TIME ebola

WHO Chief Unveils Reforms After Ebola Response Criticized

WHO Director-General Margaret Chan addresses the media during a special meeting on Ebola at the WHO headquarters in Geneva
World Health Organization (WHO) Director-General Margaret Chan addresses the media during a special meeting on Ebola at the WHO headquarters in Geneva on Jan. 25, 2015. Pierre Albouy—Reuters

"The Ebola outbreak revealed some inadequacies and shortcomings"

The head of the UN’s global health agency has laid out a set of reforms to better and more quickly fight disease outbreaks, in a frank acknowledgement that the organization struggled to confront the scale of the 2014 Ebola outbreak that killed more than 8,600 people.

“This was West Africa’s first experience with the virus, and it delivered some horrific shocks and surprises,” said World Health Organization (WHO) director General Margaret Chan in a speech on Sunday. “The world, including WHO, was too slow to see what was unfolding before us.”

The needed changes, she said, include country-specific emergency workforces trained with “military precision”; a strengthened team of epidemiologists for detecting disease and a network of other providers to allow responders to reach “surge capacity.”

“The Ebola outbreak revealed some inadequacies and shortcomings in this organization’s administrative, managerial, and technical infrastructures,” she said, calling for a “dedicated contingency fund to support rapid responses to outbreaks and emergencies.”

The remarks came as the WHO’s executive board prepared to meet in Geneva to discuss reform proposals that many in the international community consider to be overdue. The response to Ebola by the UN’s health agency was seen by many as slow and ineffectual.

Indeed, Sunday’s speech did not mark the first time Chan acknowledged her organization’s shortcomings. In October, she told TIME that “the scale of the response did not match the scale of the outbreak.”

TIME ebola

Two Ebola Vaccines Are Heading to Trials in Liberia

Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, speaks during a House Energy and Commerce Committee subcommittee hearing on the U.S. public health response to the Ebola outbreak in Washington, D.C., Oct. 2014.
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, speaks during a House Energy and Commerce Committee subcommittee hearing on the U.S. public health response to the Ebola outbreak in Washington, D.C., Oct. 2014. Andrew Harrer—Bloomberg/Getty Images

Two vaccines will start trials in February

The long-awaited vaccine for Ebola is heading to clinical trials in Liberia.

Two vaccines, with the National Institutes of Health’s (NIH) support, will start efficacy testing in Liberia in the beginning of February.

The NIH is launching the trial in collaboration with the Liberian Ministry of Health. The trial will test two vaccines against a placebo. People in Liberia who agree to participate in the trial will be split evenly into three groups. Two groups will test separate vaccines and the third group will be given a placebo. The trial will take place in Montserrado County, which includes the capital Monrovia, one of the country’s hardest-hit regions.

MORE: TIME Person of the Year: Ebola Fighters

The vaccines have already undergone early safety trials at various sites in the U.S., Europe, and in parts of Africa. “There were no significant safety concerns and [the vaccine] induced the type of response that was quite comparable to the animal response of the monkeys,” says Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID). Prior trials in monkeys had shown the vaccine made the animals immune to the virus.

Initially the target date for the vaccine trial in West Africa had been end of January, but some logistics still need to be worked out. Fauci told TIME that he can say with almost certainty that the trials will indeed launch in early February. “There are a couple of minor issues that we are just ironing out with regard to the protocol with the FDA,” says Fauci. “Nothing that’s a show stopper.”

One of the two vaccines being tested is a vaccine developed and tested by the NIH and pharmaceutical company GlaxoSmithKline (GSK), and the other vaccine is coming from biotech company NewLink Genetics and the pharmaceutical company Merck.

When the trial starts, the vaccines will initially be given to 600 people to collect additional data on the vaccine’s safety. If all goes well, the second part of the trial will launch with 27,000 people.

TIME ebola

The Ebola Fight Has Reached a ‘Turning Point’ in West Africa, the WHO Says

Guinea West Africa Ebola
A health care worker, right, takes the temperatures of school children for signs of the Ebola virus before they enter their school in the city of Conakry, Guinea, Monday, Jan. 19, 2015. Youssouf Bah—AP

But the World Health Organization says vigilance is imperative to prevent reinfection in seemingly eradicated areas

The fight against Ebola has reached a “turning point,” according to the World Health Organization (WHO), as the three West African countries hit hardest by the deadly virus — Liberia, Guinea and Sierra Leone — see a precipitous drop in the number of new cases.

Liberia, which reported almost 9,000 cases since the deadly outbreak began in 2013, only detected eight new cases last week, reports the BBC. On some days, no new cases materialize at all, a heartening sign in a country where doctors once saw 509 new cases weekly at their peak.

“I would have identified the turning point as the beginning of the decline, first in Liberia and then later in Sierra Leone and Guinea,” Dr. Christopher Dye, the director of Ebola strategy for the WHO director general, told the BBC. “The incidence is pretty clearly going down in all three countries now.”

In Sierra Leona, where the health crisis once saw 748 cases flooding into hospitals each week, numbers are also stabilizing. The story is similar in Guinea, where the Ebola crisis reached a crescendo at 292 cases per week late last year.

Worldwide, Ebola has killed nearly 8,700 people and infected over 20,000 in one of the largest public health emergencies in recent memory.

Still, health officials at the WHO are exercising caution and warning that Ebola can reappear if risks are not properly mitigated. “Contact tracing,” or detecting everyone who ever came into contact with an Ebola-afflicted patient, is crucial to thwart future infection. Even one case cropping up can re-infect seemingly eradicated areas.

TIME ebola

Priests Assaulted in Guinea After Being Mistaken for Ebola Workers

They had gone to a local village to spray insecticides

Three priests from a church in Guinea were physically assaulted while visiting the village of Kabac on Tuesday, as locals suspected they were health workers who would expose inhabitants to the Ebola virus.

The villagers beat up the priests, who had planned to spray insecticide around the area, the BBC reported. They also vandalized the nearby town council building, setting fire to it after burning the priests’ car.

Guinea, one of the three West African countries worst affected by the Ebola outbreak, has lost nearly 2,000 people to the disease. The nation’s schools reopened earlier this week following a five-month break, soon after the U.N. said the number of cases nationwide had fallen to its lowest weekly total since August.

[BBC]

TIME ebola

Mali Is Now Ebola-Free

Mali Ebola Spared No More
A health worker sprays disinfectants near a mosque, after the body of a man suspected of dying from the Ebola virus was washed inside before being buried in Bamako, Mali Baba Ahmed—AP

The country has gone 42 days without reporting a new case

Mali is officially Ebola-free after going 42 days without reporting a new case, according to the World Health Organization.

The country’s Health Minister Ousmane Kone made an announcement during a national broadcast on Sunday night.

During his speech, Kone heaped praise on the country’s health workers and Malian authorities for “weeks of intense work” that led to the result, according to Agence France-Presse.

Mali recorded its first Ebola case in October after a 2-year-old contracted the deadly virus. Following the incident, the country launched a massive eradication campaign.

In total, the disease only infected eight people in the country, but six of them were killed by it, according to statistics compiled by the WHO.

More than 8,400 people have succumbed to the deadly virus in West Africa.

TIME ebola

How Doctors Without Borders Is Fighting Malaria and Ebola at the Same Time

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Getty Images

Treating malaria makes Ebola care easier

Doctors Without Borders/Médecins Sans Frontières (MSF) is launching its second mass distribution of treatments for malaria in Ebola-stricken Sierra Leone, a move that may have the positive side effect of helping ease the burden of Ebola cases.

Malaria is a mosquito-borne disease common in the region and causes many of the same symptoms as Ebola. It’s common for people to come to Ebola treatment centers believing they have Ebola, when in fact they have malaria—which crowds the clinics and causes enormous stress for patients and their families. Treating malaria and preventing infection are ways MSF can ensure that they reduce the number of patients at Ebola treatment centers in addition to saving lives, since more people fall ill and die from malaria than Ebola.

“If MSF can provide added support to reduce the burden of malaria on the health care system, this will not only save many lives but also allow for a more focused and effective Ebola response,” said Jonathan Caplan, MSF coordinator for the distribution, in a statement.

This is the second time MSF has conducted a widespread delivery of malaria treatments. In December, the group distributed 1.5 million antimalarial drugs to the region.

In addition, trials and investment for Ebola vaccines and drugs continue to grow. On Friday Johnson & Johnson announced that groups working on the company’s experimental Ebola vaccine would receive $115 million from Europe’s Innovative Medicines Initiative. The hope is the new investment will speed the develop of vaccines for the disease.

The latest data show cases of Ebola have reached 21,373, with 10,186 in Sierra Leone alone.

TIME ebola

Ebola Epidemic May End by June 2015 In Liberia

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At one time in 2014, Liberia experienced the fastest growing number of Ebola cases SCOTT CAMAZINE—Getty Images/Photo Researchers RM

That’s only if current hospitalization rates continue, say researchers

Understanding the ebb and flow of the Ebola outbreak that erupted in West Africa last year—and continues to percolate in the three hardest hit countries—is critical to stopping it. That means knowing who’s getting infected, where the highest rates of transmission are occurring and which strategies work best to control its spread.

Scientists initially thought that even if almost every infected person could be hospitalized, it wouldn’t stop the rapid spread of the Ebola virus for months to come. But researchers in the U.S. are now predicting in the journal PLOS Biology that the epidemic in Liberia, which at one point had the biggest explosion in Ebola cases, could peter out by June 2015.

MORE: TIME Person of the Year: The Ebola Fighters

In coming up with their predictive models, the researchers, led by John Drake University of Georgia, took into account data from previous outbreaks of Ebola, as well as probabilities about infection rates among healthcare workers, family members of the infected and those who are exposed to the virus during burials.

In order for Liberia’s Ebola outbreak to end, new hospital beds would have to be added at the same current rate (300 were provided between July and September 2014), the study authors concluded. That would allow 85% of infected patients to be treated with the nutritional and hydration therapy that is critical to overcome the infection. If new beds aren’t continually added, then hospitalization rates could drop back down to 70%, and cases may start to outpace public health workers’ ability to contain the disease.

MORE: U.N. Official Says Ebola Can Be Beat in 2015

Burial practices need to change as well. Cultural norms include touching the bodies of the deceased, which spreads the Ebola virus in a community. Safer burial practices, in which infected patients are isolated from healthy people, are keeping transmission levels under control, the authors say.

MORE: Ebola Vaccine Is Safe and Effective, According to First Study

The key to reducing the number of Liberia’s Ebola cases by summer is ensuring that anyone who is sick is hospitalized. “These modeling exercises suggested that in the absence of rapid hospitalization of most cases, none of the proposed scenarios for increasing hospital capacity would have been likely to achieve containment,” the authors write. “Continuing on the path to elimination will require sustained watchfulness and individual willingness to be treated.”

TIME Photojournalism Links

Photojournalism Daily: Jan. 9, 2015

A compilation of the most interesting photojournalism found on the web, curated by Mikko Takkunen

Today’s daily Photojournalism Links collection highlights Alex Maclean‘s aerial photographs of Detroit. The work captures the contrasting fortunes and economic inequality between the depopulated areas (defined by vacant lots and boarded-up homes) and the wealth of some surrounding areas (mansions and manicured lawns). It can appear bleak, but there’s cause for optimism as Detroit’s worst decline appears to be slowing, evident by new green spaces and corporate investment. Maclean’s pictures offer an excellent and insightful bird’s-eye view on the struggles of Motor City and its fight to survive.

Alex S. MacLean: Detroit by Air (The New York Times)

In Memoriam: Remembering the Photographers We Lost in 2014 (TIME LightBox)

An Intern Learns to Swim in the Deep End (National Geographic PROOF) Sara Lewkowicz won a three-month internship at National Geographic when she came out on top at last year’s College Photographer of the Year competition. She talks about her experience and shares photographs she made during her internship project in Mexico.

John Moore (BBC Radio 4 World at One) The Getty photographer is interviewed about his Ebola coverage in Liberia. See TIME LightBox interview as well.

David Burnett (Photo Brigade) The legendary photographer talks about his career at length.

TIME ebola

Clinical Trial for Ebola Drug Starts in Liberia

University of Utah Researchers Work Toward Cure For Ebola Strains
A container holds a Peptide that contains a potential new drug candidates for testing against a part of Ebola that is vulnerable to drugs, at the University of Utah on Oct. 14, 2014 in Salt Lake City. George Frey—Getty Images

University of Oxford researchers are offering patients in Liberia a new drug for Ebola

Scientists have started testing an experimental drug for Ebola in a Liberian hospital.

University of Oxford researchers have launched a trial of the drug, brincidofovir, in Doctors Without Borders’ Ebola center in Monrovia. The drug has previously been used to treat patients with Ebola in the United States, like Thomas Eric Duncan, NBC cameraman Ashoka Mukpo, and Dr. Craig Spencer.

When patients at the unit are informed they have Ebola, they will be offered the opportunity to participate in the trial. Patients who volunteer will be given two weeks of brincidofovir. The researchers estimate there will be about 140 participants. “Typically it takes over 18 months to start a trial. Here we have done it in less than four months,” Trudie Lang, an Oxford University professor, said in a statement. “Everyone has pulled together to make it happen—a Herculean effort by all those involved.”

MORE: TIME Person of the Year, the Ebola Fighters

The drug, which was originally developed for other viruses, has shown promise fighting the Ebola virus in test-tubes, but it’s nearly impossible to know whether the drug has been of any use in the small number of patients who have tried it.

Brincidofovir is manufactured by the pharmaceutical company Chimerix in Durham, N.C. The trial is funded by the biomedical research foundation, the Wellcome Trust.

To date, 20,712 people have been infected with Ebola during the current outbreak and 8,220 have died.

TIME Photojournalism Links

Photojournalism Daily: Jan. 5, 2015

A compilation of the most interesting photojournalism found on the web, curated by Mikko Takkunen

Today’s daily Photojournalism Links collection highlights Daniel Berehulak‘s stunning work from Liberia, Guinea, and Sierra Leone for a comprehensive New York Times account that charts the devastating resurgence of Ebola in West Africa last year. One of the photographs captures the Guinean village where a one-year-old boy, considered to be Patient Zero of the outbreak, died just over a year ago. It’s both painterly yet haunting, as it captures the birth place of a health crisis that has led to thousands of deaths.

Daniel Berehulak: How Ebola Roared Back (The New York Times) See also the slideshow: Ebola Ravages Economies in West Africa

Ross McDonnell: Notes from Underground (TIME LightBox) Pictures show civilians in eastern Ukraine sheltering in Cold War era bunkers

Brendan Hoffman (BBC Radio 4 World at One) Hoffman about his work in Ukraine and on the MH17 crash site

Toward A New Documentary Expression (Aperture) Stephen Mayes reflects on documentary photography’s shifting terrain

PhotoBooks 2014 (Vogue Italia) The magazine asked photo editors, artists, photographers and photography experts to choose the photobooks that defined the year

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