In West Africa, Fewer New Ebola Cases But Epidemic Still Uncontained

Transcript

ROBERT SIEGEL, HOST:

The response to the Ebola epidemic has now moved from slowing transmission to ending the epidemic - that from the World Health Organization. The number of new cases of Ebola in West Africa is down, so we thought we would check in on lessons learned so far from the international response to the outbreak. Brice de le Vingne is director of operations for dealing with the outbreak for Doctors Without Borders, and he joins us from New York. Welcome to the program.

BRICE DE LE VINGNE: Yeah, hi. Hello.

SIEGEL: First, are new Ebola cases significantly down or might there just have been a dip in reporting over the holidays?

VINGNE: No, no. I mean, first of all, yeah, we are very happy to see this really sharp decrease of number of cases. Having said that, of course, we are still nowhere to be really in control of the epidemic. When we say control of the epidemic, it's basically that even if you have still people who are being contaminated, they are registered in a contact list. And today we still have too many patient coming in our centers who are not on those contact lists, basically. And that's really an indicator that the surveying system is not good enough.

SIEGEL: You're saying it would be more successful if there were no surprises of that sort?

VINGNE: Exactly, no surprise. Like, you have somebody coming in because he's Ebola positive, but he's already inside a so-called contact list, basically.

SIEGEL: Back in August, when Ebola was peaking in Liberia, you faulted the international effort. You called it non-existent. Is it now adequate? And how much sooner should it have begun?

VINGNE: Much sooner, obviously. I mean, we have been calling for months before August, basically, to have more deployment of more actors and so on, and the international community to be involved. The deployment we were asking was for the epidemic at that time in September. And then we were constantly like two to three months behind. The level of deployment is huge today. It's very important. You see really a lot of states have committed and have deployed more activities. But now it comes to the quality of the response. And if we need to go down to zero cases, you need to have a quality system that is really able to be very adaptive and flexible. And that's still a challenge.

SIEGEL: Is there something about Ebola or about this region, the outbreak having occurred in three different countries, that can explain the sluggish response in this case? Or do you think that, say, an influenza pandemic in Bangladesh or a cholera epidemic in a Middle Eastern refugee camp would expose the same weaknesses in world health systems that were exposed in West Africa?

VINGNE: It shows, basically, that we are not well-prepared to face, especially when a virus is crossing borders, meaning it's not only one country or one administration that is accountable to respond to the crisis, but it's much broader than that. And that's where we still don't have really a workable and proper system, especially when it happen in countries that doesn't have a very strong health system. This also a key thing, the fact that those health system, Liberia and Sierra Leone, having been through more than 10 years of war, were quite weak in the face of reconstruction, basically.

SIEGEL: Given that there were so many organizations involved, a couple of different countries involved, not just the African countries but the U.S. and Britain and - did somebody get it especially right here? Is there a model that emerged from the various approaches to the Ebola outbreak that stands out?

VINGNE: Of course you had strength and weaknesses in all of them. I think what was missing is a much better coordination, basically. The coordination was really an issue because you have all those different states and actors ready to help, but at the end you need to have a comprehensive plan and and also a clear chain of command. And and that was a huge challenge. Tomorrow, if another crisis happened somewhere, I mean, we still have a lot of improvement that needs to be done in terms of coordination.

SIEGEL: Brice de le Vingne of Doctors Without Borders, thank you very much for talking with us.

VINGNE: Thank you. Transcript provided by NPR, Copyright NPR.