Via The Los Angeles Times: Leading scientist warns that Ebola eradication may be elusive. Excerpt from a very interesting interview:
You were in Sierra Leone before Christmas. What was the situation there?
Everybody told me the response is getting much better. I think in terms of treatment centers and all that, that's now probably covering the needs. And it's much better organized than before.
But I think that the biggest challenge is going to be, now that the number of cases is starting to come down, people say it's done. But the epidemic goes up and down. It moves from there to there.
Guinea has had Ebola for over a year, but the first announcements about the epidemic were just 10 months ago, and the WHO didn't declare it an international public health emergency until August. Why did it take so long?
Ebola had never hit West Africa, so it was the unknown. There was denial, definitely, from the local authorities. The international community didn't react also.
Why was the WHO slow to react?
Their capacity to respond to epidemics was cut enormously [because of] budget cuts. And they're very decentralized. The one regional office in Africa is not very competent; they have not done their job. In Geneva they have a good team, but it was reduced due to budget cuts. I think there was a collective underestimation of the situation.
Were there problems beyond WHO?
I think the fact that the infrastructure and the health services in these countries are so under-resourced and have few doctors, nurses and all that. Because of civil war, most professionals left the country. Liberia had 51 registered doctors in 2010 for the whole country. What do you do? Where do you start?
There have been other Ebola outbreaks that were contained quickly. Were they mostly in rural areas, and doesn't that make a big difference in fighting the disease?
Yes, except for one in a town called Kikwit and one in Isiro [in Zaire, known today as the Democratic Republic of Congo]. But even then, it's like 200,000 to 300,000 people. And in Congo, mobility is difficult, so that's an issue. In West Africa, the roads are not bad.
So that helps keep the virus contained?
Yes, but also the rapid response. Once you let it get out of control, it's far more difficult to contain. What keeps me busy at the moment — besides making sure that the effort continues, that we don't think it's over — is how are we going to know that it is over, that there is no case left in these three countries?
Is it possible to eradicate it completely?
We have no choice, and it has been done before. The difference is in DRC they could eradicate that particular outbreak that's in one location. Now you have to do that in, I don't know, 1,000 locations in three countries. And each [response] has to be perfect.