Bruce Aylward: Humanity vs. Ebola. How we could win a terrifying war
ブルース・エイルワード: 人類対エボラ、恐るべき闘いにおける勝利の戦略
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,
of titles with the organizers,
kicked around and were discussed.
議論されました
was two months ago,
それは2ヶ月前に
than we had ever seen,
広い範囲にまで広がっており
concerned and alarmed
近年稀にみる勢いで
seen in recent history.
不安にかられるようになったからです
and I can talk to you about beating Ebola
についてお話し出来ると思います
whom you've never heard of,
聞いた事もない
doctor who's working in Lofa County,
ピーター・クレメントのような
never heard of, probably, in Liberia.
is so important
just starting to escalate,
この感染症がちょうど拡大し始めた頃
the epicenter of this epidemic.
正にど真ん中にありました
and the treatment center there,
そこにある治療センターで
every single day,
大勢の患者を診ていました
were becoming more and more terrified
時間が経つにつれ
and what it was doing to their families,
それが自分たちの家族やコミュニティ
to their children, to their relatives.
恐れるようになりました
driving that 12-hour-long rough road
首都モンロビアからロファ郡まで
up to Lofa County,
to the escalating epidemic there.
手助けをしようとしました
the terror that I just mentioned to you.
先ほど私が申し上げたような恐怖でした
and he listened.
彼らの話に耳を傾けました
and the desperation
that Ebola did to people,
痛みだけでなく
and what it did to communities.
痛みの話でした
and what they told him --
彼らはこう語りました
when our children are dying,
we want to be closest to them.
of them as our tradition demands.
慣習に従って彼らを弔うことも出来ない
the bodies to bury them
our rituals demand.
許されないのです」
deeply disturbed, deeply alarmed
非常に当惑し不安になり
was unraveling in front of them.
広がっていったのです
workers who had come,
感情をぶつけていました
and help save the community,
とやって来た英雄たちは
and they were unable to access them.
Peter explained to the leaders.
リーダー達に説明しました
They turned the tables.
皆は形勢を逆転させました
He explained what the disease was.
どんな病気なのか それが
to their communities.
説明したのです
everything that made us human.
脅威にさらすと彼は説明しました
the way you would in this situation.
子供を抱くことが出来ない事
the way that you would.
遺体を埋葬できない事
in these space suits to do that for you.
彼らにそうした役割を託さなければならないのです
happened then was rather extraordinary:
驚くべき事が起こりました
Peter, they sat down together
そしてピーターが協力しあえたのです
for controlling Ebola in Lofa County.
新たな共同計画を立てました
an important story, ladies and gentlemen,
となるのです 皆さん 何故なら
right at the center of this epidemic
正に中心になっているこの郡―
you've been seeing in the newspapers,
the television screens,
without seeing a single case of Ebola.
エボラの新たな症例は一例も出ていないからです
the job is done, obviously.
という訳ではありません
that there will be additional cases there.
大きなリスクがあります
is that Ebola can be beaten.
打ち勝つ事が出来ると分かったのです
that we saw in this environment here,
感染拡大の下でさえ
可能だと分かったのです
with health care workers, work together,
協力し合い 共に戦えば
可能性があるという事です
in Lofa County in the first place?
エボラ出血熱が流行したのでしょうか?
12 months, to the start of this epidemic.
12ヶ月前まで遡らなければなりません
this virus went undetected,
このウイルスは検出されないままでした
or four months when it began.
ウイルスの検出が見過ごされていました
a disease of West Africa,
half a continent away.
the disease before.
診たことがなかったのです
they were dealing with,
手に負えませんでした
even more complicated,
a type of a presentation
この病気特有の症状とは
the disease, people who knew Ebola.
この病気を認識しなかったのです
for some time,
この病気は発覚が遅れたのです
sometimes these days,
広く信じられている事とは逆に
there was a rapid surge in of support.
急速な支援の波が起きたのです
center, as many of you know, in the area.
この地域にエボラ治療センターを設立しました
and the partners that it works with
その後2ヶ月以上に渡って
over the next two months
is by then, this virus,
問題になっていたのは
had spread too far.
このウイルスが 過剰に拡大した事です
one of the largest responses
感染対策の取り組みを凌ぎ
to an Ebola outbreak.
not just Guinea
were also infected.
感染は広まっていました
the numbers were increasing
感染の数は増加し
hundreds of people infected
the front line responders,
responders
recognized the emergencies.
緊急事態を認識しました
they agreed on common action
共通の活動に取り組むことに同意し
joint operation center in Conakry
今お話しした事についての
disease and get it stopped,
we talked about.
we had never seen before with Ebola.
経験したことのない事態でした
or someone sick with the virus,
ウイルスに罹患した誰かが
flew to another country,
we saw in another distant country
エボラ患者が発見されました
in the teeming metropolis of Lagos,
2千百万人の人間がごった返す
there was international alarm,
非常事態宣言が出されました
we hadn't seen in recent years
国際的重大事が
called together an expert panel,
declared an international emergency.
宣言しました
that there would be a huge outpouring
to help these countries
and concern at that time.
something very different.
かなり違うものでした
many, many NGOs and others, as you know,
NGOや団体が支援の為にやって来たのです
happened in many places.
多くの場所で起こりました
these countries found themselves
自分たちが必要としている
but increasingly isolated.
孤立を深めている事に気づきました
started flying into these countries
入って行き
exposed to the virus
さらされていなかった人々も
for the countries themselves,
国そのものにとっての問題だけでなく
trying to bring people in,
手助けをする人々を
respond to the outbreak,
people on airplanes,
countries to be able to respond.
迎え入れることが出来なくなったのです
ladies and gentleman,
also we hadn't seen before.
continue in the places
このウイルスが
but then it started to escalate
その後拡大をし始め
that you see here,
on such a scale,
already infected in these countries
感染の広まった地域だけでなく
deeper into these countries.
ありとあらゆる場所に広がっていきました
this was one of the most concerning
これまで見てきた中で
we've ever seen.
国際的緊急事態の一つでした
read about in the newspapers,
新聞で読まれた通りです
under the weight of this epidemic.
医療システムが崩壊し始めるのを目にしました
markets no longer started,
市場はもう開かれなくなり
that they should in these countries.
misperceptions started to spread
むしろすばやく
which became even more alarmed
that you saw in those space suits,
宇宙服を着た人達と恐れ
who had come to help them.
deteriorated even further.
a state of emergency.
宣言しなければなりませんでした
in some areas, and then riots broke out.
そうして暴動が起こりました
many people began to ask,
when it starts to spread like this?
私たちはくい止める事が出来るのか?」
do we really know this virus?
どの程度の知識があるのか?」
Ebola extremely well.
あまり良く分かっていません
in terms of what we know about it.
比較的新しい病気です
最初に確認され
in Central Africa in 1976.
わずか40年しか経たないのです
分かっている事は確かに数多くあります
probably survives in a type of a bat.
種の間で生き延びました
a human population
入りこんだのは分かっています
野生動物と接触するようになり
and probably sickened by it.
病気を発症したのでしょう
spreads from person to person
感染した体液を通して
that it then causes in humans,
severe fevers, diarrhea, vomiting,
of the cases or often more, death.
それ以上が死に至ります
debilitating, and deadly disease.
衰弱した末 死に至る病です
this disease for a particularly long time,
知られていなかったという事実にもかかわらず
we do know how to stop this disease.
この病気をくい止める方法は確実に分かっているのです
that are critical to stopping Ebola.
4つの事柄があります
have got to understand this disease,
この病気を理解しなければなりません
how it spreads and how to stop it.
理解しなければなりません
systems that can find every single case,
ありとあらゆる症例を見つけ
システムを確立し
so that you can stop transmission.
伝染の連鎖を辿り始めなければなりません
specialized Ebola treatment centers,
治療センターを設立し
to the people who are infected,
the same time dignified, burial process,
私たちは安全で 且つ同時に尊厳のある
at that time as well.
strategies work, ladies and gentlemen.
これらの戦略は機能するのです 皆さん
by these four strategies
それらを実行した人々によって
them, obviously.
spread, and also in the other countries
そこはウイルスが広がり
in this outbreak.
他の国々にも広まった場所です
these strategies actually work.
疑問の余地はありません
was whether these strategies could work
皆さんがご覧になってきたように
with so many countries affected
growth that you saw.
どうかという事なのです
facing just two or three months ago.
直面していた大きな問題でした
私たちは知っています
because of the extraordinary work
素晴らしいNGO、政府
of governments, of local leaders,
その他大勢の組織が
and other organizations
挑んだ 驚異的な働きのお蔭です
to try and stop Ebola in West Africa.
挑んだ 驚異的な働きのお蔭です
was slightly different.
少しだけ違っていました
I just showed you;
ご紹介したこれらの戦略をとりました
the case finding, contact tracing, etc.,
症例の発見 保菌者の追跡等々です
they approached it differently.
異なるアプローチをとったのです
first try and slow down this epidemic
広まらないよう 特別な治療センターで
possible in specialized treatment centers
用意する事に決めました
from spreading from those were infected.
緩めようとするものでした
many, many burial teams
扱うことが出来るように
deal with the dead,
それによって
and slow this outbreak
be controlled using the classic approach
実際効果的かを見極めながら
about three months ago,
what I saw was extraordinary.
operation centers themselves against Ebola
国際的な支援の高まりをとらえ
and oversee and champion
エボラと闘うための
to try and stop this disease.
開設している姿を目にしたのです
those countries and from far beyond
あらゆる所から集まった軍隊が
Ebola treatment centers
those who were sick.
its partner agencies on the ground there
パートナーエージェンシーと協力して
they could actually safely bury their dead
コミュニティに啓蒙活動を行ったことです
コミュニティに啓蒙活動を行ったことです
the World Food Program,
corner of these countries rapidly
担当者を送ることの出来るよう
that we just talked about.
which was probably most impressive,
おそらく一番 印象的だったのは―
by the governments,
リーダー達による―
with the communities,
エボラをくい止める為に
understood this disease,
理解させる
would have to do to try and stop Ebola.
only two or three months earlier,
分からなかったことが 実現出来る
what you see now in this graph,
このグラフの通りです
bend that curve, so to speak,
下降させられるということ いわば
to the ability to control this outbreak.
希望を取り戻せるということでした
there's absolutely no question now
in West Africa and we can beat Ebola.
追いつき エボラに打ち勝つ事が出来るのです
that many people are asking,
こう尋ねられる事です
that's great you can slow it down,
数が減らせるのはのは良いのですが
drive it down to zero?"
back at the beginning of this talk,
一件も無かったことをお話しし
how Lofa County got to a situation
Ebola for eight weeks.
the other countries as well.
actually diagnosed.
in the last couple of months,
another area in the epicenter,
ここシエラレオネのケネマで
for more than a couple of weeks --
検出されていません
victory, obviously,
早すぎるのですが
catch up to the disease,
可能性があるという事なのです
is doing this on the scale needed
必要とされた規模でこれらの活動をすることであり
and that is a huge challenge.
for this long, on this scale,
取り組んでいると ある2つの脅威が
come in to join the virus.
現実的でない自己満足です
disease curve starts to bend,
the world looks elsewhere.
どこか他の場所に移っていきます
you've been working so hard for so long,
長い間一所懸命働き続け
over the past months,
start to creep into the response.
対処しなくてはならないのです
I've just come back from West Africa.
西アフリカから帰ってきたばかりです
the leaders of these countries,
これらの国々のリーダーたちは
in their countries.
ゼロにしたいと願っています
but they are not fatigued.
疲れてはいますが疲弊はしてません
to get this finished.
and gentlemen, at this point,
international community,
国際社会の確固たる支援なのです
at this time, to get the job finished.
支援を加速させることです
means turning the tables on this virus,
このウイルスの形勢を逆転させ
rather, started with one case,
一つの症例から始まった 大きな危機です
終わりを迎えるのです
have got enough epidemiologists,
十分な医療従事者 十分な事務方
and enough other people working with them
接触者を追跡し
of those cases, track their contacts
stops once and for all.
初めて収束することができます
to tell it to the people who will listen
それを伝えてもらいたいのです
on what it means to beat Ebola,
どういうことかを伝え
we need you to advocate with the people
必要な資源をもたらす支援が
need to these countries,
こう言い続けてもらいたいのです
who will survive and will thrive,
出来る事を行う事で
to help us beat Ebola.
多くの人々が存在するのです
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