-
When I was invited 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
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
the 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 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 these space suits to do that for you.
-
And ladies and gentlemen, what
happened then was rather extraordinary:
-
The community and the health workers,
Peter, they sat down together
-
and they put together a new plan
for controlling Ebola in 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 in 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)
-
Now, this doesn't mean that
the job is done, obviously.
-
There's still a 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 this 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 of 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 that 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.
-
As 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 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 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 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 expectation would be
that there would 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 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 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 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'd never seen before
on such a scale,
-
an 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 started,
-
no longer functioned the way
that they should in these countries.
-
We saw that misinformation and
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 needed to be quarantined
in some areas, and then riots broke out.
-
It was a very, very terrifying situation.
-
Around 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 cause
severe fevers, diarrhea, vomiting,
-
and then unfortunately, in 70 percent
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 the transmission chains
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 kind of exponential
growth that you saw.
-
That was the big question that we were
facing just two or three months ago.
-
Today we know the answer to that question.
-
And we know that answer
because of the extraordinary work
-
of an incredible group of NGOs,
of governments, of local leaders,
-
of U.N. 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 community engagement,
the case finding, contact tracing, etc.,
-
and they turned 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 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 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 were sick.
-
We saw the Red Cross movement working with
its partner agencies on the ground there
-
to help train the communities so that
they could actually safely bury their dead
-
in a dignified manner themselves.
-
And we saw the U.N. 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 was 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 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, they said,
-
"Well, hang on a minute --
that's great you can slow it down,
-
but can you actually
drive it down to zero?"
-
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
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 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 these 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)
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,