Humanity vs. Ebola. How we could win a terrifying war

When I was asked to -
invited, rather,

to give this talk
a couple of months ago

we discussed a number
of titles with the organizers

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

but nobody suggested this one

and the reason for that was,
two months ago

Ebola was escalating exponentially

and spreading over wider geographic areas
than we had ever seen

and the world was terrified,
concerned and alarmed

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

But today, I can stand here
and I can talk to you

about beating Ebola,

because of people
whom you've never heard of,

people like Peter Clement,

a Liberian doctor,
who's working in Lofa county,

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

The reason that Lofa county
is so important

is because
about five months ago,

when the epidemic was
just starting to escalate,

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

At that time, MSF
(Doctors Without Borders)

and the treatment center there,

they were seeing dozens of patients
every single day,

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

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

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

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

from Monrovia, the capital,
up to Lofa county,

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

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

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

And what he heard was heartbreaking.

He heard about the devastation
and the desperation

of people affected by this disease.

He heard the heartbreaking stories about

not just the damage that
Ebola did to people,

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

And he listened to the chiefs,
the local chiefs there

and what they told him - they said

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

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

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

we are not allowed to wash
the bodies to bury them

the way our communities and
our rituals demand.

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

and the entire epidemic
was unraveling in front of them.

People were turning on the health care
workers who had come,

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

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

And what happened then was
Peter explained to the leaders,

the leaders listened.
They turned the tables.

And Peter explained what ebola was.
He explained what the disease was,

he explained what it did
to their communities.

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

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

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

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

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

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

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

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

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

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

you've been seeing on
the television screens,

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

(Applause)

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

There still are huge risk that
there will be additional cases there.

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

That's the key thing.

Even on the scale, even with the rapid
kind of growth that we saw

in this environment here,
we now know Ebola can be beaten.

When communities come together
with health care workers work together,

that's when this disease can be stopped.

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

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

And as many you know,
this virus went undetected,

evaded detection for 3 or 4 months
when it began.

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

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

People hadn't seen the disease before,

health workers hadn't seen
the disease before --

they didn't know what
they were dealing with,

and to make it
even more complicated,

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

that wasn't classical of the disease.

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

For that reason it evaded detection
for some time,

But contrary to public belief
sometimes these days,

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

MSF rep relief set up
an Ebola treatment center

as many of you know, in the area
the World Health Organization

and the partners that it works with
deplored.

eventually hundreds of people
over the next two months

to be able to help track the virus.

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

well known now as Ebola,
had spread too far.

It had already outstripped what was
one of the largest responses

that had been mounted so far
to an Ebola outbreak.

By the middle of the year,
not just Guinea

but now Sierra Leone and Liberia
were also infected.

And the virus was spreading geographically
the numbers were increasing

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

and dying of the disease,
but as importantly,

the front line responders,

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

the health care workers, the other
responders

were also sick and dying by the dozens.

The presidents of these countries
recognized the emergencies

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

and they put together an emergency
joint operation center in Conakry

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

to implement the strategies
we talked about.

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

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

boarded an airplane,
flew to another country,

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

the virus pop up again.

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

21 million people.

Now the virus was in that environment.

And as you can anticipate,
there was international alarm,

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

caused by a disease like this.

The World Health Organization immediately
called together an expert panel,

looked at the situation,
declared an international emergency.

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

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

and concern at that time.

But what we saw was
something very different.

There was some great response.

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

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

Alarm escalated and very soon
these countries found themselves

not receiving the support they needed
but increasingly isolated.

What we saw with commercial airlines
started flying into these countries

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

were no longer allowed to travel.

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

but also for the response.

Those organizations that were trying to
bring people in,

to try and help them
respond to the outbreak

they could not get
people on airplanes,

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

In that situation,
ladies and gentleman,

a virus like Ebola takes advantage.

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

Not only did this virus
continue in the places

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

and we saw the case numbers that you
see here,

something we'd never seen before
on such a scale

and exponential increase of Ebola cases

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

but also spreading further and
deeper into these countries.

Ladies and gentleman, this was one of the

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

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

on the televisions, read about in
the newspapers,

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

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

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

We saw the misinformation and
the misperceptions started to spread

even faster through the communities
which became even more alarmed

about the situation.

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

as they call them,
would come to help them.

And then the situation deteriorated
even further.

The countries had to declare a state of
emergency.

Large populations needed to
be quarantined in some areas

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

And the world many people began to ask

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

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

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

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

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

in Central Africa in 1976.

But despite that we do know many things,

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

we know that it probably enters
a human population

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

infected with the virus
and probably sickened by it.

Then we know that the
virus spreads from person to person

through contaminated body fluids.

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

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

severe fevers, diarrhea, vomiting,
and then

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

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

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

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

There are four things that are critical to
stopping Ebola.

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

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

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

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

so that you can stop transmission.

We have to have treatment center
specialized Ebola treatment centers,

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

to the people who are infected,

so that they might survive the disease.

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

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

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

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

the virus was stopped in Nigeria
by these four strategies

and the people implementing them
obviously.

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

that were affected by this virus,
in this outbreak.

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

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

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

the kinda exponential growth
that you saw.

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

Today, we know
the answer to that question.

We know that answer because of
the extraordinary work

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

of UN agencies and many humanitarian
and other organizations

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

But what had to be done there
was slightly different.

These countries took those strategies
I just showed you;

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

and they turn them on their head.

There was so much disease
they approached it differently.

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

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

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

from spreading from those were infected.

They would rapidly build out
many many burial teams so that

they could safely deal with the dead,

and with that, they would try and slow
this outbreak

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

of case finding in contact tracing.

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

what I saw was extraordinary.

I saw presidents opening emergency
operation centers themselves against Ebola

so that they could personally coordinate
and oversee in champion

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

We saw militaries from within
those countries in from far beyond

coming in to help build
Ebola treatment centers

that could be used to isolate
those who were sick.

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

to help train the community
so that they could actually

safely bury their dead
in a dignified manner themselves,

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

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

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

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

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

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

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

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

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

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

when we took stock
on the first of December.

what we saw was we could bend that curve,
so to speak,

change this exponential growth
and bring some hope back

to the ability to control this outbreak.

And for this reason, ladies and gentlemen,

there's absolutely no question now
that we can catch up with this outbreak

in West Africa, and we can beat Ebola.

The big question though is,

that many people are asking even when
they saw this curve, they said,

"hang on a minute, that's great
you can slow it down,

but can you actually drive it down
to zero?"

Now we already answered that question
back at the beginning of this talk

when I spoke about Lofa county
in Liberia,

we told you the story haw Lofa county
got to a situation where they have

not seen Ebola for eight weeks.

But there are similar stories from
the other countries as well.

From Gueckedou in Guinea,

the first area where the first case was
actually diagnosed.

We've seen very very few cases
in the last couple of months,

and here in Kenema, in Sierra Leone,
another area in the epicenter,

we have not seen the virus for more than
a couple of weeks --

way too early to declare victory obviously
but evidence, ladies and gentlemen,

not only can the response catch up
to the disease but this disease

can be driven to zero.

The challenge now, of course, is doing this
on the scale needed

right across these three countries,
and that is a huge challenge.

Because when you've been at something

for this long, on this scale, two other
big threats come in to join the virus.

The first of those is complacency.
The risk that as this disease

curve starts to bend, the media look
elsewhere, the world looks elsewhere.

Complacency always a risk.
And the other risk of course

is when you've been working so hard
for so long and slept so few hours

over the past months, people are tired,
people become fatigued and these new risks

start to creep into the response.

Ladies and gentlemen, I can tell you today

I've just come back from West Africa.
The people of this countries,

the leaders of these countries,
they are not complacent.

They want to drive Ebola to zero
in their countries.

And these people, yes they're tired,
but they are not fatigued.

They have an energy, they have a courage,

they have the strength
to get this finished.

What they need, ladies and gentlemen,
at this point, is the unwavering support

of the international community, to stand
with them, to bolster and bring even more

support at this time, to get the
job finished. Because finishing Ebola

right now means turning the tables
on this virus, and beginning to hunt it.

Remember, this virus, this whole crisis,
rather, started with one case,

and is going to finish with one case.
But it will only finish if those countries

have got enough epidemiologists,
enough health workers, enough logisticians

and enough other people working with them
to be able to find every one of

those cases track their contacts and make
sure that this disease stops

once and for all.

Ladies and gentleman, Ebola can be beaten.

Now we need you to take this story out
to tell it to the people who will listen

and educate them on what it means
to beat Ebola,

and more importantly,
we need you to advocate with the people

who can help us bring the resources we
need to these countries,

to beat this disease.

There are a lot of people out there
who will survive and will thrive,

in part, because of
what you do to help us beat Ebola.

Thank you.

(Applause)