Ebola efforts shift from keeping up with new cases to eliminating the epidemic

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    President Obama announced today that the U.S. will be bring back nearly all of the 2,800 troops fighting Ebola in West Africa, while calling last year's outbreak of the disease a wakeup call to the world.

    Jeff is back with that.


    The president said that the U.S. operation will soon enter a second phase after a dramatic change in the trajectory of the new cases of the disease that has killed more than 9,000 people.


    Our focus now is getting to zero, because as long as there is even one case of Ebola that's active out there, risk still exists. Every case is an ember that, if not contained, can light a new fire. So we're shifting our focus from fighting the epidemic to now extinguishing it.


    And joining me now to discuss the past, present and future of the U.S. Ebola operation in West Africa is Rajiv Shah of USAID.

    And welcome to you.

    Today signals the end of one phase of the fight. What does that mean? Is it a moment of triumph? How do you describe it?

    RAJIV SHAH, U.S. Agency for International Development: Well, it's a moment of transition.

    And I recall when I visited the West African countries with Ebola in October, there were more than 1,000 new cases a week. I met mothers who were holding their children who were literally dying in their arms, putting themselves at huge risk of death themselves. And the destruction was almost unbelievable.

    Then I came home. And, as you recall, there was tremendous panic here in the United States, most of it not based on science. But, nevertheless, there was a deep concern. People wondered whether I should go to my kids' soccer game the weekend I got back.

    And, today, because of a huge U.S. leadership moment, because we put these troops on the ground to build confidence and build infrastructure, because we have more than 10,000 employees of the humanitarian organizations leading the fight, we have seen tremendous reduction in the disease.


    There are even still some recent reports of small spike in cases in Guinea. Is it possible, do we know that it's on the decline? Is it possible that the decline has stalled?


    Well, it's always possible.

    And we are going to be vigilant until we get to zero. But we have gone — we have seen a reduction of more than 80 percent in the number of cases. We have seen a reduction of more than 90 percent in Liberia. And we're confident that by continuing to have a strong, aggressive response, frankly rooted in science and innovation and new partnerships, we can get to zero, effectively.


    There was this extraordinary ramp-up in response, as you say. And yet so many thousands of people died.

    One wonders, looking back now, is it ever possible to be fast enough? What have we learned about the ability to ramp up?


    Well, I think the biggest thing we have learned is that we have to innovate and bring science, technology and business all to the table to join us is in these kinds of big, global ambitions.

    In this case, we have redesigned the protective equipment that health care workers wear so they can get in and out of it safer and be safer as they conduct the response.


    For the next time or whatever comes next.


    And for the reminder of this year, what has to happen to get to zero.

    We have distributed ruggedized Android devices so health care workers can collect data, project it into a central system, and we can get resources out to people who are positive right away. We have put new labs and diagnostics in place. And we're constantly inventing new ways of monitoring patients without touching them, so that health care workers can be protected and people can do better in terms of survival.

    And that basic focus on business, science and technology has transformed the effectiveness of this response and frankly has transformed a lot of how America projects its development and humanitarian work around the world.


    Well, so for this next phase, what kind of presence will still be there? What kind of infrastructure will remain?


    Well, USAID will continue to have our disaster assistance response team coordinating the whole of government effort.

    We will have about 100 service personnel after April from the military manning the labs and doing some of the specialized work that they have done so effectively and that I'm so proud of. We will continue to have hundreds of experts from the Centers for Disease Control. And we will continue to have nearly 10,000 humanitarian workers, most of whom are local, most of whom have been trained in protective activity, and most of whom will be the basis of a resilient and strong health system that we will seek to build in the coming year.


    You were mentioning the situation in this country, where there was some panic for a while.

    Are you concerned that, from what you saw, that we're not ready for what may come at some point, the potential for the next epidemic?


    Well, because the president took a very science-based approach, and didn't panic, but invested in readiness and preparedness, we are far more prepared today in the United States than we were even a little while ago.

    So, no, I'm not concerned. We will have — you know, there's always the risk that a health care worker who's been a hero on the ground in West Africa may contract the disease, and come back with that and get treated, but today the capacity to provide that treatment far exceeds what it did before because we invested in that preparedness.


    And quite — and very briefly, on the ground in the West African countries, you also think they're better prepared now? They have got past the fear that we saw in the beginning?


    Well, not only are they better prepared, but we have built a pretty amazing logistics and transportation and training system that allows us to have the confidence to know that, when there are cases of Ebola, we can see it.

    We have modern data systems to identify it, and we can get resources to isolate those patients as quickly as possible and try to save their lives.


    All right, Rajiv Shah of the USAID.

    And you are leaving your post this week. So good luck. Thank you for joining us.


    Thank you.

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