Humanity vs. Ebola. How we could win a terrifying war
-
0:01 - 0:05When I was invited to give this talk
a couple of months ago, -
0:05 - 0:09we discussed a number
of titles with the organizers, -
0:09 - 0:12and a lot of different items were
kicked around and were discussed. -
0:12 - 0:14But nobody suggested this one,
-
0:14 - 0:17and the reason for that
was two months ago, -
0:17 - 0:20Ebola was escalating exponentially
-
0:20 - 0:25and spreading over wider geographic areas
than we had ever seen, -
0:25 - 0:28and the world was terrified,
concerned and alarmed -
0:28 - 0:33by this disease, in a way we've not
seen in recent history. -
0:33 - 0:39But today, I can stand here
and I can talk to you about beating Ebola -
0:39 - 0:43because of people
whom you've never heard of, -
0:43 - 0:50people like Peter Clement, a Liberian
doctor who's working in Lofa County, -
0:50 - 0:55a place that many of you have
never heard of, probably, in Liberia. -
0:55 - 0:58The reason that Lofa County
is so important -
0:58 - 1:00is because about five months ago,
-
1:00 - 1:05when the epidemic was
just starting to escalate, -
1:05 - 1:09Lofa County was right at the center,
the epicenter of this epidemic. -
1:09 - 1:13At that time, MSF
and the treatment center there, -
1:13 - 1:16they were seeing dozens of patients
every single day, -
1:16 - 1:20and these patients, these communities
were becoming more and more terrified -
1:20 - 1:25as time went by, with this disease
and what it was doing to their families, -
1:25 - 1:28to their communities,
to their children, to their relatives. -
1:28 - 1:33And so Peter Clement was charged with
driving that 12-hour-long rough road -
1:33 - 1:37from Monrovia, the capital,
up to Lofa County, -
1:37 - 1:42to try and help bring control
to the escalating epidemic there. -
1:42 - 1:47And what Peter found when he arrived was
the terror that I just mentioned to you. -
1:47 - 1:51So he sat down with the local chiefs,
and he listened. -
1:51 - 1:55And what he heard was heartbreaking.
-
1:55 - 1:59He heard about the devastation
and the desperation -
1:59 - 2:03of people affected by this disease.
-
2:03 - 2:05He heard the heartbreaking stories
-
2:05 - 2:08about not just the damage
that Ebola did to people, -
2:08 - 2:11but what it did to families
and what it did to communities. -
2:13 - 2:17And he listened to the local chiefs there
and what they told him -- -
2:17 - 2:20They said, "When our children are sick,
when our children are dying, -
2:20 - 2:24we can't hold them at a time when
we want to be closest to them. -
2:24 - 2:29When our relatives die, we can't take care
of them as our tradition demands. -
2:29 - 2:32We are not allowed to wash
the bodies to bury them -
2:32 - 2:35the way our communities and
our rituals demand. -
2:35 - 2:38And for this reason, they were
deeply disturbed, deeply alarmed -
2:38 - 2:42and the entire epidemic
was unraveling in front of them. -
2:42 - 2:45People were turning on the healthcare
workers who had come, -
2:45 - 2:48the heroes who had come to try
and help save the community, -
2:48 - 2:53to help work with the community,
and they were unable to access them. -
2:53 - 2:58And what happened then was
Peter explained to the leaders. -
2:58 - 3:01The leaders listened.
They turned the tables. -
3:01 - 3:05And Peter explained what Ebola was.
He explained what the disease was. -
3:05 - 3:07He explained what it did
to their communities. -
3:07 - 3:12And he explained that Ebola threatened
everything that made us human. -
3:12 - 3:17Ebola means you can't hold your children
the way you would in this situation. -
3:17 - 3:19You can't bury your dead
the way that you would. -
3:19 - 3:24You have to trust these people
in these space suits to do that for you. -
3:24 - 3:27And ladies and gentlemen, what
happened then was rather extraordinary: -
3:27 - 3:30The community and the health workers,
Peter, they sat down together -
3:30 - 3:35and they put together a new plan
for controlling Ebola in Lofa County. -
3:35 - 3:40And the reason that this is such
an important story, ladies and gentlemen, -
3:40 - 3:45is because today, this county, which is
right at the center of this epidemic -
3:45 - 3:48you've been watching,
you've been seeing in the newspapers, -
3:48 - 3:51you've been seeing on
the television screens, -
3:51 - 3:57today Lofa County is nearly eight weeks
without seeing a single case of Ebola. -
3:57 - 4:04(Applause)
-
4:04 - 4:08Now, this doesn't mean that
the job is done, obviously. -
4:08 - 4:11There's still a huge risk
that there will be additional cases there. -
4:11 - 4:14But what it does teach us
is that Ebola can be beaten. -
4:14 - 4:16That's the key thing.
-
4:16 - 4:17Even on this scale,
-
4:17 - 4:21even with the rapid kind of growth
that we saw in this environment here, -
4:21 - 4:25we now know Ebola can be beaten.
-
4:25 - 4:29When communities come together
with health care workers, work together, -
4:29 - 4:31that's when this disease can be stopped.
-
4:31 - 4:35But how did Ebola end up
in Lofa County in the first place? -
4:35 - 4:40Well, for that, we have to go back
12 months, to the start of this epidemic. -
4:40 - 4:43And as many of you know,
this virus went undetected, -
4:43 - 4:47it evaded detection for three
or four months when it began. -
4:47 - 4:49That's because this is not
a disease of West Africa, -
4:49 - 4:53it's a disease of Central Africa,
half a continent away. -
4:53 - 4:55People hadn't seen the disease before;
-
4:55 - 4:57health workers hadn't seen
the disease before. -
4:57 - 4:59They didn't know what
they were dealing with, -
4:59 - 5:01and to make it
even more complicated, -
5:01 - 5:06the virus itself was causing a symptom,
a type of a presentation -
5:06 - 5:08that wasn't classical of the disease.
-
5:08 - 5:13So people didn't even recognize
the disease, people who knew Ebola. -
5:13 - 5:16For that reason it evaded detection
for some time, -
5:16 - 5:20But contrary to public belief
sometimes these days, -
5:20 - 5:25once the virus was detected,
there was a rapid surge in of support. -
5:25 - 5:30MSF rapidly set up an Ebola treatment
center, as many of you know, in the area. -
5:30 - 5:33The World Health Organization
and the partners that it works with -
5:33 - 5:37deployed eventually hundreds of people
over the next two months -
5:37 - 5:39to be able to help track the virus.
-
5:39 - 5:43The problem, ladies and gentlemen,
is by then, this virus, -
5:43 - 5:47well known now as Ebola,
had spread too far. -
5:47 - 5:50It had already outstripped what was
one of the largest responses -
5:50 - 5:54that had been mounted so far
to an Ebola outbreak. -
5:54 - 5:56By the middle of the year,
not just Guinea -
5:56 - 6:00but now Sierra Leone and Liberia
were also infected. -
6:00 - 6:05As the virus was spreading geographically,
the numbers were increasing -
6:05 - 6:10and at this time, not only were
hundreds of people infected -
6:10 - 6:12and dying of the disease,
-
6:12 - 6:15but as importantly,
the front line responders, -
6:15 - 6:18the people who had gone to try and help,
-
6:18 - 6:21the health care workers, the other
responders -
6:21 - 6:23were also sick and dying by the dozens.
-
6:24 - 6:27The presidents of these countries
recognized the emergencies. -
6:27 - 6:30They met right around that time,
they agreed on common action -
6:30 - 6:35and they put together an emergency
joint operation center in Conakry -
6:35 - 6:39to try and work together to finish this
disease and get it stopped, -
6:39 - 6:42to implement the strategies
we talked about. -
6:42 - 6:46But what happened then was something
we had never seen before with Ebola. -
6:46 - 6:50What happened then was the virus,
or someone sick with the virus, -
6:50 - 6:53boarded an airplane,
flew to another country, -
6:53 - 6:57and for the first time,
we saw in another distant country -
6:57 - 7:00the virus pop up again.
-
7:00 - 7:04This time it was in Nigeria,
in the teeming metropolis of Lagos, -
7:04 - 7:0621 million people.
-
7:06 - 7:09Now the virus was in that environment.
-
7:09 - 7:13And as you can anticipate,
there was international alarm, -
7:13 - 7:17international concern on a scale that
we hadn't seen in recent years -
7:17 - 7:19caused by a disease like this.
-
7:19 - 7:24The World Health Organization immediately
called together an expert panel, -
7:24 - 7:27looked at the situation,
declared an international emergency. -
7:27 - 7:32And in doing so, the expectation would be
that there would be a huge outpouring -
7:32 - 7:35of international assistance
to help these countries -
7:35 - 7:39which were in so much trouble
and concern at that time. -
7:39 - 7:42But what we saw was
something very different. -
7:42 - 7:46There was some great response.
-
7:46 - 7:51A number of countries came to assist --
many, many NGOs and others, as you know, -
7:51 - 7:54but at the same time, the opposite
happened in many places. -
7:54 - 7:58Alarm escalated, and very soon
these countries found themselves -
7:58 - 8:03not receiving the support they needed,
but increasingly isolated. -
8:03 - 8:07What we saw was commercial airlines
[stopped] flying into these countries -
8:07 - 8:10and people who hadn't even been
exposed to the virus -
8:10 - 8:12were no longer allowed to travel.
-
8:12 - 8:16This caused not only problems, obviously,
for the countries themselves, -
8:16 - 8:18but also for the response.
-
8:18 - 8:21Those organizations that were
trying to bring people in, -
8:21 - 8:23to try and help them
respond to the outbreak, -
8:23 - 8:25they could not get
people on airplanes, -
8:25 - 8:28they could not get them into the
countries to be able to respond. -
8:28 - 8:30In that situation,
ladies and gentleman, -
8:30 - 8:34a virus like Ebola takes advantage.
-
8:34 - 8:39And what we saw then was something
also we hadn't seen before. -
8:39 - 8:42Not only did this virus
continue in the places -
8:42 - 8:45where they'd already become infected,
but then it started to escalate -
8:45 - 8:48and we saw the case numbers
that you see here, -
8:48 - 8:51something we'd never seen before
on such a scale, -
8:51 - 8:54an exponential increase of Ebola cases
-
8:54 - 8:58not just in these countries or the areas
already infected in these countries -
8:58 - 9:02but also spreading further and
deeper into these countries. -
9:02 - 9:05Ladies and gentleman,
this was one of the most concerning -
9:05 - 9:10international emergencies in public health
we've ever seen. -
9:11 - 9:13And what happened in these countries then,
-
9:13 - 9:17many of you saw, again, on the television,
read about in the newspapers, -
9:17 - 9:22we saw the health system start to collapse
under the weight of this epidemic. -
9:22 - 9:27We saw the schools begin to close,
markets no longer started, -
9:27 - 9:30no longer functioned the way
that they should in these countries. -
9:30 - 9:34We saw that misinformation and
misperceptions started to spread -
9:34 - 9:38even faster through the communities,
which became even more alarmed -
9:38 - 9:39about the situation.
-
9:39 - 9:43They started to recoil from those people
that you saw in those space suits, -
9:43 - 9:45as they call them,
who had come to help them. -
9:45 - 9:48And then the situation
deteriorated even further. -
9:48 - 9:51The countries had to declare
a state of emergency. -
9:51 - 9:56Large populations needed to be quarantined
in some areas, and then riots broke out. -
9:56 - 10:00It was a very, very terrifying situation.
-
10:00 - 10:03Around the world,
many people began to ask, -
10:03 - 10:07can we ever stop Ebola
when it starts to spread like this? -
10:07 - 10:11And they started to ask, how well
do we really know this virus? -
10:12 - 10:15The reality is we don't know
Ebola extremely well. -
10:15 - 10:19It's a relatively modern disease
in terms of what we know about it. -
10:19 - 10:21We've known the disease only for 40 years,
-
10:21 - 10:25since it first popped up
in Central Africa in 1976. -
10:25 - 10:28But despite that, we do know many things:
-
10:28 - 10:32We know that this virus
probably survives in a type of a bat. -
10:32 - 10:35We know that it probably enters
a human population -
10:35 - 10:38when we come in contact with a wild animal
-
10:38 - 10:41that has been infected with the virus
and probably sickened by it. -
10:41 - 10:44Then we know that the virus
spreads from person to person -
10:44 - 10:47through contaminated body fluids.
-
10:47 - 10:48And as you've all seen,
-
10:48 - 10:52we know the horrific disease
that it then causes in humans, -
10:52 - 10:56where we see this disease cause
severe fevers, diarrhea, vomiting, -
10:56 - 11:03and then unfortunately, in 70 percent
of the cases or often more, death. -
11:03 - 11:08This is a very dangerous,
debilitating, and deadly disease. -
11:08 - 11:13But despite the fact that we've not known
this disease for a particularly long time, -
11:13 - 11:17and we don't know everything about it,
we do know how to stop this disease. -
11:17 - 11:21There are four things
that are critical to stopping Ebola. -
11:21 - 11:25First and foremost, the communities
have got to understand this disease, -
11:25 - 11:28they've got to understand
how it spreads and how to stop it. -
11:28 - 11:33And then we've got to be able to have
systems that can find every single case, -
11:33 - 11:35every contact of those cases,
-
11:35 - 11:39and begin to track the transmission chains
so that you can stop transmission. -
11:39 - 11:42We have to have treatment centers,
specialized Ebola treatment centers, -
11:42 - 11:45where the workers can be protected
-
11:45 - 11:50as they try to provide support
to the people who are infected, -
11:50 - 11:52so that they might survive the disease.
-
11:52 - 11:54And then for those who do die,
-
11:54 - 12:00we have to ensure there is a safe, but at
the same time dignified, burial process, -
12:00 - 12:04so that there is no spread
at that time as well. -
12:05 - 12:09So we do know how to stop Ebola, and these
strategies work, ladies and gentlemen. -
12:09 - 12:13The virus was stopped in Nigeria
by these four strategies -
12:13 - 12:16and the people implementing
them, obviously. -
12:16 - 12:20It was stopped in Senegal, where it had
spread, and also in the other countries -
12:20 - 12:23that were affected by this virus,
in this outbreak. -
12:23 - 12:27So there's no question that
these strategies actually work. -
12:27 - 12:32The big question, ladies and gentlemen,
was whether these strategies could work -
12:32 - 12:37on this scale, in this situation,
with so many countries affected -
12:37 - 12:40with the kind of exponential
growth that you saw. -
12:40 - 12:45That was the big question that we were
facing just two or three months ago. -
12:45 - 12:49Today we know the answer to that question.
-
12:49 - 12:52And we know that answer
because of the extraordinary work -
12:52 - 12:57of an incredible group of NGOs,
of governments, of local leaders, -
12:57 - 13:01of U.N. agencies and many humanitarian
and other organizations -
13:01 - 13:05that came and joined the fight
to try and stop Ebola in West Africa. -
13:05 - 13:08But what had to be done there
was slightly different. -
13:08 - 13:11These countries took those strategies
I just showed you; -
13:11 - 13:17the community engagement,
the case finding, contact tracing, etc., -
13:17 - 13:19and they turned them on their head.
-
13:19 - 13:21There was so much disease,
they approached it differently. -
13:21 - 13:27What they decided to do was they would
first try and slow down this epidemic -
13:27 - 13:32by rapidly building as many beds as
possible in specialized treatment centers -
13:32 - 13:37so that they could prevent the disease
from spreading from those were infected. -
13:37 - 13:40They would rapidly build out
many, many burial teams -
13:40 - 13:42so that they could safely
deal with the dead, -
13:42 - 13:44and with that, they would try
and slow this outbreak -
13:44 - 13:49to see if it could actually then
be controlled using the classic approach -
13:49 - 13:51of case finding and contact tracing.
-
13:51 - 13:55And when I went to West Africa
about three months ago, -
13:55 - 13:58when I was there
what I saw was extraordinary. -
13:58 - 14:03I saw presidents opening emergency
operation centers themselves against Ebola -
14:03 - 14:06so that they could personally coordinate
and oversee and champion -
14:06 - 14:10this surge of international support
to try and stop this disease. -
14:10 - 14:14We saw militaries from within
those countries and from far beyond -
14:14 - 14:17coming in to help build
Ebola treatment centers -
14:17 - 14:20that could be used to isolate
those who were sick. -
14:20 - 14:24We saw the Red Cross movement working with
its partner agencies on the ground there -
14:24 - 14:30to help train the communities so that
they could actually safely bury their dead -
14:30 - 14:32in a dignified manner themselves.
-
14:32 - 14:35And we saw the U.N. agencies,
the World Food Program, -
14:35 - 14:37build a tremendous air bridge
-
14:37 - 14:41that could get responders to every single
corner of these countries rapidly -
14:41 - 14:44to be able to implement the strategies
that we just talked about. -
14:44 - 14:47What we saw, ladies and gentlemen,
which was probably most impressive, -
14:47 - 14:50was this incredible work
by the governments, -
14:50 - 14:53by the leaders in these countries,
with the communities, -
14:53 - 14:56to try to ensure people
understood this disease, -
14:56 - 15:02understood the extraordinary things they
would have to do to try and stop Ebola. -
15:02 - 15:04And as a result, ladies and gentlemen,
-
15:04 - 15:09we saw something that we did not know
only two or three months earlier, -
15:09 - 15:11whether or not it would be possible.
-
15:11 - 15:14What we saw was
what you see now in this graph, -
15:14 - 15:17when we took stock on December 1.
-
15:17 - 15:21What we saw was we could
bend that curve, so to speak, -
15:21 - 15:23change this exponential growth,
-
15:23 - 15:27and bring some hope back
to the ability to control this outbreak. -
15:27 - 15:31And for this reason, ladies and gentlemen,
there's absolutely no question now -
15:31 - 15:37that we can catch up with this outbreak
in West Africa and we can beat Ebola. -
15:38 - 15:41The big question, though,
that many people are asking, -
15:41 - 15:43even when they saw this curve, they said,
-
15:43 - 15:46"Well, hang on a minute --
that's great you can slow it down, -
15:46 - 15:48but can you actually
drive it down to zero?" -
15:48 - 15:51We already answered that question
back at the beginning of this talk, -
15:51 - 15:56when I spoke about Lofa County in Liberia.
-
15:56 - 15:59We told you the story
how Lofa County got to a situation -
15:59 - 16:02where they have not seen
Ebola for eight weeks. -
16:02 - 16:05But there are similar stories from
the other countries as well. -
16:05 - 16:07From Gueckedou in Guinea,
-
16:07 - 16:12the first area where the first case was
actually diagnosed. -
16:12 - 16:15We've seen very, very few cases
in the last couple of months, -
16:15 - 16:20and here in Kenema, in Sierra Leone,
another area in the epicenter, -
16:20 - 16:23we have not seen the virus
for more than a couple of weeks -- -
16:23 - 16:26way too early to declare
victory, obviously, -
16:26 - 16:28but evidence, ladies and gentlemen,
-
16:28 - 16:32not only can the response
catch up to the disease, -
16:32 - 16:35but this disease can be driven to zero.
-
16:35 - 16:39The challenge now, of course,
is doing this on the scale needed -
16:39 - 16:44right across these three countries,
and that is a huge challenge. -
16:44 - 16:49Because when you've been at something
for this long, on this scale, -
16:49 - 16:53two other big threats
come in to join the virus. -
16:53 - 16:56The first of those is complacency,
-
16:56 - 16:59the risk that as this
disease curve starts to bend, -
16:59 - 17:03the media look elsewhere,
the world looks elsewhere. -
17:03 - 17:04Complacency always a risk.
-
17:04 - 17:09And the other risk, of course, is when
you've been working so hard for so long, -
17:09 - 17:12and slept so few hours
over the past months, -
17:12 - 17:15people are tired, people become fatigued,
-
17:15 - 17:19and these new risks
start to creep into the response. -
17:19 - 17:23Ladies and gentlemen, I can tell you today
I've just come back from West Africa. -
17:23 - 17:27The people of these countries,
the leaders of these countries, -
17:27 - 17:28they are not complacent.
-
17:28 - 17:32They want to drive Ebola to zero
in their countries. -
17:32 - 17:36And these people, yes, they're tired,
but they are not fatigued. -
17:36 - 17:38They have an energy, they have a courage,
-
17:38 - 17:40they have the strength
to get this finished. -
17:40 - 17:43What they need, ladies
and gentlemen, at this point, -
17:43 - 17:47is the unwavering support of the
international community, -
17:47 - 17:48to stand with them,
-
17:48 - 17:53to bolster and bring even more support
at this time, to get the job finished. -
17:53 - 17:58Because finishing Ebola right now
means turning the tables on this virus, -
17:58 - 18:00and beginning to hunt it.
-
18:00 - 18:05Remember, this virus, this whole crisis,
rather, started with one case, -
18:05 - 18:08and is going to finish with one case.
-
18:08 - 18:12But it will only finish if those countries
have got enough epidemiologists, -
18:12 - 18:17enough health workers, enough logisticians
and enough other people working with them -
18:17 - 18:20to be able to find every one
of those cases, track their contacts -
18:20 - 18:24and make sure that this disease
stops once and for all. -
18:24 - 18:28Ladies and gentleman, Ebola can be beaten.
-
18:28 - 18:32Now we need you to take this story out
to tell it to the people who will listen -
18:32 - 18:35and educate them
on what it means to beat Ebola, -
18:35 - 18:39and more importantly,
we need you to advocate with the people -
18:39 - 18:43who can help us bring the resources we
need to these countries, -
18:43 - 18:45to beat this disease.
-
18:45 - 18:49There are a lot of people out there
who will survive and will thrive, -
18:49 - 18:52in part because of what you do
to help us beat Ebola. -
18:52 - 18:54Thank you.
-
18:54 - 18:57(Applause)
- Title:
- Humanity vs. Ebola. How we could win a terrifying war
- Speaker:
- Bruce Aylward
- Description:
-
“Ebola threatens everything that makes us human,” says Bruce Aylward of the World Health Organization. With calm measure, he walks us through how the Ebola epidemic exploded — and how international alarm only fed the exponential growth of the problem. He shares four strategies critical to beating Ebola — and how they are succeeding, starting in Lofa County, Liberia, which was at the center of the outbreak but where no new case has been registered in weeks. The fight against Ebola is not won, he underscores, but if we do things right, we can look optimistically at our ability to fight back against epidemics.
- Video Language:
- English
- Team:
- closed TED
- Project:
- TEDTalks
- Duration:
- 19:11
Brian Greene edited English subtitles for Humanity vs. Ebola. How we could win a terrifying war | ||
Brian Greene commented on English subtitles for Humanity vs. Ebola. How we could win a terrifying war | ||
Brian Greene edited English subtitles for Humanity vs. Ebola. How we could win a terrifying war | ||
Csaba Lóki commented on English subtitles for Humanity vs. Ebola. How we could win a terrifying war | ||
Cynthia Betubiza edited English subtitles for Humanity vs. Ebola. How we could win a terrifying war | ||
Morton Bast edited English subtitles for Humanity vs. Ebola. How we could win a terrifying war | ||
Morton Bast edited English subtitles for Humanity vs. Ebola. How we could win a terrifying war | ||
Morton Bast edited English subtitles for Humanity vs. Ebola. How we could win a terrifying war |
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,