World Bank Head On Ebola: Put The Fire Out Where It's Raging
To stop the raging Ebola epidemic in West Africa, "we need to pay attention to where the fire is burning."
That means there is no "magic solution," Jim Yong Kim, the head of the World Bank, told NPR's Steve Inskeep during an interview on Morning Edition. So appointing an Ebola czar to monitor the international response isn't going to suddenly stop the outbreak.
Neither will closing the borders between U.S. and the three hardest-hit countries: Guinea, Liberia and Sierra Leone.
To Kim, that's not a long-term solution: "It's like you're in your room and the house is on fire, and your approach is to put wet towels under the door. That might work for a while, but unless you put the fire out, you're still in trouble.
"The way to stop this epidemic from coming at an even higher level in the United States is actually try to stop it in its tracks," he says of the many U.S. health workers who have volunteered to go overseas.
He says what's most important is not only getting protocols in place in the United States but also in Guinea, Liberia and Sierra Leone. That means quickly identifying cases and instituting a high level of infection control — not just standard precautions.
"We've got to have very high-quality protective equipment," he says. "When patients get sick we need to provide intensive care."
The good news, he says, is that leaders like President Obama and British Prime Minister David Cameron have stepped up in their aid. But the response has just been inadequate for an outbreak that dates back to December of last year. "We are only now getting comprehensive plans for how we are going to attack this epidemic," he says.
What's really missing are health workers, he says. "While we can move thing and build structures what we need are skilled health workers who can do all the complicated things you need to stop the epidemic."
Kim pointed to Nigeria to illustrate the level of intervention needed to stop the current outbreak. With the help of the Centers for Disease Control and Prevention and the World Health Organization, Nigeria was able to contain the outbreak, with 19 confirmed cases and only seven related deaths.
Still, "it cost them $13 million and more than 200 physicians [and] 600 other health workers," he says. "They had to do 19,000 home visits taking temperatures in order to get it control."
He acknowledges that with nearly 9,000 cases so far, there's a lot of work to be done. Yet he's confident that the international community will be able to stop Ebola — although he stresses that "we've got to move much more quickly."
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Transcript
STEVE INSKEEP, HOST:
Now let's talk about the spreading problem of Ebola. The president of the World Bank says the international community is failing to meet the challenge of this disease. Jim Yong Kim used to work for the World Health Organization, one of the groups he now says is falling short.
JIM YONG KIM: It is as if the world right now is at war with the virus. The virus is winning. And so citizens from all over the world have to step up and say, we are now ready to go and fight the virus.
INSKEEP: We spoke with Dr. Kim on a day when members of Congress were calling for a U.S. ban on travel from countries that are hard-hit by the virus.
What would you say to Americans who are saying, wow, we need some kind of greater security, close off contact with West Africa or do something to make sure it doesn't keep spreading here?
KIM: There's just really no way to close borders these days because right now, there are so many people coming in and out and for very good reasons. There are people who are going over there recognizing that the way to stop this epidemic from coming at an even higher level into the United States is to go over there and actually try to stop it in its tracks. And so if you spend all your time focusing on closing your borders, you're really missing the point. It's like you're in a house and you're in a room, and the house is on fire. And your approach is to put wet towels under the door. That might work for a while, but unless you put the fire out, you're still in trouble.
INSKEEP: Well, let's talk about the frustrations of putting the fire out in West Africa, where you say that it is. We have seen news stories from that region about aid arriving and sitting on docks for a long period of time. There doesn't seem to be the capacity to do more very much more than is being done right now.
KIM: We are very much engaged in improving that capacity. You know, I'm on the phone talking with my colleagues on the ground there. And they said that the U.S. military presence, the presence of U.S. contractors, of people from the USAID, there's clearly a greater presence. What's really missing right now is health workers who can do all the complex things that you need to do in order to stop the epidemic.
I mean, where they have been able to do this extremely well for one cross-border case is in Nigeria. And the United States Centers for Disease Control were absolutely critical in working with the Nigerian government in putting that kind of system in place. And they stopped it with that one cross-border case. I had lunch with President Goodluck Jonathan of Nigeria, and he told me in detail how they responded. And that was the key I think - the fact that the president was managing the response directly, that the United States CDC was right there working with the country, and they got it under control. You know, it cost them $13 million, more than 200 physicians, more than 600 other health workers, and they had to do 19,000 home visits, taking temperatures in order to get it under control.
It's a great success story; it gives you a sense of how complicated this is. And for everyone who's listening, I would just say, you know what? It's complicated, but this is what we have to do. But we've got to move much more quickly.
And so there's no magic solution here. We have to get the protocols in place in every hospital in the United States. Moreover, we have to get those protocols in place in Liberia, Sierra Leone and Guinea. That's when we'll start to see light at the end of the tunnel.
INSKEEP: Americans have been asking a lot of questions about this country's readiness and this country's response so far. How would you rate the readiness of the United States and the response so far?
KIM: Well, I think as Tom has said, there have been some mistakes made. But I think we're learning. And I think the sense of urgency in the United States will lead toward people stepping up. I know that there's a lot of concern right now, but again we do know how to stop this infection. I think that very focused and intensive efforts have to be made to make sure that all hospitals in the United States are up to speed. But I'm hopeful that that will happen in the very near future.
INSKEEP: Dr. Kim, thanks very much.
KIM: Thank you, Steve.
INSKEEP: Jim Yong Kim is president of the World Bank. Transcript provided by NPR, Copyright NPR.
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