What’s next in the global response to Ebola?

What's next for curbing the Ebola epidemic in West Africa, where the death toll now exceeds 8,000? For one, drug companies have begun to experiment on humans in the affected region. Gwen Ifill talks about new approaches with Anthony Banbury, former head of the UN Mission for Ebola Emergency Response, and Delaware Sen. Chris Coons, who have both recently returned from West Africa.

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    With the death toll in West Africa now over 8,000, government and humanitarian organizations are reassessing the most effective way to tackle the deadly Ebola virus.

    From launching new drug trials to building new clinics, the United Nations, the United States and nongovernmental agencies around the world are ramping up, scaling back and searching for new approaches to curb the epidemic in Liberia, Sierra Leone and Guinea.

    Delaware Democrat Chris Coons, the outgoing chairman of the Senate Foreign Relations Subcommittee on Africa Affairs, has just returned from Monrovia. And Anthony Banbury has just completed a 90-day term as head of the United Nations Mission for Ebola Emergency Response.

    Welcome to you both, gentlemen.

    Senator Coons, you just came back here. You're the first and only member of Congress to actually have gone to the Ebola zone, as it were. What did you see?

    SEN. CHRIS COONS, (D) Delaware: Well, I was really impressed by the impact that America's troops have had in the country of Liberia. Let's just go back for a second to September, when President Obama took the decisive, the brave action of deploying the entire 101st Airborne Division, 2,400 U.S. troops, to Monrovia, Liberia.

    At that point, the Ebola epidemic in Liberia was raging out of control, and there were predictions by the CDC that, by now, in January, there would be at least half-a-million people infected by Ebola if it continued at the rate it was on at that point.

    What I saw when I visited was that our troops all over the country have made a dramatic difference. They have built Ebola treatment units. They have deployed military-grade high-quality labs and testing facilities. They have provided the logistics and support to reinforce and reassure volunteer doctors and nurses and missionaries from around the world, and the rate of new infections in Liberia has dropped dramatically.

    There's also been real changes in social practices. Every place I went, folks were being checked for their temperature, washing their hands in a bleach solution. Nobody was shaking hands, and, most importantly, both safe and dignified burial practices were being put in place around the country.

    So I'm optimistic about the impact that we have been able to make in Liberia, and eager to talk tonight about how we might apply those lessons learned to Sierra Leone and Guinea, where it still is largely out of control.


    Well, let me ask Anthony Banbury.

    After 90 days as the head of the U.N. effort, where does the global response stand?

    ANTHONY BANBURY, Former Head, UN Mission for Ebola Emergency Response: The global response is actually in very good shape.

    I think, just as Senator Coons described the progress that's being made in Liberia, we're starting to see similar progress in Sierra Leone. We're a few weeks behind where we were in Liberia, but the response capabilities are being put in place in Sierra Leone, particularly the main hot spots around Freetown and in an area called Port Loko.

    We're also seeing the response grow in Guinea. So I think we're going to see the numbers go down, the total numbers go way down in all three countries in the weeks ahead. But what's going to happen, what's already happening is, the disease is spreading geographically. It's becoming more dispersed, and that means we need a lot of capability spread across the three countries. And that's going to be a big challenge going forward.


    Senator Coons, does the U.S. military effort that you described, does it have to remain open-ended for now?


    Well, I have called on the Pentagon to change strategy, to reduce the total number of our troops that are there, but to extend the amount of time that they will be there and to make sure that we are transitioning, the big investment that we have made in new Ebola treatment units and mobile labs and in the infrastructure to support the sort of grassroots outreach across the whole country that Tony is talking about, to do that in a way that would empower and strengthen Liberian efforts that will make sure that this epidemic gets to zero.

    We shouldn't leave Liberia in a significant way until we have gotten to zero, because I'm very concerned that this Ebola epidemic could just come roaring back if the international community that has made such a difference in this region withdraws too early.


    Let me ask Mr. Banbury about that, because you — you too have said that not getting to zero would constitute failure in this case. What happens if the U.N. does pull back? What happens if the U.S. does pull back, as Senator Coons is suggesting, to that effort?


    The U.N. secretary-general, Ban Ki-Moon, was just in the region a couple weeks ago, and he made very clear to the presidents of the country, to the people, and to the U.N. family that we will be there side by side with the governments and people of the countries until there are zero cases.

    That's the only option. It's the only way to go. It's going to be hard getting there. I think everything Senator Coons just said is absolutely right about working with the communities, building and strengthening the national health care system, so they can have good disease surveillance in place, so we can have early detection of small outbreaks, and a quick response to snuff them out, so two cases become zero, rather than 20 or 200.

    We all recognize now what we have to do as the disease evolves and we move from the first phase to the current phase. The challenge will be execution, but we can't let up, by any means, until we're at zero.


    Part of the execution — and I want to direct this to both of you today — we have heard pharmaceutical companies talking about clinical drug trials.

    Starting with you, Anthony Banbury, how practical, how hopeful is that?


    Well, we're all hoping that we're going to have a vaccine, improved treatments, so fewer people die who do contract it.

    But in terms of the current operation and what we're doing day to day, we can't rely on the arrival of a vaccine or improved treatment. We have to deal with the realities that are on the ground now, the tools that we have at our disposal. And they're what Senator Coons said. They're the treatment centers that do isolation.

    They're the safe burial practices. They are social mobilization. We have to break the transmission. And that's working. Where we put those response capabilities in place, we see dramatic drops in the numbers. The challenge will be to have that capability across these three countries that have really poor roads. They're very isolated villages. Sometimes, they take two days, three days to drive to.

    So we have a challenge on our hand, but we know what we need to do.


    Well, as you talk about the improvements on the ground, Senator Coons, how much of that is sustainable? How — it's nice to talk about hope, but is hope sustainable in this case?


    Well, one of the things I heard all across Liberia was that when the message went out from President Obama that he had made the decision September 16 to deploy U.S. troops, it lifted the spirits of all Liberians, who were feeling abandoned by the world community at the time, who were concerned that lots of airlines and shipping lines and expatriate groups and nonprofit groups had withdrawn from the country.

    Our intervention there, I think, significantly lifted the spirits of people of Liberia and brought them hope. But, to your point, I'm calling on the Pentagon to change to a strategy that's more sustainable. And that requires investing in skills, in making sure that Liberians have the skills, the equipment, the resources to sustain the sort of grassroots testing labs, treatment capability, clinics, the social mobilization and contact tracing that you have just heard discussed by Dr. Banbury.

    We know how to get to zero in Ebola, but it is going to take a different sort of strategy. We have brought some hope with a big footprint, expensive emergency intervention by the United States military. We need to now sustain that hope in a more practical and cost-effective way by using the great human resources of the Liberian nation and Guinea and Sierra Leone, and the remarkable resources of the missionaries and volunteers who are there to ensure that we make a lasting difference, not just for this epidemic and this outbreak, but to strengthen the public health infrastructure and the social infrastructure of these three West African countries.


    Senator Chris Coons and Anthony Banbury of the U.N., thank you both very much.


    Thank you.


    Thank you.

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