately, and 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
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    that could find every single case,
    every contact of those cases,
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    and begin to track the transmission chain
    so that you can stop transmission.
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    We have to have treatment centers,
    specialized Ebola treatment centers,
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    where the workers can be protected
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    as they try to provide support
    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,
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    we have to ensure 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,
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    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,
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    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,
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    was whether these strategies could work
    on this scale, in this situation,
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    with so many countries affected
    with the exponential growth that you saw.
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    That was the big question that we were
    facing just two for 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,
    of 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, the community engagement,
    the case finding and contact tracing,
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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
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    they would first try
    and slow down this epidemic
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    by rapidly building
    as many beds as possible
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    in specialized treatment centers,
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    so that they could prevent the disease
    from spreading from those were infected.
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    They would rapidly build out
    many many burial teams
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    so they could safely deal
    with the dead,
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    and with that, they would try
    and slow this outbreak to see
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    if it could actually then be controlled
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    using the classic approach
    of case finding and 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
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    opening emergency operation centers
    themselves against Ebola
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    so that they could personally coordinate,
    and oversee, and champion
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    this surge of international support
    to try and stop this disease.
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    We saw militaries
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    from within those countries
    and 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 are sick.
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    We saw the Red Cross Movement
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    working with its partner agencies
    on the ground there
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    to help train the community so that they
    could actually safely bury their dead
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    in a dignified manner themselves.
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    And we saw the UN agencies,
    the World Food Program,
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    build a tremendous air bridge
    that could get responders
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    to every single corner
    of these countries rapidly
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    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,
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    by the leaders in these countries,
    with the communities,
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    to try insure
    people understood this disease,
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    understood the extraordinary things
    they'd have to do to try and stop Ebola.
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    And as a result, ladies and gentlemen,
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    we saw something that we did not know
    only two or three months earlier,
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    whether or not it would be possible.
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    What we saw was
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    what you see now in this graph
    when we took stock on December 1.
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    What we saw was
    we could bend that curve, so to speak,
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    change this exponential growth,
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    and bring some hope back
    to the ability to control this outbreak.
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    And for this reason, ladies and gentlemen,
    there's absolutely no question now
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    that we can catch up with this outbreak
    in West Africa, and we can beat Ebola.
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    The big question though,
    that many people are asking,
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    even when they saw this curve, [is]:
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    "Well, hang on a minute;
    that's great, you can slow it down,
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    but can you actually
    drive it down to zero?"
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    We've already answered that question
    right back at the beginning of this talk,
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    when I spoke about Lofa County in Liberia.
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    We told you the story
    how Lofa County got to a situation
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    where they have not seen Ebola
    for eight weeks.
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    But there are similar stories
    from the other countries as well.
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    From Guéckédou in Guinea,
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    the first area where the first case
    was actually diagnosed.
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    We've seen very, very few cases
    in the last couple of months,
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    and here in Kenema, in Sierra Leone
    - another area in the epicenter -
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    we have not seen the virus
    for more than a couple of weeks.
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    Way too early to declare
    victory, obviously,
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    but evidence, ladies and gentlemen,
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    not only can the response
    catch up to the disease
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    but this disease can be driven to zero.
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    The challenge now, of course,
    is doing this on the scale needed
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    right across these three countries,
    and that is a huge challenge.
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    Because when you've been at
    something for this long, on this scale,
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    two other big threats
    come in to join the virus.
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    The first of those is complacency,
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    the risk that as this disease curve
    starts to bend,
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    the media look elsewhere,
    the world looks elsewhere.
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    Complacency's always a risk.
  • 17:33 - 17:36
    And the other risk, of course, is
    when you've been working so hard
  • 17:36 - 17:40
    for so long and slept so few hours
    over the past months,
  • 17:40 - 17:43
    people are tired, people become fatigued,
  • 17:43 - 17:47
    and these new risks
    start to creep into the response.
  • 17:47 - 17:52
    Ladies and gentlemen, I can tell you today
    I've just come back from West Africa.
  • 17:52 - 17:55
    The people of this countries,
    the leaders of these countries,
  • 17:55 - 17:57
    are not complacent.
  • 17:57 - 18:01
    They want to drive Ebola
    to zero in their countries.
  • 18:01 - 18:04
    And these people, yes they're tired,
    but they are not fatigued.
  • 18:04 - 18:07
    They have an energy, they have a courage,
  • 18:07 - 18:09
    they have the strength
    to get this finished.
  • 18:09 - 18:12
    What they need,
    ladies and gentlemen, at this point,
  • 18:12 - 18:15
    is the unwavering support
    of the international community,
  • 18:15 - 18:18
    to stand with them, to bolster,
  • 18:18 - 18:21
    and bring even more support
    at this time, to get the job finished.
  • 18:21 - 18:25
    Because finishing Ebola right now means
  • 18:25 - 18:28
    turning the tables on this virus
    and beginning to hunt it.
  • 18:28 - 18:34
    Remember, this virus, this whole crisis,
    rather, started with one case,
  • 18:34 - 18:36
    and is going to finish with one case.
  • 18:36 - 18:41
    But it will only finish if those countries
    have got enough epidemiologists,
  • 18:41 - 18:45
    enough health workers, enough logisticians
    and enough other people working with them
  • 18:45 - 18:49
    to be able to find every one
    of those cases, track their contacts,
  • 18:49 - 18:53
    and make sure that this disease
    stops once and for all.
  • 18:53 - 18:55
    I can tell you just having come back,
  • 18:55 - 18:58
    they are not complacent,
    they are not fatigued,
  • 18:58 - 19:02
    and they will finish the job,
    if they have the support that they need.
  • 19:02 - 19:05
    Ladies and gentlemen,
    you know the story of Ebola,
  • 19:05 - 19:09
    we just told you the story
    of Ebola, Ebola can be beaten.
  • 19:09 - 19:12
    Now, we need you to take this story out
  • 19:12 - 19:14
    to tell it to the people who will listen
  • 19:14 - 19:17
    and educate them
    on what it means to beat Ebola,
  • 19:17 - 19:20
    and more importantly,
    we need you to advocate with the people
  • 19:20 - 19:24
    who can help us bring the resources
    we need to these countries,
  • 19:24 - 19:26
    to beat this disease.
  • 19:26 - 19:27
    Ladies and gentleman,
  • 19:27 - 19:31
    there are a lot of people out there
    who will survive and will thrive
  • 19:31 - 19:34
    in part because of what you do
    to help us beat Ebola.
  • 19:34 - 19:35
    Thank you.
  • 19:35 - 19:37
    (Applause)
Title:
Beating Ebola | Bruce Aylward | TEDxPlaceDesNations
Description:

This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/ted

Ebola: efforts to combat the unprecedented outbreak in West Africa can succeed, and have already led to marked improvements in certain areas, but the fight will not be ‎over until the last case is addressed.

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Video Language:
English
Team:
TED
Project:
TEDxTalks
Duration:
19:50

English subtitles

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