Bruce Aylward: Humanity vs. Ebola. How we could win a terrifying war
Bruce Aylward: De mensheid versus Ebola. De winnende strategieën in een angstaanjagende oorlog
As the Assistant Director-General of the World Health Organization’s Polio and Emergencies Cluster, Bruce Aylward works to ensure that polio stays under control and that the world is prepared to respond to health crises. Full bio
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a couple of months ago,
werd uitgenodigd voor deze talk,
of titles with the organizers,
met de organisatoren.
kicked around and were discussed.
[Ebola overwinnen]
was two months ago,
than we had ever seen,
dan we ooit eerder zagen,
concerned and alarmed
bezorgd en gealarmeerd
seen in recent history.
eerder zagen in de recente geschiedenis.
and I can talk to you about beating Ebola
kan praten over het overwinnen van Ebola
whom you've never heard of,
nog nooit gehoord hebt,
doctor who's working in Lofa County,
die werkt in Lofa County,
never heard of, probably, in Liberia.
onbekend is, in Liberia.
is so important
just starting to escalate,
in het epicentrum van de epidemie.
the epicenter of this epidemic.
and the treatment center there,
tientallen patiënten,
every single day,
were becoming more and more terrified
gemeenschappen werden steeds banger
and what it was doing to their families,
met hun families deed,
to their children, to their relatives.
hun gezinsleden.
driving that 12-hour-long rough road
12 uur rijden over die ruige weg
up to Lofa County,
naar Lofa County,
to the escalating epidemic there.
onder controle te krijgen.
the terror that I just mentioned to you.
de verschrikkingen die ik zojuist noemde.
and he listened.
en hij luisterde.
and the desperation
en de wanhoop
door deze ziekte.
over de schade die Ebola toebracht,
that Ebola did to people,
and what it did to communities.
and what they told him --
en wat zij hem vertelden:
when our children are dying,
wanneer we juist dicht bij ze willen zijn.
we want to be closest to them.
of them as our tradition demands.
niet verzorgen zoals de traditie vereist.
the bodies to bury them
niet wassen en begraven
our rituals demand.
en onze rituelen voorschrijven.
deeply disturbed, deeply alarmed
erg verontrust, gealarmeerd,
was unraveling in front of them.
vlak voor hun neus.
workers who had come,
het medisch personeel dat was gekomen
and help save the community,
en met hen te werken.
and they were unable to access them.
Peter explained to the leaders.
They turned the tables.
De rollen waren omgekeerd.
He explained what the disease was.
Hij legde uit wat de ziekte was
to their communities.
everything that made us human.
menselijk maakt in gevaar bracht.
the way you would in this situation.
vasthouden zoals je wil in zo´n situatie.
the way that you would.
niet begraven zoals je wil.
in these space suits to do that for you.
vertrouwen dat ze dat voor je doen.
happened then was rather extraordinary:
was behoorlijk bijzonder:
Peter, they sat down together
en Peter kwamen bijeen
for controlling Ebola in Lofa County.
in Lofa County te beheersen.
an important story, ladies and gentlemen,
dames en heren,
right at the center of this epidemic
in het centrum van de epidemie
you've been seeing in the newspapers,
the television screens,
without seeing a single case of Ebola.
geen enkel geval van Ebola meer gezien.
the job is done, obviously.
het werk nu gedaan is.
that there will be additional cases there.
dat er meer gevallen bijkomen.
is that Ebola can be beaten.
dat Ebola overwonnen kan worden.
that we saw in this environment here,
in deze omgeving zagen,
overwonnen kan worden.
with health care workers, work together,
gezondsheidswerkers, en samenwerken,
in Lofa County in the first place?
in Lofa County?
12 months, to the start of this epidemic.
naar het begin van de epidemie.
this virus went undetected,
werd het virus niet opgemerkt.
or four months when it began.
niet gedetecteerd.
a disease of West Africa,
uit West Afrika,
half a continent away.
een half continent verder.
the disease before.
de ziekte niet eerder gezien.
they were dealing with,
even more complicated,
a type of a presentation
een bepaalde weergave,
the disease, people who knew Ebola.
mensen die Ebola kenden.
for some time,
sometimes these days,
denkt tegenwoordig,
there was a rapid surge in of support.
zodra het virus gedetecteerd was.
center, as many of you know, in the area.
in het gebied, zoals velen weten.
and the partners that it works with
en hun partners
over the next two months
gedurende de volgende twee maanden
is by then, this virus,
dames en heren, is dat dit virus,
had spread too far.
al veel te ver verspreid was.
one of the largest responses
een van de grootste acties
to an Ebola outbreak.
tegen een Ebola-uitbraak.
not just Guinea
niet alleen Guinea,
were also infected.
en Libera geïnfecteerd.
the numbers were increasing
van het virus stegen de aantallen
hundreds of people infected
honderden mensen besmet
the front line responders,
de mensen in de frontlinie,
responders
de andere hulpverleners,
recognized the emergencies.
erkenden de noodsituatie.
they agreed on common action
gezamenlijke maatregelen
joint operation center in Conakry
noodcentrum op in Conakry
disease and get it stopped,
en deze ziekte te stoppen,
we talked about.
die we noemden.
we had never seen before with Ebola.
nooit eerder gezien met Ebola.
or someone sick with the virus,
flew to another country,
vloog naar een ander land
we saw in another distant country
zagen we in een land ver weg
in the teeming metropolis of Lagos,
in de dichtgepakte wereldstad Lagos,
there was international alarm,
internationaal onrust veroorzaakte,
we hadn't seen in recent years
in jaren niet hadden gezien,
called together an expert panel,
riep direct een panel van experts bijeen,
declared an international emergency.
internationale noodsituatie uit.
that there would be a huge outpouring
to help these countries
en hulp voor deze landen
and concern at that time.
en zorgen in die tijd.
something very different.
iets heel anders.
many, many NGOs and others, as you know,
vele ngo's en anderen, zoals bekend,
happened in many places.
het tegenovergestelde op vele plekken.
these countries found themselves
werden deze landen
but increasingly isolated.
maar juist geïsoleerd.
started flying into these countries
vliegmaatschappijen deze landen invlogen,
exposed to the virus
het virus waren blootgesteld,
for the countries themselves,
problemen voor deze landen,
trying to bring people in,
mensen te brengen
respond to the outbreak,
people on airplanes,
countries to be able to respond.
om te helpen.
ladies and gentleman,
also we hadn't seen before.
nog niet eerder gezien.
continue in the places
op plaatsen
but then it started to escalate
maar het begon te escaleren
that you see here,
dat je hier ziet,
on such a scale,
op zo'n grote schaal,
already infected in these countries
regio's van deze landen,
deeper into these countries.
dieper deze landen in.
this was one of the most concerning
de meest zorgwekkende
we've ever seen.
de volksgezondheid aller tijden.
read about in the newspapers,
en lazen in de kranten,
under the weight of this epidemic.
onder het gewicht van de epidemie.
markets no longer started,
markten die niet meer open gingen,
that they should in these countries.
in deze landen.
misperceptions started to spread
en misvattingen rond gaan,
which became even more alarmed
nog ongeruster werden
that you saw in those space suits,
in die ruimtepakken,
who had come to help them.
die kwamen om te helpen.
deteriorated even further.
a state of emergency.
de noodtoestand uitroepen.
in some areas, and then riots broke out.
in bepaalde regio's en opstand brak uit.
angstaanjagende situatie.
many people began to ask,
when it starts to spread like this?
nu het zich zo verspreidde.
do we really know this virus?
hoe goed we dit virus kennen.
Ebola extremely well.
bijzonder goed kennen.
in terms of what we know about it.
de zin van wat we erover weten.
in Central Africa in 1976.
in Centraal Afrika, in 1976.
probably survives in a type of a bat.
overleeft in een vleermuisras.
a human population
de menselijke populatie komt
and probably sickened by it.
en er allicht ziek van is.
spreads from person to person
verspreidt van mens tot mens
that it then causes in humans,
die het in mensen veroorzaakt,
severe fevers, diarrhea, vomiting,
overgeven veroorzaakt ,
of the cases or often more, death.
of meer, de dood.
debilitating, and deadly disease.
en dodelijke ziekte.
this disease for a particularly long time,
nog niet erg lang kennen,
we do know how to stop this disease.
weten we wel hoe we ze kunnen stoppen.
that are critical to stopping Ebola.
om Ebola te stoppen.
have got to understand this disease,
deze ziekte begrijpen.
how it spreads and how to stop it.
verspreidt en hoe ze wordt gestopt.
systems that can find every single case,
die ieder geval kunnen opsporen,
so that you can stop transmission.
zodat deze verbroken kan worden.
specialized Ebola treatment centers,
gespecialiseerde Ebola-behandelcentra,
to the people who are infected,
die besmet zijn,
the same time dignified, burial process,
manier van begraven zijn.
at that time as well.
geen verspreiding optreed.
strategies work, ladies and gentlemen.
Deze strategieën werken, dames en heren.
by these four strategies
door deze 4 strategieën
die ze toepassen natuurlijk.
them, obviously.
spread, and also in the other countries
en ook in andere landen
in this outbreak.
tijdens deze uitbraak.
these strategies actually work.
deze strategieën werken.
was whether these strategies could work
of ze zouden werken
with so many countries affected
met zoveel getroffen landen
growth that you saw.
die jullie zagen.
facing just two or three months ago.
2 of 3 maanden geleden hadden.
because of the extraordinary work
dankzij de buitengewone inspanningen
of governments, of local leaders,
overheden, lokale leiders,
and other organizations
en andere organisaties
to try and stop Ebola in West Africa.
tegen Ebola in West Afrika.
was slightly different.
was lichtelijk anders.
I just showed you;
die ik u zojuist liet zien:
the case finding, contact tracing, etc.,
opsporing, contact achterhalen enz.,
they approached it differently.
dat ze het anders benaderden.
first try and slow down this epidemic
de epidemie af te remmen,
possible in specialized treatment centers
in gespecialiseerde centra
from spreading from those were infected.
besmette personen.
many, many burial teams
deal with the dead,
de dood omgingen.
and slow this outbreak
de uitbraak af te remmen
be controlled using the classic approach
kon worden via de klassieke methoden
en contacten achterhalen.
about three months ago,
naar West Afrika ging,
what I saw was extraordinary.
operation centers themselves against Ebola
noodcentra tegen Ebola openden
and oversee and champion
toezicht konden houden
to try and stop this disease.
ondersteuning om deze ziekte te stoppen.
those countries and from far beyond
en van ver daar vandaan
Ebola treatment centers
those who were sick.
geïsoleerd konden worden.
its partner agencies on the ground there
partnerorganisaties ter plaatse
they could actually safely bury their dead
zodat ze zelf hun doden
konden begraven.
the World Food Program,
het Wereldvoedselprogramma
corner of these countries rapidly
hoek van deze landen kon krijgen
that we just talked about.
waar we het net over hadden.
which was probably most impressive,
by the governments,
with the communities,
gemeenschappen,
understood this disease,
wat deze ziekte was
would have to do to try and stop Ebola.
only two or three months earlier,
2 of 3 maanden eerder nog niet wisten
what you see now in this graph,
in deze grafiek van 1 december,
bend that curve, so to speak,
de curve konden ombuigen,
to the ability to control this outbreak.
op controle van deze uitbraak.
there's absolutely no question now
is er nu geen enkele twijfel
in West Africa and we can beat Ebola.
kunnen inhalen en Ebola kunnen stoppen.
that many people are asking,
mooi dat je het afremt,
that's great you can slow it down,
drive it down to zero?"
back at the beginning of this talk,
over Lofa County in Liberia.
how Lofa County got to a situation
de situatie heeft bereikt
Ebola for eight weeks.
geen Ebola hebben gezien.
the other countries as well.
uit andere landen.
actually diagnosed.
gediagnostiseerd werd.
in the last couple of months,
gezien de afgelopen maanden,
another area in the epicenter,
ook een gebied in het epicentrum,
for more than a couple of weeks --
al enkele weken niet gezien.
victory, obviously,
om de overwinning te claimen,
catch up to the disease,
is doing this on the scale needed
om dit op de vereiste schaal te doen
and that is a huge challenge.
een gigantische uitdaging.
for this long, on this scale,
op deze schaal,
come in to join the virus.
bij het virus.
disease curve starts to bend,
begint te buigen,
the world looks elsewhere.
de wereld focust op iets anders.
hard werkt voor zo lang,
you've been working so hard for so long,
over the past months,
start to creep into the response.
I've just come back from West Africa.
uit West Afrika en ik kan je vertellen:
the leaders of these countries,
de leiders van die landen,
in their countries.
uitbannen in hun landen.
but they are not fatigued.
maar ze zijn niet uitgeput.
to get this finished.
af te handelen.
and gentlemen, at this point,
international community,
de internationale gemeenschap,
at this time, to get the job finished.
om de klus te klaren.
means turning the tables on this virus,
de overhand te krijgen op het virus
rather, started with one case,
eigenlijk, begon met één geval,
have got enough epidemiologists,
als die landen genoeg epidemiologen,
and enough other people working with them
en anderen hebben die meewerken
of those cases, track their contacts
hun contacten na te gaan
stops once and for all.
voor eens en voor altijd te stoppen.
Ebola kan worden overwonnen.
to tell it to the people who will listen
aan de mensen die luisteren,
on what it means to beat Ebola,
om Ebola te overwinnen,
we need you to advocate with the people
we moeten pleiten bij mensen
need to these countries,
naar deze landen te brengen
who will survive and will thrive,
en die zullen opbloeien,
to help us beat Ebola.
om Ebola te helpen verslaan.
ABOUT THE SPEAKER
Bruce Aylward - EpidemiologistAs the Assistant Director-General of the World Health Organization’s Polio and Emergencies Cluster, Bruce Aylward works to ensure that polio stays under control and that the world is prepared to respond to health crises.
Why you should listen
A Canadian physician and epidemiologist who has authored some 100 peer-reviewed articles and chapters, Bruce Aylward is an expert on infectious diseases. He joined the World Health Organization in 1992 and worked in the field for seven years on national immunization programs for measles, tetanus and hepatitis in the Middle East, Africa and Asia.
Aylward has overseen and managed the scale-up of the Global Polio Eradication Initiative since 1998, during which time the program expanded to operate in every country of the world, the annual global budget increased to $700 million a year, polio-funded staff deployed by WHO grew to over 3,500 people worldwide, and new monovalent oral poliovirus vaccines were developed for the programme. In 2014, only three countries remained polio-endemic.
He says: "It's been estimated that our investment in smallpox eradication pays off every 26 days."
Since 2011, Aylward has also led WHO’s work in preparedness, readiness and response to health emergencies. By developing global strategies, analyzing health trends and advising on policies and country collaboration, the WHO helps make sure that outbreaks — like the 2014 ebola epidemic — stay under control.
Bruce Aylward | Speaker | TED.com