TIME ebola

The Psychology Behind Our Collective Ebola Freak-Out

Airlines and the CDC Oppose Ebola Flight Bans
A protester stands outside the White House asking President Barack Obama to ban flights in effort to stop Ebola on Oct. 17, 2014 in Washington, DC. Olivier Douliery—dpa/Corbis

The almost-zero probability of acquiring Ebola in the U.S. often doesn’t register at a time of mass fear. It’s human nature

In Hazlehurst, Miss., parents pulled their children out of middle school last week after learning that the principal had recently visited southern Africa.

At Syracuse University, a Pulitzer Prize–winning photojournalist who had planned to speak about public health crises was banned from campus after working in Liberia.

An office building in Brecksville, Ohio, closed where almost 1,000 people work over fears that an employee had been exposed to Ebola.

A high school in Oregon canceled a visit from nine students from Africa — even though none of them hailed from countries containing the deadly disease.

All over the U.S., fear of contracting Ebola has prompted a collective, nationwide freak-out. Schools have emptied; businesses have temporarily shuttered; Americans who have merely traveled to Africa are being blackballed.

As the federal government works to contain the deadly disease’s spread under a newly appointed “Ebola czar,” and as others remain quarantined, the actual number of confirmed cases in the U.S. can still be counted on one hand: three. And they’ve all centered on the case of Thomas Eric Duncan, who died Oct. 8 in a Dallas hospital after traveling to Liberia; two nurses who treated him are the only other CDC-confirmed cases in the U.S.

The almost-zero probability of acquiring something like Ebola, given the virus’s very real and terrifying symptoms, often doesn’t register at a time of mass paranoia. Rationality disappears; irrational inclinations take over. It’s human nature, and we’ve been acting this way basically since we found out there were mysterious things out there that could kill us.

“There are documented cases of people misunderstanding and fearing infectious diseases going back through history,” says Andrew Noymer, an associate professor of public health at the University of California at Irvine. “Stigmatization is an old game.”

While there was widespread stigma surrounding diseases like the Black Death in Europe in the 1300s (which killed tens of millions) and more recently tuberculosis in the U.S. (patients’ family members often couldn’t get life-insurance policies, for example), our current overreaction seems more akin to collective responses in the last half of the 20th century to two other diseases: polio and HIV/AIDS.

Concern over polio in the 1950s led to widespread bans on children swimming in lakes and pools after it was discovered that they could catch the virus in the water. Thirty years later, the scare over HIV and AIDS led to many refusing to even get near those believed to have the disease. (Think of the hostile reaction from fellow players over Magic Johnson deciding to play in the 1992 NBA All-Star Game.)

Like the first cases of polio and HIV/AIDS, Ebola is something novel in the U.S. It is uncommon, unknown, its foreign origins alone often leading to fearful reactions. The fatality rate for those who do contract it is incredibly high, and the often gruesome symptoms — including bleeding from the eyes and possible bleeding from the ears, nose and rectum — provoke incredibly strong and often instinctual responses in attempts to avoid it or contain it.

“It hits all the risk-perception hot buttons,” says University of Oregon psychology professor Paul Slovic.

Humans essentially respond to risk in two ways: either through gut feeling or longer gestating, more reflective decisionmaking based on information and analysis. Before the era of Big Data, or data at all, we had to use our gut. Does that look like it’s going to kill us? Then stay away. Is that person ill? Well, probably best to avoid them.

“We didn’t have science and analysis to guide us,” Slovic says. “We just went with our gut feelings, and we survived.”

But even though we know today that things like the flu will likely kill tens of thousands of people this year, or that heart disease is the leading cause of death in the U.S. every year, we’re more likely to spend time worrying about the infinitesimal chances that we’re going to contract a disease that has only affected a handful of people, thanks in part to its frightening outcomes.

“When the consequences are perceived as dreadful, probability goes out the window,” Slovic says. “Our feelings aren’t moderated by the fact that it’s unlikely.”

Slovic compares it to the threat from terrorism, something that is also unlikely to kill us yet its consequences lead to massive amounts of government resources and calls for continued vigilance from the American people.

“Statistics are human beings with the tears dried off,” he says. “We often tend to react much less to the big picture.”

And that overreaction is often counterproductive. Gene Beresin, a Harvard Medical School psychiatry professor, says that fear is causing unnecessary reactions, oftentimes by parents and school officials, and a social rejection of those who in no way could have caught Ebola.

“It’s totally ridiculous to close these schools,” Beresin says. “It’s very difficult to catch. People need to step back, calm down and look at the actual facts, because we do have the capacity to use our rationality to prevent hysterical reactions.”

Read next: Nigeria Is Ebola-Free: Here’s What They Did Right

TIME ebola

Hospital Staffer Who May Have Had Ebola Contact Left U.S. on Cruise Ship

The Texas hospital employee has shown no indications of becoming sick

Updated Friday, Oct. 17

An employee of Texas Health Presbyterian Hospital in Dallas who may have come in contact with specimens taken from an Ebola patient left the United States aboard a cruise ship, the State Department said Friday. The revelation raises further questions about travel policies regarding health workers involved in treating Ebola patients after it came to light that a nurse later diagnosed with the virus was allowed to fly earlier this week despite self-reporting an elevated temperature.

The employee on the cruise did not have direct contact with the patient, is not contagious, and has shown no indication of having contracted the illness in the 19 days since she came into contact with the Ebola patient’s fluid samples. The individual is nonetheless being monitored by doctors aboard the ship and has remained along with a traveling partner in voluntary isolation in a ship cabin.

The hospital employee, who is a lab supervisor at the hospital where she works, according to Carnival Senior Cruise Director John Heald, left aboard a commercial cruise ship from Galveston, Texas, on October 12, before learning of new monitoring requirements from the Centers for Disease Control and Prevention.

“We are working with the cruise line to bring them back to the United States out of an abundance of caution,” the State Department said in a statement.

In a Facebook post published Friday, Heald said the cruise line learned that the guest was aboard the ship on Wednesday.

“It is important to reiterate that the individual has no symptoms and has been isolated in an extreme abundance of caution,” Heald said in his post. “We are in close contact with the CDC and at this time it has been determined that the appropriate course of action is to simply keep the guest in isolation on board.”

TIME Disease

A Major Ebola Outbreak in the U.S. or Europe Is Unlikely, Says WHO

The statement comes as the U.S. moves quickly to contain the disease after the reporting of a third case

The World Health Organization (WHO) has said a widespread outbreak of the Ebola virus, which has killed thousands in the West African countries of Guinea, Sierra Leone and Liberia, will probably not be replicated in the U.S. or Europe thanks to the advanced health care systems in the West.

Christopher Dye, the director of strategy for the WHO, told the BBC that the potential spread of Ebola in the West was a matter “for very serious concern,” but added that an epidemic was improbable.

“We’re confident that in North America and Western Europe, where health systems are very strong, that we’re unlikely to see a major outbreak in any of those places,” Dye said.

The U.S., meanwhile, is dealing with its third Ebola case as Amber Vinson, a nurse who treated the country’s first patient who died earlier this month, was diagnosed with the disease.

It was revealed on Wednesday that Vinson was cleared to get on a plane by a Centers for Disease Control and Prevention official just a few days prior, despite having a mild temperature. Officials are attempting to track down and monitor her 131 fellow passengers.

U.S. President Barack Obama, who canceled two consecutive campaign events in order to take firmer action on Ebola, echoed the WHO view in a statement. “The dangers of a serious outbreak are extraordinarily low,” he said, “but we are taking this very seriously at the highest levels of government.”

[BBC]

TIME ebola

Facebook’s Mark Zuckerberg Donates $25 Million to Fight Ebola

Facebook founder Mark Zuckenberg speaks to media after the meeting with Indonesian President-elect Joko Widodo in Jakarta, Indonesia on October 13, 2014.
Facebook founder Mark Zuckenberg speaks to media after the meeting with Indonesian President-elect Joko Widodo in Jakarta, Indonesia on October 13, 2014. Anadolu Agency—Getty Images

Social network’s CEO and founder makes donation to the Center of Disease Control Foundation

Facebook CEO and founder Mark Zuckerberg has announced he will donate $25 million to the Center of Disease Control Foundation, funds meant to help the agency fight Ebola.

“The Ebola epidemic is at a critical turning point,” Zuckerberg said in a post on Facebook. “We need to get Ebola under control in the near term so that it doesn’t spread further and become a long term global health crisis that we end up fighting for decades at large scale, like HIV or polio.”

Zuckerberg, who is donating the funds along with his wife Priscilla, said he believed such grants could “directly help the frontline responders” that are responsible for setting up care centers, training local staff and identifying Ebola cases.

The 2014 Ebola epidemic is already the largest in history, according to the CDC, affecting multiple countries in West Africa. While the CDC says the risk of an Ebola outbreak in the U.S. is very low, fears have escalated, especially after a travel-associated case was diagnosed at the end of September and shortly afterward, a healthcare worker at a Texas hospital who provided care for that patient also tested positive. The patient, Thomas Eric Duncan, died last week.

Zuckerberg isn’t the first deep-pocketed tech titan to donate to the cause. Last month, Bill Gates’s foundation pledged $50 billion to fight the viral outbreak in West Africa. The earliest grants from the Gates Foundation were made to the World Health Organization for emergency operations and research and development and to the U.S. Fund for UNICEF to support Liberia, Sierra Leone and Guinea to buy essential medical supplies and coordinate response activities.

This article originally appeared on Fortune.com

TIME ebola

Dallas Ebola Patient’s Son: “Keep Praying”

Karsiah Duncan, Mike Rawlings, Saymendy Lloyd
Karsiah Duncan, center, son of Ebola patient Thomas Eric Duncan speaks during a news conference while Dallas Mayor Mike Rawlings, left rear, and Saymendy Lloyd look on, Tuesday, Oct. 7, 2014, in Dallas. Tim Sharp—AP

Thomas Eric Duncan’s son sent a message to his mom in quarantine: be strong

The son of the Liberian man fighting for his life in a Dallas hospital after contracting Ebola asked the community to keep praying for his family in a statement to the media Tuesday night.

“I just came out here because I feel like God was calling me to see my dad even though I got school still going on,” said Karsiah Eric Duncan, who is in college in West Texas and hasn’t seen his father, Thomas Eric Duncan, since he was three.

Karsiah has visited Texas Health Presbyterian Hospital, where his father is in critical condition and being treated with an experimental Ebola drug, but did not get to see him.

Duncan is the first person diagnosed with Ebola outside of Africa, though a nurse in Spain has since come down with the disease after treating two Ebola-stricken missionaries who had returned from Sierra Leone.

Karsiah thanked members of the community for their support, the hospital treating his father, and President Obama for deploying troops to join the fight against Ebola in West Africa. He also had a message for his mother, Louise Troh, who has been living under quarantine for a week so far to ensure that she has not contracted the disease.

“Be strong,” he said. “Even though it’s hard being in a house for 21 days and not knowing what’s going to happen after she gets out.”

Ebola can take up to 21 days to manifest symptoms.

The young man also had a request for the community at large. “Keep praying that my family is going to be okay and my dad makes it out safely,” he said. “I hope they find a cure for it.”

TIME ebola

This Texas Judge Is Fighting Fear and Ebola in Dallas

First Ebalo case diagnosed in the United States
Dallas County Judge Clay Jenkins speaks to the media during a press conference on the status of Ebola patient Thomas Eric Duncan in Dallas, on Oct. 2, 2014. Larry W. Smith—EPA

Dallas County Judge Clay Jenkins tells TIME about the challenges of an Ebola emergency in America

Dallas County Judge Clay Jenkins is the first local elected official in the world to oversee the emergency response to a case of Ebola diagnosed outside of Africa. From the moment he took charge of coordinating the Dallas response, after a man visiting from Liberia tested positive for the disease, he’s found himself with responsibilities he never anticipated. He made a point of visiting the home of the infected man without protective clothing, took the responsibility for driving his quarantined family to their new home, and has been doing what he can to coordinate the state and federal response, while keeping his voters calm.

None of that means he had to miss this week’s Cowboys game. During a moment of relative calm away from the Emergency Command Center that hums with activity from 7 in the morning to around 10 at night, TIME caught up with Jenkins in his downtown office Sunday at the old Texas School Book Depository, across the street from Dealey Plaza and the grassy knoll. He was wearing a black shirt with “Homeland Security” emblazoned on it, meeting with staff and catching the end of the NFL game between the Dallas Cowboys and the Houston Texans. They were tied 17-17. I sat with my back to the TV so Jenkins could watch the game as we spoke about the moment on Tuesday September 30 that he heard Ebola might be in Dallas.

“We’ve got a hospital with 10,000 employees, I’ve got a county with 6,000 employees and I’m the highest elected official in that county, so things are happening all the time and that’s one data point that was happening,” he said. “I wasn’t envisioning that an instant command structure would be requested by our federal and state partners and that I’d be all that involved in that, at that point.”

Judges in Texas are the highest administrative officials in each county, with extraordinary powers that are a vestige of the Old West when a rural judge could make a claim as broad as “I am the law” without being too far off the mark. In Dallas today, the County Judge has two main responsibilities: get truant children back into school and, in the event of a disaster, lead the county’s response as the Director of Homeland Security and Emergency Preparedness.

A Democrat first elected to office in 2010, Jenkins cut his teeth in emergency response with an outbreak of West Nile virus in in 2012. Earlier this year he stirred up controversy by offering Dallas County facilities to house undocumented immigrant children flooding across the U.S.-Mexico border. He’s up for re-election in just a few weeks.

By Wednesday afternoon, after Ebola test results came back positive and following a series of meetings between officials from Texas, the Centers for Disease Control and Prevention and the White House, Jenkins was firmly in charge. That night he and others began sorting through the immediate challenges ahead: getting the infected man Thomas Eric Duncan’s potentially-toxic belongings out of the North Dallas apartment where he’d been staying, identifying and monitoring every person with whom Duncan may have come in contact, and, Jenkins said, finding a better living situation for Duncan’s partner Louise Troh and the three young men who had been placed under quarantine with her in the apartment. Law enforcement officers stood outside the door blocking the family’s exit from a home where they were forced to stay with linens stained with the sweat of a man infected with one of the most deadly diseases known to man.

“One of the first things we wanted to do is move the family,” Jenkins said. “The problem is that when you’ve got Ebola, it’s very difficult to find somebody that wants to open up a shelter or a home or rent to you even if you want to pay for it.” Jenkins said his office called the Greater Dallas Apartment Association, the Dallas Housing Authority and “basically called through every listed renter in Dallas.” All turned them down.

As much as with Ebola itself, Jenkins has been doing battle a contagion that can under the wrong circumstances turn just as deadly: fear. If people with the sniffles convinced they have Ebola start overfilling the Dallas-area’s already stressed emergency rooms—Texas has the highest rate of uninsured citizens in the country—perfectly treatable infirmities could become more lethal. If scared parents keep their kids out of school too long, it creates a whole separate problem in the education system—one, as it happens, that Jenkins would also be responsible for fixing.

That is why Jenkins obsessively reminds anyone who will listen of Ebola’s achilles heel: it isn’t contagious unless a person is showing symptoms of the disease. It’s the key both to stopping pandemic fear from disrupting day to day life and to defeating Ebola itself. Isolate and monitor the health of everyone who might be infected for a 21 day incubation period and, if they are symptom free, they’re healthy and you’ve beaten the disease.

To get this point across, Jenkins has employed some unorthodox tactics over the past week, like walking into an apartment where an Ebola patient had been staying without protective gear. Clearing the apartment of both contaminated linens and the symptom-free people in it was delayed by permitting issues and “that’s when I went out to see Louise and the young men,” Jenkins said, “to go into their apartment and see them as human beings and explain to them the situation.” But by entering the apartment Jenkins was also, at least as importantly, sending the message to the wider world that hazmat suits milling around or not these people, lacking any symptoms, were incapable, even if infected, of passing along Ebola.

Unsuccessful in finding anywhere else for Louise and the young men to stay, Jenkins said he called a local faith leader. “What I told them is there is literally no more room at the inn and I need your help,” he said.

The same impetus that led him to enter the apartment helps explain Jenkins’ decision to drive the family himself to their new home. Philip Haigh, a member of Jenkins’ executive staff, was initially set to drive the Ford Explorer while Jenkins rode along and spoke with the family but when they couldn’t all fit because a seat couldn’t be raised out of the down position Jenkins took the wheel and Haigh rode behind in a police cruiser.

“The sheriff’s deputy that I ended up riding with initially didn’t shake my hand because he was afraid that I had gotten too close to the scene,” Haigh told TIME. By driving the car himself, Jenkins sent the same message as before to first responders: until a person show’s symptoms, Ebola isn’t contagious and fear itself is the greater enemy.

Jenkins drove Troh and the three men to their new temporary home, where, according two people who have spoken with her on the phone, Troh is comfortable and understandably glad to be away from the apartment in which she was imprisoned the better part of a week. “They can go outside, they have room to roam,” Jenkins said. “It’s the kind of place that a young man can go out and exercise and even explore. Walk around. It’s a large premises away from other people.”

After dropping off the family Jenkins spoke to the press. “I’m wearing the same shirt I was when I was in the car for 45 minutes today with that family,” he said. “If there was any risk, I wouldn’t expose myself or my family.”

For now, pandemic fear has not gripped the better part of the Dallas area. Life goes on as before, except among the Liberian community here, where rumors fly about stigmatization at work and school and people typically prone to warm embraces keep their distance even from each other. With Louise Troh and the boys in a safe place and everyone who Duncan may have interacted with identified, Jenkins’ office must now wait and hope: that Thomas Eric Duncan survives and that no one else gets sick.

In the meantime, there was some good news. The Cowboys won Sunday with a field goal in overtime.

TIME Genetics

New Study Makes Great Strides in Understanding Human Height

Nearly 700 gene variants linked to height have been identified

What makes tall people tall and short people short is becoming less of a mystery to scientists. An international team of researchers has identified nearly 700 gene variants in more than 400 gene regions that are connected to height — an estimated 20 percent of all the gene variants that play a role in determining one’s size.

The findings of the study were published in the journal Nature Genetics, Reuters reports. It is believed to be the biggest study of its kind to date.

Scientists believe that about 80 percent of a person’s height is hereditarily determined, with environmental factors such as nutrition determining the rest. The average height of humans around the world has risen throughout the last few generations as world nutrition generally improves.

Researchers studied the genomes of 253,288 people from Europe, North America and Australia, all with European ancestry and found 424 gene regions with 697 gene variants that are linked to height. Many of the genes identified were not previously known to have an effect on skeletal growth.

“For over 100 years, [height has] been a great model for studying the genetics of diseases like obesity, diabetes, asthma that are also caused by the combined influence of many genes acting together,” Dr. Joel Hirschhorn, a pediatric endocrinologist and geneticist at Boston Children’s Hospital and the Broad Institute. “So by understanding how the genetics of height works, we can understand how the genetics of human disease works.”

[Reuters]

TIME ebola

Liberians in Dallas Convey Hope Back Home

Liberia Races To Expand Ebola Treatment Facilities, As U.S. Troops Arrive
A Liberian Ministry of Health worker, dressed in an anti-contamination suit, speaks to a child in a holding center for suspected Ebola patients at Redemption Hospital on Oct. 3, 2014 in Monrovia, Liberia. John Moore—Getty Images

The disease and its aftershocks have been ravaging their homelands for months; now the U.S. is joining the fight

The first diagnosed case of Ebola in the U.S., discovered nearly a week ago at a hospital in north Dallas, seized the country, as public health officials rushed to contain both the virus and the fear it inevitably caused. But Ebola has been tearing through the lives of West Africans in Dallas for months, killing loved ones back in Africa and putting a strain on bank accounts here in Texas.

Now that the virus has reached America’s shores there’s a grim sort of hope that help may finally be on the way.

“People are not happy that the disease has made it to America,” Alben Tarty, spokesperson for the Liberian Community Association of Dallas-Fort Worth, told TIME Saturday. “But with the attention it has garnered they think, ‘Ok, this is a bad thing, but maybe America can now appreciate what we’re going through.”

Jenny Dakinah lost her half brother and almost his entire household to Ebola (his wife, niece, mother-in-law and teenage son all died; miraculously, her now 10-month-old nephew survived). She’s mailing canned food to her family still in Liberia.

“You don’t know who you come in contact with when you buy food,” she said. Sending food and money to help her family survive the sputtering economy is straining her resources. “It’s getting harder and harder.”

Liberia is one of the most remittance-dependent countries on earth. Money sent to relatives from Liberians living in the U.S. accounted for 20% of the West African country’s economy in 2012 (the second highest percentage in Africa, after Lesotho), according to a 2014 World Bank report. As Ebola takes lives—both directly and by overwhelming the healthcare infrastructure so that even less lethal diseases become more deadly—it is also gutting economies where it strikes.

In Liberia, the hardest-hit country in this outbreak, the economy is buckling as society and its markets hunker down. Schools and offices close as a precaution. People interact less, leave the house less, and thus buy less. Without revenue many businesses that do stay open eventually shut down and lay off workers. The Liberian economy has been clawing its way back to health since the end of the country’s civil war in 2003 but the World Bank projects that if the virus isn’t substantially contained by next year its growth rate will plummet—to negative 4.9%.

“The financial implications of this are huge. Tremendous,” said James Kollie, the pastor of Better Life Church, a largely Liberian congregation in the Dallas area. “Millions of dollars have been lost in this outbreak. As I’m talking to you, more. Billions of dollars could be lost.” Kollie has family and a business back in Liberia. “Right now everything has been affected. I’m not making an income right now. Everything has come to a standstill.”

Albert Travell has lost seven nieces and nephews to Ebola. With the country now on lockdown he sends what he can to help his brother and sister get by. “I helped them with money just yesterday for them to buy food because they’re not working.” He sends $100 at a time. Sometimes $125. “The little money I had, I had to send to them”

Amid this dire situation, news that up to 4,000 U.S. troops will head to West Africa to help fight back against the disease has been a welcome ray of hope.

“We were just Africa, just hurting every once in awhile, but now that it’s affecting America, every hour it’s on the news,” Tarty said. “America is the most powerful country in the world with robust healthcare systems and is now paying attention to the virus and will do something about it. That’s the feeling people have right now.”

TIME Disease

What It Will Take to End Polio

President Franklin D. Roosevelt leaves his home at 49 East 65th Street for a short visit to his family estate at Hyde Park, north of New York City on Sept. 27, 1933.
President Franklin D. Roosevelt leaves his home at 49 East 65th Street for a short visit to his family estate at Hyde Park, north of New York City on Sept. 27, 1933. Martin Mcevilly—NY Daily News/Getty Images

Jeffrey Kluger is Editor at Large for TIME.

Franklin Roosevelt never knew the Pakistani babies battling polio today, but he knew their pain. The world is fighting to end that suffering forever

You can still see the ramps and rails at Franklin Roosevelt’s house on East 65th Street in Manhattan—even though they’ve been gone for decades. They’re easily visible in the pictures that decorate the home. They’re visible, too, in the popular iconography of Roosevelt, who was photographed standing countless times after being paralyzed by polio in 1921, but always with a hand on a bannister, an arm on an aide, a cane in his grip—and ramps and rails at the ready.

The six-story Roosevelt house, where the family lived from 1908 until their move to the White House in 1933, is now owned—and was restored—by New York’s Hunter College. These days it’s a place of learning and policy conferences. But it is also a place of historical serendipity.

“When the house was built, it was one of the first private residences in New York that had its own elevators,” Hunter president Jennifer Raab told me as we toured the building this morning. Those became indispensable once FDR became paralyzed, and it was in that house that his kitchen cabinet thus gathered in the four months between his election in 1932 and his inauguration 1933. “The New Deal was born here,” Raab says.

For FDR, there were abundant compensations for polio. As Ken Burns’ documentary The Roosevelts makes clear, the disease deepened and grounded him. It made him a champion of children with polio—an effort that led to the March of Dimes and the later Salk and Sabin vaccines—and for that matter a champion of all people who suffered hardship. It was polio that gave Roosevelt a fuller temperament—and in turn gave the nation a fuller Roosevelt.

There are no such compensations for the handful of children around the world who still contract the crippling disease. On the same morning I was making my visit to the Roosevelt house, word came out of Pakistan that the country is on target to top 200 polio cases in 2014, its biggest caseload since 2000. Pakistan is one of only three countries in the world where polio remains endemic—the other two are Afghanistan and Nigeria, with 10 and six cases respectively so far this year—and it’s the only one in which the caseloads are moving in the wrong direction.

As recently as 2005, Pakistan’s case count was down to just 28, helping to push polio to the brink of eradication. That same year, however, religious leaders in northern Nigeria declared a boycott of the vaccine, claiming that it contained HIV and was intended to sterilize Muslim girls. This led to a wildfire spread of the Nigerian strain that stretched as far southeast as Indonesia.

But Nigeria got its house in order, and the hot zone now—a more challenging one—has shifted to Pakistan, particularly in the tribal areas in the north and in the mega-city of Karachi. Some of the problem is simply the crowded, unhygienic conditions in Karachi. But the bigger piece is the fighting in the tribal regions, which have made vaccinations difficult or impossible. That’s been exacerbated by Taliban gunmen, who have shot and killed 59 polio field workers and police officers trying to protect them since 2012.

“It’s a very sad thing,” Aziz Memon, head of Rotary International’s PolioPlus team, told TIME by phone from Pakistan today. “We’re trying to get vaccinators on the ground and into the field despite the ban. And now rains and flooding that have broken 100-year-old records are creating more problems.”

Rotary, which has been the point-organization for the eradication of polio for more than 25 years, is being assisted by the Gates Foundation, Save the Children and multiple other international groups, all working to push back against the Taliban blockade. Vaccinators routinely wait at bus stops around Pakistan, climbing aboard and looking for kids who have no vaccination records and administering the drops on the spot. Refugee camps in the war torn tribal regions provide another way of standing between the virus and the babies.

“When the virus is contained like this it’s a good opportunity to step in and control it,” says Memon. “We can also take advantage of the low-transmission season, which starts soon.”

The effort to snuff out polio altogether is more than merely the moral thing, it’s also the practical thing. Bill Gates repeatedly stresses that $1 billion spent per year over the next few years can save $50 billion of the next 20 years, money that would otherwise be spent treating polio and constantly fighting the brushfire war of vaccinating against outbreaks. Eliminate the disease for good and those costs go with it. What’s more, the delivery networks that are put in place to do the job can be easily repurposed to fight other diseases.

None of this long-range thinking makes a lick of difference to the 187 Pakistani children—or the 10 Afghanis or six Nigerians—who forever lost the use of their legs this year. They are paralyzed, as they will be for life. For them, there is no offsetting wealth, no townhouse with an elevator, no path to global greatness. There is only the disease—a pain FDR recognized and fought to fix. In Pakistan, that same fight is being waged today.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Innovation

Five Best Ideas of the Day: October 2

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. A global competition could prime the pump for development of disease-fighting treatments.

By James Surowiecki in New Yorker

2. Cancer detecting yogurt? New technology could make diagnosing colon cancer as simple as taking a pregnancy test.

By Kevin Bullis at the MIT Technology Review

3. Youth-targeted networks are leading a surge in LGBT-friendly television programming.

By Joanna Robinson in Vanity Fair

4. California’s massive expansion of teledentistry could revolutionize delivery of oral hygiene to underserved areas.

By Daniela Hernandez in Kaiser Health News

5. The climate change movement desperately needs diversity and corporate leadership.

By Caitlin Colegrove in conversation with M. Sanjayan in the Aspen Idea

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

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