"It's when you get into the urban areas that it just turns crazy."
October 16, 2014 11:33 AM   Subscribe

Don Francis, epidemiologist and member of the World Health Organization team that investigated the first documented Ebola outbreak in 1976, gave a fascinating interview on KPFA's "Letters and Politics" in September. Francis shared more recollections and some of his photos from the investigation with an audience at UC Berkeley in August.
posted by ryanshepard (18 comments total) 17 users marked this as a favorite
 
Related: interview with Ebola Discoverer Peter Piot
posted by tykky at 11:40 AM on October 16, 2014 [1 favorite]


I should also have noted that Francis went on to become an important early HIV researcher - his arrival in Zaire in 1976 (w/him being portrayed by Matthew Modine) opens the film version of "And the Band Played On".
posted by ryanshepard at 12:01 PM on October 16, 2014 [2 favorites]


Glenn Close's father was also an early figure in the ebola story. She recently did an interview about him that she seemed to immediately regret (he was also involved with a cult, which is probably what she regretted talking about.)
posted by maxsparber at 12:11 PM on October 16, 2014 [1 favorite]


what I find disgusting and damning from a purely ethical sense is that from what I gather in this article, it seems like okay, we've known this was a disease with horrible outcomes for forty years now, but that no real effort to come up with a vaccine has had any momentum behind it until oops, suddenly it's become an issue in the U.S.

I mean that's just gross to think about the ethical, sociopolitical and economical reasoning behind the lack of progress to this point, and it leads me to the not-shocking theory that (among other icky things) the for-profit healthcare & pharmaceutical industries have no meaningful place in a truly progressive culture.

just, ugh. reading that makes me want to take a bath. in 200 proof IPA, preferably.
posted by lonefrontranger at 2:05 PM on October 16, 2014 [4 favorites]


By coincidence, I had just watched 'And The Band Played On' last week, so the ebola reference at the beginning of the film really caught me by surprise. It's worth watching if you're interested in this kind of thing.
posted by ovvl at 2:46 PM on October 16, 2014 [1 favorite]


okay, we've known this was a disease with horrible outcomes for forty years now, but that no real effort to come up with a vaccine has had any momentum behind it until oops, suddenly it's become an issue in the U.S.

It's not true that everyone was just ignoring the disease the whole time. There have even been infections and deaths caused by accidents in laboratories studying the virus.

Certainly this work became a lot higher priority once we had a year with more than a couple hundred cases worldwide. But earlier in this year we were flying ebola patients back to the US to work on it, before there were any other cases here.

So while it's always true that we could do better, I don't really think the global medical community has been particularly negligent in dealing with this disease.
posted by aubilenon at 3:00 PM on October 16, 2014 [6 favorites]


From tykky's link:

"SPIEGEL: Why did WHO react so late?

Piot: On the one hand, it was because their African regional office isn't staffed with the most capable people but with political appointees. And the headquarters in Geneva suffered large budget cuts that had been agreed to by member states. The department for hemorrhagic fever and the one responsible for the management of epidemic emergencies were hit hard."


it's difficult for me to read that particular admission, in light of the many global sociopolitical discussions I've seen of late, and not come away with anything but a nasty sense of "meh, brown people problems", honestly.

I work at a pharma manufacturing site. The fact that I know firsthand about the cost-benefit analysis discussions that take place regarding the profitability (or not) of drug development only contributes to my general sense of ickiness here.
posted by lonefrontranger at 3:12 PM on October 16, 2014 [4 favorites]


Why did WHO react so late?

They missed the signal from I DON'T GIVE A DARN.
posted by fairmettle at 3:23 PM on October 16, 2014


it seems like okay, we've known this was a disease with horrible outcomes for forty years now, but that no real effort to come up with a vaccine has had any momentum behind it until oops, suddenly it's become an issue in the U.S.

I'm not sure this is entirely true?

For one thing, when this outbreak started, there were already limited doses of experimental drugs available. Which implies that some research has been going on, since it's not like the current outbreak happened and some guy somewhere was like "Oh wait this seems bad, Imma start working on a cure..." The existence of doses of an experimental drug implies that people had been doing funded research on Ebola treatments long before the past few months.

Secondly, Ebola has only been known since the 70s, and from what I understand the current outbreak is the largest ever. Would it be great if medical research was so well funded that a relatively rare disease could be not only cured but have a widely available vaccine without pulling funding from more obvious world health crises like HIV and malaria? Sure. But that's not the world we live in.

Also... is it really an "issue" in the US? Three people in the US have been diagnosed so far, which is fewer people per year than the number killed by vending machines. It's only an issue because of hysteria, not actually as a public health crisis in the way that it currently is in Guinea, Liberia, and Sierra Leone.
posted by Sara C. at 5:26 PM on October 16, 2014 [1 favorite]


Suppose they did develop a vaccine, would people get it? In the U.S., thousands of people die from influenza every year but only about 40 per cent of people bother to get the shots.
posted by charlesminus at 9:22 PM on October 16, 2014


It takes YEARS of research and work to go through all the proper processes/trials to get a vaccine even close to a human trial. The Canadian Government donated to WHO 1,000 doses back in August one of the several experimental vaccines that has been developed and is in the late stages of testing. That people are suddenly aware of this particular medical research doesn't mean it hasn't been happening for years.
posted by saucysault at 2:18 AM on October 17, 2014


He talks about vaccine: when it stays out the hospitals, it burns itself out because people literally leave the areas where the virus is active. So, maybe you vaccinate the hospital workers - but again, it's not a huge population that you'd be vaccinating and what about Yellow fever or testse/Sleeping sickness? Both infect vastly larger numbers of people… Ebola is getting all the press because it's 'exciting' and 'scary' but it falls down the order of what to act on because of the relatively small numbers it kills (and thus the small economic foot-print. Bummer, but money does make these things happen.)

Cool talk: didn't think I'd listen to the whole thing.
posted by From Bklyn at 3:43 AM on October 17, 2014


The political apointees, not capable, is perfectly accurate for a corrupt nepotistic country. A smart researcher who doesn't have connections is a lab tech, while the moron who paid someone else to sit his exams but is the nephew of a minister heads the entire research department. That's about corruption, not race.
posted by viggorlijah at 4:54 AM on October 17, 2014 [2 favorites]


For what it's worth, the UN has reviewed its own response and among other self-criticisms echos Piot:

The U.N. health agency acknowledged that, at times, even its own bureaucracy was a problem. It noted that the heads of WHO country offices in Africa are "politically motivated appointments" made by the WHO regional director for Africa, Dr. Luis Sambo, who does not answer to the agency's chief in Geneva, Dr. Margaret Chan....

Dr. Peter Piot, the co-discoverer of the Ebola virus, agreed in an interview Friday that WHO acted far too slowly, largely because of its Africa office.

"It's the regional office in Africa that's the front line," he said at his office in London. "And they didn't do anything. That office is really not competent."

WHO's other regional directors — the Americas, Southeast Asia, Europe, Eastern Mediterranean and the Western Pacific — are also not accountable to Geneva and are all elected by their regions.


Seems like a system that might work 99% of the time for the plodding, bureaucratic functions like comparing national health outcomes or coordinating measles response, but fails spectacularly when you have a code red emergency.
posted by dhartung at 3:05 PM on October 17, 2014


Dr. Luis Sambo, who does not answer to the agency's chief in Geneva, Dr. Margaret Chan....

Not to be an asshole or anything, but anytime Margaret Chan is interviewed by anyone, she comes off like an incompetent assface. The WHO always sounded nice and official to me, and I had a degree of faith that they had the ability to respond to the major public health issues of the day. But with her in charge? Ugh.

But I don't know, maybe it's just her tone or she's not used to being in this much media spotlight. Maybe she's all substance and no style. Either way, I worry for the human race every time I hear her voice on NPR.
posted by Sara C. at 3:15 PM on October 17, 2014


From day one, the handling of the Ebola outbreak has been a study in the dysfunction of the aid system. The aid community has created a mentality that the country cannot act on its own. Instead Liberia’s leaders have chosen to wait for the slow moving bureaucracies that have occupied it for a decade to wake from the inertia of the well-fed aid system. They have convened press conference and made pledges, but there is no plan in place for a comprehensive response.

Efforts thus far have been so externally driven that even the identification of the virus itself took place in France. MSF staff who first picked up on the outbreak early this year had to fly blood samples to a lab in Lyons because there is not a single institute for tropical health and medicine on the African continent. This bears repeating: despite the existence of tropical medicine institutes on the continent, the blood samples were sent to Lyons for checking.

The Liberian Ebola situation can be summed up thusly: a virus that is deadly but can be effectively contained with good planning and logistics has managed to escape from a country that has one of the largest concentrations of ‘helpers’ in the world.

It is no wonder then that those requiring the help – the ordinary people of Liberia – have largely refused to take the advice that is being given to them. The questions about whether or not Ebola is real began to emerge in April when the media picked up on the story of a group of Monrovians who had attacked a clinic. The looters had insisted “there is no Ebola here.” So little did they trust their own government that they thought that Ebola was invented by Ellen Johnson Sirleaf and others as a ploy to get more development aid. They were saying, in no uncertain terms, that the hand that feeds them is also the hand that pinches them.

There can be no more damning an indictment on the aid industry than the fact that these deeply held suspicions exist.

posted by infini at 4:10 AM on October 24, 2014 [1 favorite]


there is not a single institute for tropical health and medicine on the African continent. This bears repeating: despite the existence of tropical medicine institutes on the continent

Am I misreading this or does this sentence completely contradict itself?
posted by saucysault at 8:07 PM on October 24, 2014 [2 favorites]




« Older Some people are so poor   |   Women in Clothes Newer »


This thread has been archived and is closed to new comments