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 titles were kicked around and were discussed,
but nobody suggested this one that you see here today.
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 and the treatment center there,
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 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 healthcare workers who had come,
the heroes who 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, and Peter 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, Lofa County is nearly eight weeks without seeing a single case of Ebola.
(Applause)
This doesn't mean that the job is done, obviously;
there's still a huge risk that there'll 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 healthcare 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,
it evaded detection for three or four 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 rapidly set up an Ebola treatment center as many of you know, in the area.
The World Health Organization and the partners it works with deployed
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.
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 healthcare 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 Lagos, 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 haven'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 expectation 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 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 was 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 we're trying to bring people in,
to try and help them respond to the outbreak,
could not get people on airplanes,
couldn't get them into 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 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 television, 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 functioned the way that they should in these countries.
We saw the misinformation, 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 those space suits, as they call them,
who had come to help them.
And then the situation deteriorated even further:
the countries had to declare a state of emergency,
large populations need 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 40 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 causes severe fevers, diarrhea, vomiting,
and then, unfortunately, and 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 could find every single case, every contact of those cases,
and begin to track the transmission chain so that you can stop transmission.
We have to have treatment centers, 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 exponential growth that you saw.
That was the big question that we were facing just two for 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, of 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, the community engagement, the case finding and contact tracing,
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
in specialized treatment centers,
so that they could prevent the disease from spreading from those were infected.
They would rapidly build out many many burial teams
so 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 and 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, and champion
this surge of international support to try and stop this disease.
We saw militaries
from within those countries and from far beyond,
coming in to help build Ebola treatment centers
that could be used to isolate those who are sick.
to help train the community so that they could actually safely bury their dead
We saw the Red Cross Movement
working with its partner agencies on the ground there
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 insure people understood this disease,
understood the extraordinary things they'd 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 December 1.
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, that many people are asking,
even when they saw this curve, [is]:
"Well, hang on a minute; that's great, you can slow it down,
but can you actually drive it down to zero?"
We've already answered that question right back at the beginning of this talk,
when I spoke about Lofa County in Liberia.
We told you the story how 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 Guéckédou 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's 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,
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.
I can tell you just having come back,
they are not complacent, they are not fatigued,
and they will finish the job, if they have the support that they need.
Ladies and gentlemen, you know the story of Ebola,
we just told you the story of Ebola, 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.
Ladies and gentleman,
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)