Guinea reaches Ebola-free milestone, but wariness lingers

Guinea, the first country hit with the deadly Ebola outbreak nearly two years ago, is now free of the disease, according the the World Health Organization. More than 2,500 people died in that nation before the virus was fully contained. William Brangham talks with Sheri Fink of The New York Times.

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    For the first time in two years, the country where the Ebola outbreak began can say it's free of the virus. That's also true for the region of West Africa, where more than 11,000 people have died in the epidemic.

    Ebola sickened more than 28,000 people across 10 countries, mostly in Africa. But a long international effort eventually paid off.

    William Brangham begins our look at the lessons learned and the challenges that remain.


    The outbreak first began in Eastern Guinea back in December of 2013 and then spread to neighboring Liberia and Sierra Leone. More than 2,500 people died in Guinea before it was fully contained. And, today, an estimated 6,000 children there are orphans because of the epidemic.

    But it's now been six weeks since the last known Ebola patient repeatedly tested negative for the virus. Reports from Guinea today suggest a mix of both celebration and wariness.

    Sheri Fink has chronicled the impact of the epidemic for The New York Times, and was part of the team who won the Pulitzer Prize for its coverage.

    So, Sheri Fink, Guinea says no more Ebola. Tell us, how big a deal is this?

  • SHERI FINK, The New York Times:

    It's a big deal.

    As you have said, it's been two years since experts believe that that first case in a little village in Guinea started this epidemic. That's a very long time. And today marks the date that all three of those most affected countries have broken that original chain of transmission, that human-to-human transmission that has led us to this day, with thousands of deaths and many, many thousands of people getting sick with Ebola.


    Is the scientific community pretty confident that we are in fact at zero? Liberia at one point was declared Ebola-free, and then some new cases erupted. So how confident can we be that this really is it?


    So, this has been something that we have learned this year.

    In fact, people might even be surprised Ebola has slipped from the headlines, that the transmissions continued to go up until this date. And that is because there have been sort of these cases that nobody knew about of potential Ebola kind of hanging out in certain parts of the body that are immunologically protected and reemerging in some survivors, causing these little mini-outbreaks.

    So, indeed, Liberia reached this milestone a few months ago and twice has had small flare-ups that are thought to be linked to transmission from survivors in very rare cases thought to be sexually transmitted, for one thing.

    So now the World Health Organization is saying, OK, human-to-human transmission has stopped, but Guinea will enter a 90-day period of what they're calling enhanced surveillance to be really on the lookout for occasional sporadic cases that could pop up and lead to more cases.


    Your reporting over the last months and year have revealed that there are some real problems with the way the World Health Organization responded to this epidemic.

    Can you tell us about some of those — some of the problems that they had, and how have they been addressed?


    Well, the World Health Organization has really been a punching bag for this outbreak. And it should be said that nobody responded very well at the beginning.

    But, certainly, the World Health Organization, as that U.N. body that's in charge of the world's health, came in for a lot of criticism, and they said it was justified. And numerous groups have come out, experts, trying to say, what can we learn from this?

    The essential fact was, early in the outbreak, the WHO failed to sort of understand its gravity. I mean, these cases popped up in a part of the world that hadn't been known really to have Ebola outbreaks in the past, right at the border of three countries, and very quickly had hit capital cities.

    So there wasn't just enough of a sense of urgency in that very early response, a sense that this was different from the WHO. Plus, they had cut down their outbreak response units just before the outbreak happened. This was because, you know, they hadn't had as much money to work with, with the global financial crisis, and so they chose to cut certain aspects of their global health portfolio.

    Unfortunately, one of them was outbreak response. So now the focus is how to strengthen that in the future.


    You reported also that, sometimes, political concerns got in the way of public health concerns. Explain how that happens.


    So, the WHO is made up of its member countries.

    And in the past, even with this outbreak, we saw that there is sort of a punitive response when a country has a dangerous disease like Ebola within its borders. Airlines shut down flights, countries pull out, and the thought is also that these countries put pressure on the local — the regional WHO offices.

    They don't want a big deal to be made of this outbreak. So, looking forward, a lot of these groups are saying the WHO needs to be protected from that political pressure, so that they can address an outbreak, not minimize it, in the beginning, as well as the other countries of the world need to reward countries that are willing to come forward and say, we have got an outbreak.

    And that reward is, you know, immediate assistance to fight the outbreak. More broadly, health systems really need to be strengthened in all these countries. These are countries with poor health systems to begin with, and all the countries of the world have realized that there is an interest in strengthening those health systems.

    You know, that's partly to help people, humanitarian, but partly so that future outbreaks of even more dangerous, you know, epidemics would be stopped at their source.


    All right, Sheri Fink of The New York Times, thank you so much.



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