Ebola: 'Wow, that is really tough' - Interview with Aylward, WHO

[Gert van der Hoek]

Ebola: 'Wow, that is really tough'

By Leslie Roberts 10 September 2014

Bruce Aylward is used to mobilizing armies of health workers. An assistant director-general at the World Health Organization (WHO) in charge of polio and emergencies, he leads the massive global effort to eradicate the poliovirus. But Aylward says he has never encountered a challenge as great as the Ebola outbreak in West Africa, which has infected more than 4000 people and killed more than 2000.

Margaret Chan, who heads WHO, asked Aylward to help with the response in August; since then, he has been running operations and helped draw up WHO’s Ebola Response Roadmap, released on 28 August. He spoke with Science on 4 September. (This interview has been edited for clarity and brevity.)

Q: Why is stopping this outbreak so hard compared with controlling polio?

A: The polio program is really tough because of the level of programmatic perfection you need. You have to get to every single kid with vaccine over a huge geography and in very challenging environments. But even if you don’t, you still have a level of control over the virus. Now, when I look at Ebola, you need a whole other level of perfection.

You have to do perfect contact tracing, because one contact can blow open a whole new chain of transmission. You have to get your burials perfectly safe. You have to get your laboratory testing right. There isn't a lot of capacity in the world on that. You have to get your social messages right. You have to be perfectly safe and protect health care workers. And you have to do all this in incredibly weak environments, in three countries that are near the bottom of the development index, and also deal with the embers that land in Nigeria or in Senegal. Wow, that is really tough.

Q: So you need more people and you need more money, but it's simply not coming?

A: Not yet, but I’m optimistic. I think it’s taking the world time to grapple with this. It is so new, and it plays to people’s deepest fears and their greatest uncertainties. People will learn MSF is going to stay on the ground there. And then one or two NGOs are going to go in and run a facility, and they’re going to do fine. And then it’s going to escalate. The world doesn’t want to be beaten by a pathogen. But the question is: Are they going to do it fast enough?

Read more: Science Mag