At this time last year, Ebola had been reported in West Africa for six months, and in Liberia and Sierra Leone the number of new cases was doubling every few weeks. In Nigeria, where a man sick with the virus had landed in the capital city three months earlier and sparked an outbreak culminating in 20 cases, the epidemic was effectively over. In the country that is home to the largest and most populated city in Africa, where overcrowding, a shaky infrastructure, and a steady stream of travelers challenge disease control, public health responders had contained the virus.
“The world would look completely different today, if that had not happened,” Dr. Thomas Frieden said Friday. “This was really the brink of disaster.”
What the outbreak in Nigeria had brought the world instead, Frieden added, was an example of what can happen when a country is already primed with emergency and infectious disease responses, as Nigeria had been through efforts to eradicate polio and accelerate HIV treatment and prevention access.
The director of the U.S. Centers for Disease Control and Prevention was speaking at Africa Braintrust, part of the Congressional Black Caucus Foundation’s Annual Legislative Conference, featuring panels with African leaders, policymakers, academics, advocates and industry experts. Frieden was joined by U.S. Global AIDS Coordinator Ambassador Deborah Birx, who reviewed the impact of the President’s Emergency Plan for AIDS Relief over the last decade in Africa, and emphasized that the program’s infrastructure and health workforce capacity building efforts had been essential to antiretroviral treatment access acceleration. She is looking forward to new World Health Organziation treatment guidelines set to be released in December, she said, that will recommend immediate treatment for HIV upon diagnosis.
In the meantime, Birx pointed to the HIV pandemic’s ongoing toll, in Africa, where she said, “this week 34,000 new infections will occur, 20,000 people will die.”
Frieden also weighed the relative impact of tuberculosis, which, David Bryden of RESULTS pointed out, claims as many lives every three days, as the West Africa Ebola outbreak has so far, also with a disproportionate impact on health workers.
Tuberculosis, too, can be controlled, said Frieden, who led efforts in New York that during the 1990s reversed the trajectory of an outbreak of multidrug resistant disease there. It won’t be, however without greater progress in detecting the disease, and making correct, consistent effective treatment accessible on the necessary scale, he added.
“Nigeria’s success reminded us the horrific impact of Ebola in West Africa did not have to be,” Frieden said.
The examples he provided from the swift responses in Nigeria, which included the construction of an Ebola treatment unit in 14 days, contrast sharply with a litany of failures in the World Health Organization led response — of leadership, communication, supply chains, of infrastructure, and training — reported by the Associated Press Monday.