TIME Africa

Ebola Nations Request Debt Cancellation and Billions in Aid

People stand in line for food to be distributed to them as a health worker makes an announcement in Freetown, Sierra Leone on March 27, 2015.
Michael Duff—AP People stand in line for food to be distributed to them as a health worker makes an announcement in Freetown, Sierra Leone on March 27, 2015.

The countries in West Africa affected most by the Ebola outbreak are asking donors to cancel their debts and give them $5 billion to $6 billion in aid over two years.

“Our social services are ruined, our economies have halted, and we need a real Marshall Plan to take us out of the woods,” Ernest Bai Koroma, the president of Sierra Leone, told Reuters Thursday.

Sierra Leone, Guinea and Liberia are working on a regional reconstruction program, but they will need about $4 billion in debt relief on top of the billions they are requesting to rebuild their countries. The countries’ will unveil their program at a meeting on Friday with the heads of the World Bank, the United Nations and the International Monetary Fund.

“If that (debt) is canceled and support is provided to our regional program, it will take us a long way forward in our transformation agenda,” Koroma said.

There were only 37 cases of Ebola reported in the region last week. But as leaders in West Africa and the World Health Organization have made clear, much more money and time is needed to fully eradicate the disease and help get the countries ruined by its spread.

TIME ebola

Ebola Fighters Say Now Is Not the Time to Let Up

Barack Obama, Ellen Johnson Sirleaf, Alpha Condé
Manuel Balce Ceneta—AP President Barack Obama, flanked by Liberian President Ellen Johnson Sirleaf, left, and Guinean President Alpha Condé, speaks in the Cabinet Room of the White House in Washington, Wednesday, April 15, 2015, to discuss the progress made in the international Ebola response.

Cases may be nearing zero in certain areas, but the threat of the disease lingers

There were only 37 confirmed cases of Ebola last week, just a year after the deadly virus was spreading quickly across Western Africa. But key stakeholders in the effort to reduce the number of cases to zero said Thursday that success is not guaranteed.

“We are dealing now with the most difficult areas,” said Bruce Aylward, the assistant director-general of polio and emergencies at the World Health Organization. “We’re dealing with issues of fear, of trust with communities that have been marginalized. That have not been fully engaged.”

Alyward added, “These are issues that take time to resolve.” What’s more, the most affected areas are nearing their annual rainy season in April and May, which could exacerbate the disease’s spread. And, Alyward says, the eradication effort is running out of money.

“The only thing that’s falling faster than this graphic right here,” he said, holding up a chart that showed new confirmed cases, “is the one that shows you new financial contributions.”

The message on Thursday was clear: in the fight against Ebola, there’s no room for complacency. That’s not to say there hasn’t been progress. There has been a decline in new cases over the past several weeks and Liberia is inching closer to zero cases. In Sierra Leone, there were nine cases this past week and the week before. In Guinea, the situation is more mixed—there were 28 cases this week, up from 21 the week before. In an effort to keep numbers low, the government instituted a four-day stay-at-home policy in the most infected area so that teams can go to homes and share information.

Alyward, who joined WHO Director General Margaret Chan and others for a roundtable briefing at the United Nations Foundation on Thursday, said it’s important to keep up the fight, because if a single case or contact is missed, the community will suffer the consequences.

That message was similar to one that President Obama reiterated before meeting with leaders from Sierra Leone, Liberia and Guinea at the White House on Wednesday. “We can’t be complacent. This virus is unpredictable,” Obama said. “We have to be vigilant, and the international community has to remain fully engaged in a partnership with these three countries until there are no cases of Ebola in these countries.”

Presidents from the three countries will also appear Friday with World Bank Group President Jim Yong Kim to discuss the continued effort to get to zero. The meetings and appearances on the Ebola effort come in the wake of a scathing New York Times report that said the U.S.’s response to the crisis was too much, too late. Few of the treatment centers the U.S. military spent resources and manpower to complete have been put to use, the report found.

David Nabarro, who has organized the UN’s response to Ebola, said Thursday the American response should be commended. “This immediate and rapid response by the U.S. to use military to build treatment centers was amazing,” he said. “Instead of feeling abandoned by the world, they felt there was a group who believed they were worth supporting.”

TIME Innovation

Five Best Ideas of the Day: April 16

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

1. Go ahead and start a new career in your fifties. It’s easier than you think.

By Donna Rosato in Money

2. This is what sex-ed would look like if it took place entirely on social media.

By Kate Hakala in Mic

3. Here’s why the FDA doesn’t really know what’s in our food.

By Erin Quinn and Chris Young at the Center for Public Integrity

4. What critical resource helps the sharing economy make billions? People trusting people.

By the editorial board of the Christian Science Monitor

5. Could a continent-wide CDC for Africa stop the next Ebola outbreak?

By Jim Burress at National Public Radio

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.

TIME Infectious Disease

African CDC to Open in 2015

The goal for the agency is to support the continent with active disease surveillance and response

Secretary of State John Kerry signed an agreement Monday to help establish a Centers for Disease Control and Prevention (CDC) in Africa.

The memorandum of cooperation, signed by Kerry and African Union Commission (AUC) Chairperson Nkosanzana Dlamini Zuma, makes formal the relationship between the United States CDC and AUC, and mandates the establishment of an African CDC. The new institute, set to launch in 2015, will work to prevent and respond to future outbreaks in the continent, like the Ebola epidemic.

“The West African Ebola epidemic reaffirmed the need for a public health institute to support African ministries of health and other health agencies in their efforts to prevent, detect, and respond to any disease outbreak,” said CDC director Dr. Tom Frieden, in a statement. “This memorandum solidifies the commitment by the United States to advance public health across Africa and global health security.”

The formation of an African CDC has been under development for a few years, and the physical launch of the health institute will happen later this year. An African Surveillance and Response Unit will be established with an emergency operations center. Five regional centers will also be identified with a coordinating center in Ethiopia’s capital, Addis Ababa. Like the U.S. CDC, there will be epidemiologists at the various locations who will perform disease surveillance, investigation and tracking of infection trends. The new unit will also provide response expertise during large outbreaks.

“With the African CDC in place, these volunteers and others can be organized to form a deployable force ready to serve Member States during future health emergency responses on the continent,” said a CDC statement.

TIME ebola

American Treated for Ebola Released From NIH Hospital

Patient was volunteering for an aid group in Sierra Leone

The American patient being treated for Ebola at the National Institutes of Health (NIH) was declared Ebola-free and released on Thursday.

The patient, whose identity has not been released, was volunteering for the aid group Partners in Health (PIH) in Sierra Leone, one of the three countries hit hardest during the Ebola outbreak in West Africa. The patient had arrived for treatment at the NIH treatment unit in Bethesda, Md., on March 13.

PIH says the patient, who had two Ebola tests come back negative before NIH declared them Ebola-free, was one of several of the aid group’s volunteers who were brought back to the United States for monitoring. None of the other volunteers were infected.

The group says two of its volunteers who returned to the U.S. for precautionary monitoring are heading back to Sierra Leone to continue their work. “We’re cheering here in rural Liberia and in Sierra Leone, and are sure our co-workers in Boston and Haiti and Rwanda and Peru and elsewhere are too,” Dr. Paul Farmer, co-founder and chief strategist for PIH, said in a statement.

The PIH volunteer is the second person with Ebola to be successfully treated for Ebola at the NIH. The facility’s team also treated Dallas nurse Nina Pham, who contracted Ebola last fall after treating Thomas Eric Duncan, the first person to be diagnosed with Ebola in the U.S.

To date, there have been 25,178 cases of Ebola in Sierra Leone, Guinea, and Liberia and 10,445 have died from the disease.

TIME ebola

A New Ebola Vaccine Shows Promise

With nearly a dozen Ebola vaccines now in various stages of development, researchers of one report promising results against the recent strain

A vaccine designed from a crippled virus with Ebola genes stitched in—the first tested against the strain that caused the outbreak in West Africa that has killed 10,000 and infected thousands more—protected every monkey tested from being infected with Ebola.

Reporting in the journal Nature, Thomas Geisbert, a virologist from the University of Texas Medical Branch, and his colleagues describe a vaccine made from a virus that commonly infects cows—called vesicular stomatitis virus (VSV)—that’s had some of its genetic material replaced with genes for surface proteins from the Ebola virus. None of the eight monkeys inoculated with the shot showed any signs of severe Ebola infection after being exposed to the virus 28 days later, while both of the control animals died of the disease seven and eight days after infection.

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

The vaccine is the second generation of one that Geisbert and Heinz Feldmann, from the National Institute of Allergy and Infectious Diseases, co-developed in the 2000s. But because the vaccine relies on a live, albeit hampered virus, it raised concerns about safety that killed-virus vaccines, like polio and hepatitis A, don’t have. Neither the VSV nor Ebola virus are capable of replicating, since the VSV has part of its genome cut out and replaced with Ebola material, and the Ebola virus only has its outer surface genes and none of its dividing machinery. But a growing virus, even a slowly growing one, can cause problems. That’s what researchers saw in an early human trial of the first generation VSV Ebola vaccine, which was tested among 40 healthy volunteers in the Washington DC area. Some developed arthritis-like conditions, which added to existing concerns about the vaccine’s safety profile.

MORE: The Ebola Fighters

“Clearly there was a lot of room for improvement. It’s a balancing act,” says Geisbert. “What makes it such a good vaccine is that it grows. But we are trying to find the balance between efficacy and safety.”

MORE: The First Ever Large-Scale Ebola Vaccine Trial Begins in Liberia

He may have hit upon that parity with the latest version of the shot. By changing where in the VSV genome he inserted the Ebola genes, he found a vector that seems to deliver the same immune response against the Ebola virus, yet at lower cost to the person being vaccinated. The VSV loaded with Ebola grew at a five to 10 times slower rate than it did in the first vaccine, and animals inoculated with the newer vaccine showed 10 to 50-fold lower levels of both VSV and Ebola in their blood compared to animals given the first generation shot.

The slower growing VSV, says Geisbert, “in a well ordered universe is associated with less possibility of an adverse event” from the vaccine.

That won’t be known for sure until the vaccine is tested in the first healthy human volunteers, which may happen as soon as this summer.

TIME ebola

Ebola Cases Top 25,000

The outbreak has infected 25,178 people and killed 10,445

More than 25,000 people have been infected with Ebola in Sierra Leone, Liberia and Guinea, according to a new report.

As of Tuesday, the outbreak, which has persisted for more than a year, has infected 25,178 people and killed 10,445, according to new numbers released by the World Health Organization (WHO).

Overall, the region has seen a drop in the number of confirmed cases and the number of patients filling Ebola treatment centers. However, medical groups have warned against complacency and Guinea has seen a recent uptick in infections. The country also just recently launched an Ebola vaccine trial.

MORE: 14 Emotional Dispatches From Key Ebola Fighters

 

TIME ebola

American Patient With Ebola Has Condition Upgraded

The patient is now in serious, rather than critical, condition

The American patient being treated for Ebola is improving, according to the National Institutes of Health (NIH).

The NIH announced on Thursday that the patient has had her condition upgraded from critical to serious. The patient, who was working to combat Ebola in Sierra Leone, arrived at the NIH in Bethesda, Md. on March 13 for treatment.

The patient is one of 17 volunteers for Partners in Health who were brought to the United States for precautionary monitoring. The NIH has not released any further details about the patient.

The American patient is the second to be treated by the NIH for Ebola. The team also treated Dallas nurse Nina Pham who was infected after treating Thomas Eric Duncan, the first person to be diagnosed with Ebola in the United States.

The current Ebola outbreak reached one year this week. So far 24,927 people have been infected and 10,338 people have died from the disease.

TIME ebola

The Red Cross: ‘Ebola Started In Silence and Will End With Our Words’

Leaders of the Red Cross reflect on the year of Ebola

A year ago, the World Health Organization (WHO) confirmed the mysterious disease that had earlier swept through the tiny village of Meliandou, in Guinea’s southern forested region, had been identified as a “rapidly evolving outbreak” of Ebola, affecting several districts of the country and its capital, Conakry.

Suspected cases were also being investigated in border areas of neighboring Liberia and Sierra Leone.

Ebola had started to become an emergency.

Last month, our thoughts turned to another place in Guinea: the town of Forécariah at the other end of the country, in the west. Two Red Cross volunteers had been attacked there while attempting to provide “safe and dignified burials.”

Probably the single most-important factor in driving down cases over the past year has been a reduction in unsafe burial practices in which the still-contagious bodies of the deceased are handled by bereaved relatives. Unsafe practices still continue, however, in many places.

In Guinea, Red Cross personnel have faced an average of ten verbal or physical assaults a month; Liberia and Sierra Leone have also reported some form of “refusal to comply” with public-health measures.

Our words, our actions

In the Ebola hotspot of Kono, Sierra Leone, and according to local data, many communities still prefer traditional funerals to safer alternatives.

Most medical equipment we need to stop the outbreak is now in place, and yet new cases are still occurring, particularly in Guinea and Sierra Leone.

We need more than just medical hardware to get to zero cases. Now our words must pave the way to the last mile.

Words to break the stigma against healthcare workers and survivors, words to educate communities on prevention, words of solidarity from all over the world to say to affected people and communities: We won’t let you down, and together we can end Ebola.

We are trying to change behaviors and practices, and learning along the way that the transmission of knowledge is not enough.

Let’s use the power of words to repair misconceptions, promote dialogue, heal, reconcile and engage to overcome resistance, facilitate behavioural change, and ultimately get us to zero new cases.

Let’s do it fast: the rainy season will soon be upon us, and some areas could become very difficult to access. There is still work to do, and time is of the essence.

Adapting our response

We will not just treat our way out of this disease.

In Liberia, most people – local data suggests as many as 70 percent – believe all that’s required to ward off Ebola is to refrain from eating bush meat, rather than avoiding contact with the bodily fluids of patients.

In one district surveyed by the Red Cross in Sierra Leone, 90 percent believed this, although nationwide there has been a significant increase in safe burials.

It’s easy to imagine how health-workers in full protective garb, looking like creatures from a nightmare, spraying homes with foul-smelling chlorine, might appear to isolated villagers.

There has also been miscommunication. The black body bags our volunteers and staff were using in some communities were rejected by bereaved people for whom tradition dictates that bodies should be wrapped in white, signifying respect – a vitally important word in the context of funeral rites.

We may not have listened quite as carefully to local people as we should have at the beginning. The black bags were replaced with white ones.

Walking the right path

On the Ebola response overall, the road is forking. Down one path – characterized by sustained international solidarity and yet further heroism by local volunteers and health workers – lie zero cases, stronger health systems, and eventual recovery from the wounds Ebola has inflicted on human societies.

But if complacency or fatigue marks the other path, we may find ourselves dealing with a silent disaster that will threaten the gains already made as well as recovery.

We in the Red Cross Red Crescent warn that complacency is the enemy; but we believe we are not helpless in the face of Ebola. Our words and our actions will make a difference. They will pave the last mile back to trust and resilience.

Elhadj As Sy is Secretary General of the International Federation of Red Cross and Red Crescent Societies, responding to Ebola in 16 African nations; Yves Daccord is General Director of the International Committee of the Red Cross, which has long been present in the region, particular Liberia and Guinea, due to past conflicts.

TIME ebola

Ebola Vaccine Trial Starts in Guinea

A health worker prepares a vaccination on March 10, 2015 at a health center in Conakry during the first clinical trials of the VSV-EBOV vaccine against the Ebola virus.
CELLOU BINANI Cellou Binani—AFP/Getty A health worker prepares a vaccination on March 10, 2015 at a health center in Conakry during the first clinical trials of the VSV-EBOV vaccine against the Ebola virus.

10,000 people will be vaccinated

An efficacy trial for an Ebola vaccine launched in Guinea on Wednesday.

The vaccine, VSV-EBOV, was developed by the Public Health Agency of Canada and has already shown positive results in smaller safety trials. NewLink Genetics and Merck are collaborating on the vaccine, and the Guinean government and World Health Organization (WHO) are leading the trial, which is taking place in Basse-Guinée, a community where many Ebola cases spread.

MORE: 14 Emotional Dispatches From Key Ebola Fighters

The trial is using what’s called a “ring vaccination” strategy, which means that when a person is infected with Ebola, a group, or ring, of their contacts will be vaccinated. Some of the contacts will be vaccinated immediately, and some will be vaccinated three weeks later. The format was chosen so that everyone could get the vaccine, instead of giving some people a placebo. The hope is that the people who are vaccinated will create a “ring of immunity” from the virus, which could prevent its spread. Similar strategies have been used for smallpox, according to the WHO.

The trial plans to vaccinate 10,000 people in 190 rings in the next six to eight weeks, and all of those vaccinated will be followed for three months. The trial is voluntary, and researchers estimate that results may be available in July.

“We are committed to ending this epidemic,” said Dr. Sakoba Keita, the national coordinator of the Ebola fight in Guinea, in a statement. “Combined with control measures that we are putting in place with our partners, a safe and effective vaccine will allow us to close this trying chapter and start rebuilding our country.”

A total of 3,429 people have been infected with Ebola in Guinea, and 2,263 have died. The country recently experienced an uptick in cases.

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