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  • 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,

  • 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