With the Ebola crisis still far from unresolved, Devex spoke to the scientist who helped to discover the Ebola virus almost four decades ago to learn more about what the global development community needs to do right now to tackle the disease.
Peter Piot, director and professor of global health at the London School of Hygiene & Tropical Medicine and founding director of UNAIDS, traveled in 1976 to Zaire — now Democratic Republic of the Congo — to help quell an outbreak that was rapidly spreading from village to village. After identifying the virus from a Belgian nurse, Piot’s team put infected people into quarantine and was able to contain the epidemic within three months and after the disease had killed over 300 people.
Here are Piot’s four pieces of advice for the ongoing international effort to contain Ebola in West Africa and beyond:
1. Deliver on all promises.
Nongovernmental organizations, governments and others engaged in fighting the disease and supporting victims should first deliver on the promises they have made, said Piot. That involves delivering on funding pledges, but more importantly, getting more people on the ground.
“Frankly, there are still not enough,” he explained. “There’s a need for money, but it’s really having people on the ground that’s important.”
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Some states in the United States and elsewhere have been enforcing quarantine measures on medical and humanitarian aid workers returning from infected countries. That practice, Piot said, needs to end as it is affecting the aid community’s ability to act.
“People want to help now, but we need conditions where you’re not locked up and put in quarantine when you get back,” he said.
In October, Maine Governor Paul LePage sought to impose a 21-day quarantine on nurse Kaci Hickox when she returned home from treating Ebola patients in Sierra Leone for Médecins Sans Frontières. This was despite her not showing any symptoms of the virus; a judge ruled against the move. MSF responded by releasing a statement that warned how quarantines undermined efforts to curb the epidemic at its source.
2. Share data and information.
Figures suggesting numbers of cases were rising in Sierra Leone, but falling in Liberia, have been confusing. Too few global development community actors, Piot said, are sharing information; coordination must improve.
“There needs to be open access to data and information,” he mentioned. “We need to share what are the best treatments — what everyone is doing, and constantly evaluate what we’re doing.”
Data collection has been a key role for the World Health Organization, which has faced some criticism for its response to this year’s Ebola outbreak. Still, WHO should lead on information gathering, Piot said.
In October, Piot publicly stated that WHO had responded too slowly to the outbreak.
3. Create a flexible response.
Ebola is not spreading in a continuous way.
“It pops up here, then it goes there,” Piot said.
People tackling the outbreak need to constantly track how the virus is evolving and be able to respond accordingly. More treatment centers and frontline health workers are needed, Piot said, but also more mobile treatment units.
“That is what has helped in the past with smaller outbreaks,” he argued. “There are going to be pockets here and there so we need strategies that are far more flexible.”
4. Develop vaccines.
It’s crucial that the numerous vaccines and treatments being developed across the world are evaluated rapidly, Piot said, warning that because the Ebola virus reservoir was in bats, it would never be possible to eliminate the virus completely.
“It’s always going to pop up, that’s why its important to stop this epidemic but also make sure of the opportunity to develop and test these new drugs,” Piot said. “If we have a vaccine, for example, and we know where the reservoir is, which we also still need to research, then we make sure that vaccine is available there.”
It is unlikely, he added, that the virus could ever be eliminated among animals. Many of the world’s most challenging diseases originated with animals — HIV from chimpanzees and flu strains from poultry or pigs, for instance.
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