Global Health – PBS NewsHour

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JUDY WOODRUFF: Turning a corner, after decades of health warnings, cigarette sales have fallen sharply in the United States and Europe, but multinational tobacco corporations are targeting huge new markets in the developing world, including countries in Asia. In a report produced with Global Health Frontiers, Hari Sreenivasan explains that in the Philippines, anti-smoking activists are now pushing back.

ACTIVISTS: We want the pictures now! Pictures save lives!

HARI SREENIVASAN: On the streets in Manila, demonstrators march against tobacco.

ACTIVIST: We want to make our voices heard.

HARI SREENIVASAN: Their cause is supported by the medical profession here.

DR. TONY LEACHON, Philippine College of Physicians: Smoking’s the number one killer in the Philippines.

HARI SREENIVASAN: Dr. Tony Leachon is the president of the Philippine College of Physicians.

DR. TONY LEACHON: For the young Filipinos, smoking is considered a macho image for men.

SMOKER: I know it’s bad — it’s bad for our health, but this is to relax myself out from work.

RACHEL ROSARIO, Philippine Cancer Society: Culturally, smoking seems to be an accepted mode of socialization, an accepted mode of relaxation.

HARI SREENIVASAN: Rachel Rosario is with the Philippine Cancer Society.

RACHEL ROSARIO: There is that vision of holding a cigarette and smoking with makeup — it seems to be something that we have to fight against.

SMOKER: It’s really hard to kick the habit. I try to lessen it down, cut it, but then you always have that urge.

HARI SREENIVASAN: The fight against smoking here won a major victory four years ago when the Philippine Congress passed what is called the “Sin Tax Law”, imposing a tax that effectively doubled the price of cigarettes.

MAN (through translator): It’s expensive. It’s five pesos a stick.

SMOKER (through translator): The effect on me is I’m smoking less. It’s more expensive.

SMOKER: I used to be a pack a day, now I’m like half.

HARI SREENIVASAN: Dr. Maria Encarnita Limpin leads the framework convention on Tobacco Control Alliance Philippines.

DR. ENCARNITA BLANCO-LIMPIN, Framework Convention on Tobacco Control Alliance: From 1990 to 2008, the rate of smoking in the country has never really gone below 30 percent. The latest survey that we did in the country showed dramatic drop in the prevalence rate of smoking. This time, it is going down from above 31 percent to 25 percent. That’s a big deduction.

HARI SREENIVASAN: Private held leaders say a major reason why the sin tax law was passed was the grassroots campaign organized by cancer survivor Emer Roxas.

EMER ROJAS, Cancer Survivor: I started smoke can at the age of 17. And at the age of 44, I got stage 4 throat cancer, and that was 12 years ago. They removed my vocal cords so that the cancer would go away.

HARI SREENIVASAN: Before cancer, Rojas was a successful engineer, businessman and radio broadcaster.

ERIKA ROJAS, Emer’s Daughter: I still remember that voice when he was singing. Before, he used to sing a lot whenever there was a birthday party.

EMER’S WIFE: He loves to sing “I Left My Heart in San Francisco.”

EMER ROJAS: That’s my favorite song.

EMER’S WIFE: Yes, I know.

HARI SREENIVASAN: Rojas says he felt he was given a second life, and he decided he would commit his life to making people aware of what happened to him because of smoking, and his family has joined him.

ACTIVIST: All of us in the family, we’re volunteers.

ACTIVIST: I want to save lives of other people. I don’t want for them to experience what we experience with Emer.

HARI SREENIVASAN: With rallies, speeches, and messaging on radio and television, Rojas developed the new voice association as a powerful advocate against smoking, especially to protect children.

DR. ENCARNITA BLANCO-LIMPIN: All of the strategies of the tobacco companies, particularly their advertising strategy. They’re all geared to hook the young children into starting smoking at an earlier age. And since of the adults would actually grow old and eventually die. And therefore, they need new market.

ACTIVIST: The children agree that cigarette smoking is really bad, right, kids? Cigarette smoking is bad.

STUDENTS: Cigarette smoking is bad.

HARI SREENIVASAN: Another new law, following examples in other countries, requires health warnings and graphic pictures on cigarette packaging.

DR. TONY LEACHON: The graphic health warnings have been helpful in other countries, and basically we’re going to use this for the young population, of course, to women as well.

SMOKER: I’ve been to some airports and they do sell those packs with pictures of throat cancer, your lungs are all wrecked up, I guess it made you think a bit, but at the end of the day, I’m, like, where’s my pack of cigarettes?

ACTIVIST: Pictures save lives!

HARI SREENIVASAN: After months of delay, and rallies like this, the law requiring graphic health warnings is now in effect. But public health advocates say they’ve not yet won the war against tobacco. Millions of Filipinos still face lifelong addiction, and the benefits from the sin tax and graphic warnings won’t be clearly evident for decades.

ACTIVIST: One, two, three —

STUDENTS: Do not smoke!

ACTIVIST: Very good!

HARI SREENIVASAN: For the “PBS NewsHour”, I’m Hari Sreenivasan.

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GWEN IFILL: Next: As we have seen with recent pandemics, emerging diseases like Zika and Ebola can cross continents and oceans with uncontrolled speed.

Scientists are identifying areas where new infectious diseases are most likely to emerge, where there are high risks of animal viruses passing to humans. One of those areas is Southern China.

Hari Sreenivasan brings us this report, which was produced in collaboration with Global Health Frontiers.

DR. PETER DASZAK, President, EcoHealth Alliance: We’re in Guilin in Southern China, in one of the most beautiful parts of China with these amazing limestone hills and valleys and very scenic and picturesque.

HARI SREENIVASAN: Peter Daszak is the president of EcoHealth Alliance, a nonprofit organization based in New York dedicated to protecting wildlife and public health from the emergence of disease.

DR. PETER DASZAK: The reason we’re here is, we’re interested in the risk of new diseases emerging out of the wildlife trade in China, just like SARS did a few years ago and just like ultimately HIV did in Africa 40-odd years ago.

If we can get to the source of where they come from and reduce the risk, we could solve a huge problem and save millions of lives, rather than waiting for them to emerge and try to mop it up afterwards.

HARI SREENIVASAN: At markets across China, like this one, people come in daily to buy chickens and ducks.

DR. PETER DASZAK: It increases the risk of a pathogen like avian flu from spreading, because you have got live chickens. If one of them is infected, it brings the virus in, and it spreads to this flock over a few hours, and then those animals are taken to all distant parts of the region.

Now, you could see this activity anywhere in the world. This is just like what happens in rural America and rural parts of Europe. But the difference is, here, we’re in a hot zone for emerging diseases. This is a place where we have repeatedly seen outbreaks from poultry moving into people and spreading globally.

HARI SREENIVASAN: Natural habitats can also contribute to the spread of viruses.

DR. PETER DASZAK: We have got people fishing in the river. We have got people washing in the river. We know there is sewage coming directly from the houses into the river. There is not much wildlife here, but wild ducks will come down to this river as well and mix in and migrate with the viruses and spread them backwards and forwards into this mix.

It’s a big mixing vessel for pathogens.

HARI SREENIVASAN: At a goose farm, Daszak and his team are looking for signs of avian flu.

DR. PETER DASZAK: The idea is that, if we can catch the viruses they carry here, we can prevent them going to market and potentially spreading the disease.

OK, ready.

We take swabs from the mouth, and we take cloacal swabs. We put them in viral transport medium and then ship them in liquid nitrogen to the lab for testing. Avian flu is a virus that’s common in many types of birds. But especially in poultry and waterfowl, it’s a real killer.

And some of these strains can also jump directly into people. So that’s the problem.

HARI SREENIVASAN: Viruses that can cross over and infect humans have led to previous pandemics, including the most devastating in recorded world history, the 1918 flu, which killed more people than the First World War, more than 500 million infected worldwide, and as many as 100 million deaths over a two-year period.

DR. PETER DASZAK: We’re trying to say, where is the next avian flu going to come from? Can we see it before it becomes a pandemic problem and stop it?

There you go.

I look at this a little bit like earthquakes. We know earthquakes can be devastating. We know they’re pretty rare, and we know where they happen.

So, this is the same for pandemics. We know that this is a hot spot for pandemics. We know why it happens, but what we’re not doing with pandemics that we are doing with earthquakes is reducing the damage initially. This has been going on for 5,000 years.

HARI SREENIVASAN: Working with EcoHealth Alliance in this part of China is field operations manager Dr. Guangjian Zhu, a biologist trained in the ecology of bats, which are known to be the source of the SARS virus.

DR. GUANGJIAN ZHU, Field Operations Manager: It’s really urgent to teach people how to deal with the virus and just change our normal behavior to decrease the risk of virus transfer.

DR. PETER DASZAK: This is a big tourist cave. Shall we go?

HARI SREENIVASAN: Daszak is concerned about a bat cave that is a popular tourist destination.

DR. PETER DASZAK: You have got the Rhinolophus horseshoe bats right here in this cave with all these tourists going through.

DR. GUANGJIAN ZHU: Yes.

DR. PETER DASZAK: Yes.

The bats here in this cave are the same bats that carry SARS virus. Bats live in the cave all day long, because they’re nocturnal. And when they’re up there, they urinate and defecate, right on top of the tourists that are walking through.

And all you have got to do is be that one person to breathe in at the wrong time, and suddenly you have been infected with a virus that is not only potentially lethal to people. It could cause a future pandemic.

We sent you the samples from these bats.

HARI SREENIVASAN: Daszak and his team have used mathematical models to try to understand what is driving these diseases.

DR. PETER DASZAK: We went back to every known example of emerging disease, HIV, Ebola, West Nile virus, SARS, plotted where it originated. And we said, what are the things that are going on in those places?

The two big drivers are growing human populations, land use change, and high wildlife diversity.

HARI SREENIVASAN: Rapid global response to disease outbreaks is essential to stopping transmission and saving lives. But Daszak and his team of virus hunters believe that forecasting where outbreaks are most likely to occur is a critical part of a defensive strategy needed to prevent outbreaks before they emerge.

For the “PBS NewsHour,” I’m Hari Sreenivasan.

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JUDY WOODRUFF: U.S. health officials put out new guidance today about the Zika virus. For the first time, they recommended that men who have traveled to an area with Zika should use condoms if they have sex with a pregnant woman for the entire duration of the pregnancy. The CDC also says those men may want to consider abstaining from sex with women who are trying to get pregnant.

While the disease is overwhelmingly spread by mosquitoes, questions about three possible cases of sexual transmission led to these new guidelines.

In Brazil, Zika has been found in the saliva and urine of two people. And more than one million people there are said to be infected with Zika.

Our science correspondent, Miles O’Brien, is covering the story. He joins me now from Recife, Brazil, where Carnival celebrations are beginning.

So, Miles, this is a country that’s hardest-hit. It also happens to be you’re there at the time of this big annual holiday.

MILES O’BRIEN: Yes, Judy. Here we are in the middle of this public health crisis and this celebration, this national holiday begins on this night, Carnival.

What’s interesting about Carnival is that at the very core the philosophy is, forget your troubles and party like there is no tomorrow. That’s how the Brazilians view it and that’s why in most cases the party has gone on.

I talked to a lot of public health officials and doctors and scientists who have been involved in this hurt for some action and some way to control the Zika outbreak, and many of them express misgivings about it, frankly, but the show is going on.

JUDY WOODRUFF: Now, Miles, we know the Centers for Disease Control said today that the cooperation with Brazil is getting better. That’s the CDC here in the U.S. But they also have some expressed some frustration about not getting enough data from down this. What do you know about that?

MILES O’BRIEN: We heard a lot about this when we spoke to some of the scientists on the front lines here, some of the epidemiologists and the virologists who are working on this scientific riddle.

This is a virus that has presented a whole new problem for them, and it’s a virus, like so many things these days, that instantly become a global problem. The problem is, there is legislation, there is law in this land which makes it all but impossible for them to share samples with their colleagues in Atlanta or Glasgow or elsewhere In Europe.

And so they have been frustrated by that inability to share their data. Having said that, in a briefing today, the head of the CDC, Tom Frieden, said that is improving. But it’s a reminder that when you’re in a situation like this with a fast-moving virus, it’s time to bring all kinds of borders and privileges and scientific prerogatives down and try to fight the problem.

JUDY WOODRUFF: And, Miles, for the medical profession, I know you’re talking to physicians there, researchers. You were saying this has to be very frustrating for them, that they don’t feel, you said, that they have the tools in the toolbox that they need.

MILES O’BRIEN: I spoke to a gynecologist today who’s dealt with several mothers who have had to contend with this, and she’s so frustrated.

She said: “I feel like I’m in the Stone Age. I can see this coming, I see the problem developing, and I have no tools in my toolbox to help these women.”

It’s an unfortunate case. They have got this virus that came out of the blue, and they really don’t have a way of coping with it right now.

JUDY WOODRUFF: And, Miles, in terms of the science of it and dealing with the mosquitoes who are carrying this virus around, what about that front? Are they able to — I mean, are they able to project any kind of precautions that can be taken? Where are they on that front?

MILES O’BRIEN: Well, obviously, they’re telling pregnant women to be very careful and to guard against being bitten by mosquitoes. It’s worth mentioning that those are the people. It’s the pregnant women and their babies in utero that are of concern.

When an adult gets bitten by a mosquito and gets Zika, four out of five people don’t even know they have had it. So, part of it is public education. Part of it is going through and doing some spraying, which has limited efficacy.

They have got 200,000 troops in the military knocking on doors, looking for standing water, but ultimately they’re way outnumbered by the mosquitoes. We were in a lab just the other day where they’re actually genetically engineering mosquitoes, male mosquitoes, to mate with females, creating progeny which will die very quickly.

And that kind of clever approach is part of putting some tools in the toolbox to try to control how mosquitoes are carrying Zika.

JUDY WOODRUFF: But, meantime, finally, Miles, warnings going out to women and to men about the dangers of this virus.

MILES O’BRIEN: You know, Judy, it’s really a heartbreaking scenario, how this cropped up. It’s dangerous and it caught public health officials by surprise.

Today, I was with a mother with a 2-month-old son who is drastically affected by this microcephaly. And it means a lifelong problem of disability and care for this now 2-month-old child of hers. And so it’s — the danger cannot be understated for pregnant women. And that set against this Carnival offers up quite a contrast this year.

JUDY WOODRUFF: Well, it’s heartbreaking. It’s frightening.

And, Miles, I know we look forward to the reporting that you’re doing down there. And we will be having that in the days to come.

Miles O’Brien, we thank you.

MILES O’BRIEN: You’re welcome, Judy.

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JUDY WOODRUFF: Let’s dive deeper now into the president’s plan to ramp up the response to the Ebola outbreak and to try preventing a humanitarian catastrophe.

It comes amid prior criticism of the administration, along with the WHO and of other countries, for not doing more and for not getting it done faster.

We turn back to two who have been closely watching this and speaking with government officials in recent days.

Laurie Garrett of the Council on Foreign Relations, she has written widely about Ebola, including the books “Betrayal of Trust” and “The Coming Plague,”and Lawrence Gostin of Georgetown University.  He’s the director of the O’Neill Institute for National and Global Health Law.

And we welcome you — welcome both of you back to the program.

Laurie Garrett, to you first.  What is your assessment of the president’s plan that he outlined today?

LAURIE GARRETT, Council on Foreign Relations: Well, it’s a bold step forward.  I’m delighted it’s actually taking place.

But I think everything depends on the haste with which we can mobilize.  And I am afraid a lot of people don’t understand that committing troops and saying you’re going to build a hospital are all very good steeps, but it takes weeks to execute these things.  And, in the meantime, the epidemic is doubling every 10 to 20 days.  We don’t have a lot of time.  We’re racing against a clock.

JUDY WOODRUFF: Lawrence Gostin, do you have the same concerns?  What’s your assessment?

LAWRENCE GOSTIN, Georgetown Law: I think Laurie is right about timing.

First of all, I am very proud of my country.  I mean, we have stepped forward when no one else would or could.  But there are major unanswered questions.  It’s not just timing, but also command-and-control.  There’s chaos on the ground.  It’s uncoordinated.

I was very pleased to see the president say that we have a command post, but how are we going to command Chinese or Cuban workers?  I do think we need a U.N. Security Council resolution to actually have the kind of international legitimacy that we need.

JUDY WOODRUFF: So going beyond what the U.S…

LAWRENCE GOSTIN: Yes, the U.S. can’t do it alone.

JUDY WOODRUFF: Well, let me just go further here with what the U.S. is doing.  You said you’re proud of your country.  What specifically do you think is going to make the most difference here?

LAWRENCE GOSTIN: Well, I think the most difference will be training health workers, although — and building health facilities in the community, contact tracing.  All of those things are very important.

JUDY WOODRUFF: Meaning going back and finding out where…

LAWRENCE GOSTIN: Meaning going back, finding out who has been in contact with whom, and quickly isolating them in safe conditions.

One of the big problems, though, is, is that even once we have built these treatment facilities, it’s going to be handed over eventually to the Ministry of Health in Liberia.  And they just don’t have the health workers.  The doctors and the nurses have been decimated.  And so we really do have a huge infrastructure task.

JUDY WOODRUFF: Laurie Garrett, you laid out your concerns, but of what has been announced, how do you see this unfolding and making any difference?

LAURIE GARRETT: Well, first of all, we don’t have any commercial flights landing in the area now.  And so just getting doctors on the ground, getting medical supplies, keeping stocks in place of such simple things as latex gloves to protect you from infection have all proven daunting, in the absence of real solidarity from neighboring countries and the willingness to have planes land and commercial flights.

So one huge role for the U.S. military is going to be helping Ghana, which has very kindly and generously agreed to be the air bridge for all supplies and human movement into the area, to extend their runway, build their airport up, have logistic and supply operations in place, and then to have smaller flights go from Ghana into specific targeted areas carrying supplies with them as needed.

But Larry points out a crucial problem with all of this.  We don’t have a central command, which means we don’t even have a centralized list of what’s needed.  Who needs latex gloves where?  Is the situation more dire in this county in Sierra Leone or in this county in Liberia?  Where do we need to deploy people first?

We don’t have that kind of operation in place.  And our U.S. military is not going to play that role.  We will have a central command, but it will be commanding U.S. military personnel, not people from other countries and certainly not the Liberians themselves.

And we also see that the response is not a regional one.  We are, unfortunately, dividing our response according to kind of old colonial ties.  So the French are focusing on Guinea, which used to be a French colony.  The United Kingdom is focused on Sierra Leone, which is settled by the descendants of British slaves who came from the Caribbean, and we’re focused on Liberia, which is settled by former American slaves.

And so there’s this sort of distasteful neocolonial feel to things, and it means that the responses are not unified.  They are very divided by country.  So you have heard of 165 Cuban responders and 59 Chinese.  They’re all going to Sierra Leone, where they will be under we don’t know what kind of command, loosely coordinated by the Sierra Leone government.

JUDY WOODRUFF: And, Lawrence Gostin, this is sounding like a very complicated effort, which we already knew, but it sounds even more complicated listening to the two of you.

What about the timing of this?  How long is it going to take to begin to make a difference, to begin to get to the people who need treatment and are not receiving it?

LAWRENCE GOSTIN: Well, first of all, we are very late to the game.  The fire has nearly burned the house down, and we have arrived.  The cavalry has arrived.

It will take a long time, I think, to build the kind of facilities that we want.  I mean, the whole idea, for example, that we’re sending 500,000 home kits suggests that we can’t get people into hospitals quick enough to treat them and isolate them, and people who…

JUDY WOODRUFF: These are self-testing kits?

LAWRENCE GOSTIN: These are self-testing kits or self-protecting kits.  I’m not sure the community will know what to do with them when they get them.

And so this is a — this is a makeshift response to a huge humanitarian crisis.  I don’t think it had to come to this, but now that we’re there, I’m really glad the see the United States military involved.

JUDY WOODRUFF: So, Laurie Garrett, should we be pleased that this is happening or more worried because it’s not the holistic response that I heard you describing that’s necessary?

“…if we can’t get a response on the ground immediately, effectively, across the region … then we’re talking about something equivalent to the Black Death’s impact on Tuscany and Florence in 1346. “

LAURIE GARRETT: Look, I’m delighted, like Larry, to see my country step up to the plate and play a role.  And I’m hoping that we can save lots and lots and lots of lives and bring this epidemic under control.

But I agree completely we’re late to the game.  And if you just do the math, based on the statement made today by WHO, a doubling time every 10 to 21 days, and you take the number of actually identified and suspected cases existing now and do your math, you can see that if we can’t get a response on the ground immediately, effectively, across the region, we will be looking at a quarter of a million cases by Thanksgiving, and 400,000 by Christmas if this is not abated and brought under control.

And then we’re talking about something equivalent to the Black Death’s impact on Tuscany and Florence in 1346.

JUDY WOODRUFF: Sobering, sobering any which way you look at it.  We appreciate both of you joining us.

Laurie Garrett, Lawrence Gostin, thank you.

LAWRENCE GOSTIN: Thank you.

JUDY WOODRUFF: And one country in West Africa that has had rel

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JUDY WOODRUFF: The United States military is joining the fight to stop the spread of Ebola in Africa.  President Obama laid out a plan today to send 3,000 troops, amid increasingly dire forecasts of the epidemic’s potential to grow even worse.

PRESIDENT BARACK OBAMA: If the outbreak is not stopped now, we could be looking at hundreds of thousands of people infected, with profound political and economic and security implications for all of us.

JUDY WOODRUFF: The president traveled to Atlanta this afternoon and the U.S. Centers for Disease Control and Prevention to announce the ramped-up American effort.

BARACK OBAMA: And our forces are going to bring their expertise in command-and-control, in logistics, in engineering.  And our Department of Defense is better at that, our armed services are better at that than any organization on earth.

JUDY WOODRUFF: The focus is on helping overwhelmed local health care systems across West Africa.  Under the president’s plan, U.S. forces will build 17 new treatment facilities in the region, each with 100 beds.

The U.S. military is also establishing an instruction facility to train up to 500 medical workers a week, deploying 65 officers to staff a hospital for treating health care workers, and airlifting hundreds of thousands of home health kits to the affected nations.

While the president laid out that plan, top federal health officials appeared at a Senate hearing on the Ebola threat.

DR. BETH BELL, Centers for Disease Control and Prevention: There is a window of opportunity to control the spread of this disease, but that window is closing.  If we do not act now to stop Ebola, we could be dealing with it for years to come, affecting larger areas of Africa.

JUDY WOODRUFF: In all, the virus has infected nearly 5,000 people across five countries and left more than half dead.

In Geneva today, the World Health Organization issued a stark new warning.

DR. BRUCE AYLWARD, Assistant Director General, World Health Organization: With 5,000 now infected, twice the number when we met a couple of weeks ago, over 2,500 dead, nearly twice the number of when we met a couple of weeks ago, you start to get a sense of the rapid escalation now we’re seeing of the virus at it moves from what was a linear increase in cases to now almost an exponential increase in cases.

JUDY WOODRUFF: The grim forecast envisions the number of cases doubling every three weeks.  And from medical supplies to health worker salaries to burial costs, the WHO estimates it will take nearly $1 billion to contain the outbreak.  That’s a nearly 10-fold increase from a month ago.

DR. DAVID NABARRO, UN Coordinator for Ebola: The reason for that is the outbreak in last months has doubled in size.  And we realize, because it’s going to go on doubling in that sort of frequency if we don’t deal with it, the amounts requested have increased dramatically.

JUDY WOODRUFF: In addition to the U.S. response, China today dispatched a mobile laboratory and 59 medical experts to Sierra Leone to help speed up testing.

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JUDY WOODRUFF: In West Africa, doctors are fighting the world’s most deadly Ebola outbreak with makeshift hospitals, a handful of vehicles and a few brave volunteer health workers. Meanwhile, terrified villagers and city-dwellers alike can only watch helplessly as their loved ones succumb to the disease.

Tonight’s episode of “Frontline” on PBS takes an intimate and harrowing look at all this on the ground in Sierra Leone. In the following scene, “Frontline” cameras travel with a group of health workers who go to remote villages, searching for Ebola’s victims.

NARRATOR: They’re heading to a village where Ebola has already killed an old man. Everyone they encounter, even those who look healthy, could be infectious.

The team used to wear protective clothing, but the suits terrified the villagers, who ran, hid and sometimes even attacked them. Manjo now relies on keeping his distance from everyone he meets.

MANJO: My name is Manjo, and this is Ishata (ph) from the World Health Organization.

NARRATOR: A young woman is clearly unwell.

MANJO: What’s wrong with you?

NARRATOR: Kadiatu Jusu (ph) is 25 years old, the mother of four children.

WOMAN: Do you have a fever?

WOMAN: Yes, I have temperature, diarrhea and I’m vomiting.

NARRATOR: Her husband, Fallah (ph), is a farmer. He’s 35. It was his father who died two weeks ago. Ishata Conteh (ph) can see Kadiatu is almost certainly infected.

WOMAN: She actually fits into the case definition, because she was the one taking care of the old man, feeding him, cleaning where the old man was vomiting, and there was direct physical contact.

MANJO: I’m going to spray this area.

NARRATOR: Manjo disinfects Kadiatu’s home with chlorine. Everything she touched could have been contaminated. Ishata notes the names of everyone who’s been in close contact with Kadiatu. Her children and husband are at the top of the list.

WOMAN: Seventeen. All these 17 people here. If anyone gets a fever or the cough or feels like they have malaria or pain all over their body or is vomiting or going to the toilet a lot, any of those symptoms, you must call us. They are all at risk. We need to monitor them for the next 21 days.

WOMAN: She, too, is going with the same thing.

NARRATOR: Fallah can’t risk touching his wife to say goodbye.

JUDY WOODRUFF: And that’s from a “Frontline” episode airing tonight.

As we reported earlier, the number of Ebola deaths in this latest outbreak now tops 2,300.

To find out what the U.S. is doing to combat the deadly epidemic, I’m joined by Nancy Lindborg. She’s assistant administrator at the United States Agency for International Development, which has been heading up the government’s response to this growing crisis.

Nancy Lindborg, thank you for joining us.

Again, how typical would you say that scene is that we just watched?

NANCY LINDBORG, U.S. Agency for International Development: I think that scene was, unfortunately, very typical, and what we’re seeing is an unprecedented outbreak that is occurring across West Africa, but particularly focused in countries that are only recently emerging from decades of civil war.

So they had very fragile health systems to begin with. And they also have practices that are enhancing the spread. You heard about the burial practices that involve touching the dead. So we are working on a strategy across the U.S. government that involves USAID, Centers for Disease Control, and DOD, State Department to work with the global community and countries on the ground to help stop the transmission, to expand treatment, and to stand up greater capacity at the local level to do exactly what you saw, be able to address this.

JUDY WOODRUFF: It’s clear that this is an epidemic that is much worse than was thought just a few — a matter of certainly a few months ago, even a few weeks ago.

What is the U.S. responsibility in all this?  At this point, there is not an Ebola patient in the U.S., except those who have been transported to the U.S. from West Africa. But what is the U.S. responsibility in this?

NANCY LINDBORG: Our responsibility as a global leader is to do what we can to contribute to that stopping of the transmission and the provision of the treatment and helping these countries stand up better systems.

We’re working closely with the global community, and this is really going to take an all-hands-on-deck kind of approach. We just announced this morning a $10 million contribution to the African Union as they mobilize a continent response. They have mobilized 100 health workers who are going in and will provide the logistical support for them to be successful.

This will — we know what it takes to stop this. We also know that it will take significant ramping up by all the various partners, and it will probably take several months to get this under control.

JUDY WOODRUFF: Ten million dollars, is that enough at this point?  Is that just a drop in the bucket?  I mean, how do you compare that to the challenge out there?

NANCY LINDBORG: That’s — that was just to support the African Union mobilization.

USAID has committed about $100 million. We have got additional commitments from the Department of Defense. They’re bring in diagnostic labs, a field hospital. We’re bringing in almost a daily airlift of supplies, the protective personal gear that you saw people wearing, the backpack sprayers, household kits, so that households have what they need to take care of loved ones and keep themselves safe, food, a whole variety of supplies.

JUDY WOODRUFF: What — is the U.S. able to understand and to — I mean, is — do you now have a list somewhere that says, OK, here are all the things that are needed, and we’re going to provide these things, or are you still figuring this out as you go along?

NANCY LINDBORG: We have a very clear strategy that we’re pursuing, in coordination with the World Health Organization, with the local countries and their health systems and with our partners, the Europeans and the African Union.

There is — it’s stop the transmission, expand the treatments, and set up local systems, and also help the home health care strategy, so that people are not continuing to handle the dead the way that they do and to — and practice the kind of daily health practices that can change forever the way this is transmitted.

JUDY WOODRUFF: But that means getting more people on the ground to spread the word, doesn’t it?

NANCY LINDBORG: Absolutely. Absolutely.

Well, both to spread the word and to help with the setting up of the treatment facilities.

JUDY WOODRUFF: And as you — as you — at this point, is this a matter of resources, or is it a matter of time, people?  What is it that’s needed the most to bring this raging epidemic under control?

NANCY LINDBORG: It’s really all of the above.

It’s surging in the supplies. It’s surging in the people who are trained to have the very rigorous protocols required to provide the treatment. It’s activating all the ways that we can provide the information to people in the communities. We are — we have surged about 100 people into the region of USAID.

JUDY WOODRUFF: Americans?

NANCY LINDBORG: Of American, USAID, CDC, Department — the DOD, all parts of the U.S. government on the ground to get us moving ahead and further identify how to plug in, how to activate a coordination system on the ground.

JUDY WOODRUFF: How much are you concerned?  What are the odds, the chances that Ebola could spread to the United States?

NANCY LINDBORG: You know, part of what we have done is brought in a lot of those thermometers that you saw the health workers using, and set up the kind of screening that is done at the airports, so that there’s that additional control.

There’s — we always want to be concerned about global epidemics, but this — this is controllable and this is — what we have seen is, as it’s spread to places like Senegal, that they have the systems to do the tracing, the treatment, and they’re able to keep it from spreading.<

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JUDY WOODRUFF: The U.N.’s nuclear watchdog conceded that its progress investigating Iran’s nuclear program has hit a wall. The latest confidential report by the International Atomic Energy Agency was obtained by several news media outlets.

It said the IAEA had satellite imagery showing ongoing construction activity a Parchin military base, a suspected nuclear site. It also revealed that Tehran had only implemented three out of five measures to be more transparent under a deal with the IAEA. Iran denies that it wants or is working on nuclear arms.

A plane chartered by coalition forces in Afghanistan, and carrying about 100 Americans, had to land in Iran today after filing the wrong flight plan. The Washington Post first reported the incident. Iranian air traffic control reportedly asked the plane to return to Bagram Air Base in Afghanistan, but it didn’t have enough fuel. A senior State Department official said the issue has been resolved and the plane is scheduled to resume its flight.

There was new information released today on one of the deadliest friendly-fire episodes of the war in Afghanistan. An investigation by the U.S. military into the June episode found communication errors led to the deaths of five American soldiers and one Afghan. The incident happened in Zabul province when a B-1 bomber crew failed to check their information properly before launching two laser-guided bombs which hit the soldiers.

The Pentagon confirmed the death of the leader of the African terror group Al-Shabab today. Ahmed Abdi Godane was killed in a U.S. airstrike on Monday in Somalia. In a statement, the Defense Department said it was a major symbolic and operational loss for the terrorist organization.

Flash floods and landslides sparked by torrential monsoon rains have killed at least 116 people in Eastern Pakistan and Kashmir. Swollen rivers today swept away buildings and bridges and left many trapped on their own rooftops. Soldiers and emergency workers used boats and helicopters to ferry the stranded to safety. The flooding was forecast to intensify this weekend.

A third American aid worker infected with the Ebola virus in Liberia is now in stable condition in Nebraska. Dr. Rick Sacra arrived at a hospital in Omaha early this morning with a police escort. He had been evacuated from West Africa. The 51-year-old delivered babies at a Liberia hospital, and it’s still unclear how he contracted the virus. The head of the Nebraska Center’s Infectious Diseases Division said the patient is in a specially equipped bio-containment unit.

DR. MARK RUPP, Infectious Diseases Division Chief, Nebraska Medical Center:  We’re doing our basic checks on him right now with getting some of our baseline laboratories, making sure that his fluid status is equilibrated, that his electrolytes are in control. We know that he is seriously ill with a virus that has a fairly high mortality rate associated with it.

Like I said, we will continue to care for him with very aggressive, supportive care, and we’re looking into alternatives for some of our experimental therapeutics right now.

JUDY WOODRUFF: Two other American health workers who contracted the virus in Liberia were treated and cured at Emory University in Atlanta.

Also today, the World Health Organization reported the death toll in West Africa from the Ebola outbreak passed the 2,000 mark. Half of those deaths were in Liberia.

Job growth slowed in August, as U.S. employers hired fewer workers than analysts had expected. But stocks on Wall Street seemed undeterred by the news. The Dow Jones industrial average gained more than 67 points to close at 17,137; the Nasdaq rose 20 points to close above 4,582; and the S&P 500 added 10 points to finish at 2,007. For the week, the Dow, the Nasdaq, and the S&P all rose a fraction of a percent.

And in a special piece of good news, the California blue whale has bounced back from near extinction. A study done at the University of Washington found that they have recovered to number about 2,200 in the Pacific Ocean. That’s about 97 percent of historic 19th century levels. But the largest animals on earth are still vulnerable to being stuck by large ships.

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JUDY WOODRUFF: Finally tonight, one woman’s efforts to transform the way orphans are cared for in China.

“NewsHour” correspondent Fred de Sam Lazaro reports as part of his Agents for Change series. A version of Fred’s story aired on the PBS program “Religion & Ethics Newsweekly.”

And a warning:  This piece contains some disturbing images.

FRED DE SAM LAZARO: For the Bowen family, this was a huge day.

MAN: She got the international baccalaureate diploma, and then she got the biliteracy medal, as opposed to bilingual. It’s like she can read and write and talk.

FRED DE SAM LAZARO: That 18-year-old Maya Bowen can talk, let alone graduate with honors, seems both natural and unlikely, given her early childhood in a distant orphanage. Richard and Jenny Bowen adopted her when she was two.

Jenny Bowen, Half the Sky Foundation: No one had ever talked to her and, you know, language develops when people talk to you. That’s how you learn to speak, so she had no language at all.

WOMAN: OK. Daddy is going to take pictures of you.

FRED DE SAM LAZARO: Jenny Bowen recently published a book called “Wish You Happy Forever,” chronicling how Maya and later Anya came to be part of the family. The California couple were already in their 50s, with grown children, but they were moved by reports of child neglect on a vast scale in China.

WOMAN: Here, we found toddlers tied to bamboo seats, with their legs splayed over makeshift potties.

FRED DE SAM LAZARO: This 1995 film, shot undercover, called “The Dying Rooms” showed orphanages filled with girls, abandoned in a country that had begun restricting families to one child in a culture that traditionally favored boy children.

JENNY BOWEN: We thought the thing we could do was save one life. So that’s what we did. We went to China to save a life.

FRED DE SAM LAZARO: But she found it impossible to ignore the conditions Maya would escape, but where millions of others still languished — in the custody of indifferent or untrained workers, invisible in a nation focused on industrializing its way out of Third World poverty.

Sixteen years later, Jenny Bowen heads a group called the Half the Sky Foundation that’s helping transform the way orphans are cared for across China, with the blessings of and often in partnership with the government.

The name derives from a Chinese proverb that says women hold up half the sky. The group has so far trained 12,000 teachers and nannies in 27 provinces. We visited in the northeastern city of Shenyang.

JENNY BOWEN: All these children are abandoned. Many of them are abandoned because they have what are called special needs.

Before Half the Sky, children are tied to their chairs. They were lying in bed. You could see the tragedy. You walk into a room, and you were just confronted with the tragedy. Here, it’s invisible. These children are going on with their lives. They’re being treated like their lives matter. And they know it. They know they’re loved, and so they thrive.

FRED DE SAM LAZARO: She says children need a sense of being part of a family, in whatever shape family takes.

JENNY BOWEN: It doesn’t mean that they have to be back with their birth families or permanently adopted or anything. They just need to have the love that a family gives naturally to a child, and, to me, it was like a no-brainer.

FRED DE SAM LAZARO: It was not a no-brainer to get her ideas across in an opaque state-run welfare system. What’s more, the publicity about orphanage conditions was deeply insulting to a government highly sensitive about China’s image.

Zhang Zhirong works for Half the Sky’s China offices.

ZHANG ZHIRONG, Half the Sky Foundation: China always want to tell the world she is the best, everything perfect. We are serving the people. We are helping the people. That’s China politically. But, as you know, China is such a big country. At that time, it was difficult to let people, especially foreigners, to come in to see some of the problems, to see some of the dark side.

FRED DE SAM LAZARO: Zhang was a key early ally, an English professor and official interpreter well-versed in the culture and politics of the bureaucracy. She was convinced of Bowen’s sincerity.

ZHANG ZHIRONG: I really feel she had the heart. She wanted to help. No other intentions.

FRED DE SAM LAZARO: Did it help that she had Chinese daughters as well?

ZHANG ZHIRONG: That’s also — we would tell — she always says, “I’m half-Chinese. My daughters are all Chinese.”

JENNY BOWEN: I know that resonated. Certainly, the international criticism let them know that something had to be done. I probably was the least threatening of the options out there.

FRED DE SAM LAZARO: Bowen began by seeking guidance from child development experts. She raised funds in Hollywood, where she was a screenwriter and filmmaker, and from American couples who’d adopted Chinese daughters. She organized volunteer trips to train caregivers and spruce up the environment in which orphans spent their days.

Children who once sat impassively are now in busy preschools. Walls that had generic cartoon images now display the children’s own artwork and pictures.

JENNY BOWEN: Children in institutions, in traditional institutions, they move in packs. They all eat at the same time, they all sleep at the same time, they all pee at the same time, and they don’t separate themselves from each other.

So we use a lot of mirrors, we use things like this, where they can identify themselves and their friends, and it’s a way for them to start knowing who they are, and that’s the beginning of developing intellectual curiosity and opinions.

I can tell you already have opinions, right?

FRED DE SAM LAZARO: Teacher Lin Lin says Half the Sky’s approach, called responsive care, is tailored to children’s individual learning interests — a far cry from the previous rote learning.

LIN LIN, Schoolteacher, Half the Sky Foundation (through interpreter):  Kids were asked to recite a lot of things, old poems and literature, which they did not understand, they weren’t interested in. Now we’re doing things that are interesting to them. Gradually, you build a trust with these children, and they begin to consider you as part of their family.

FRED DE SAM LAZARO: That’s a key goal: to make such caregivers part of the child’s understanding of family. But Half the Sky is also building so-called family villages, a more traditional setting.

Couples, most with grown children, like Liu Peng Ying and her husband, Chen Yung Chang (ph), are given housing and a small stipend to raise their young orphaned charges. It’s an easy sell in a country where large families used to be the tradition.

LIU PENG YING, China (through interpreter): These are like my own children, like my grandchildren. My husband likes children even more than I do. That’s why we decided to apply for this program.

FRED DE SAM LAZARO: In today’s wealthier, more urbanized China, Bowen says fewer healthy female babies are abandoned. About three quarters of a million children are in state custody.

They are more likely to be from impoverished rural areas and more likely to have congenital or medical conditions their families cannot afford to treat.

JENNY BOWEN: So, in this room, we find children who have pretty severe special needs.

FRED DE SAM LAZARO: For them, Half the Sky runs a care center in Beijing, with corporate foundation and government support. It provides care for children as they await or recover from surgery or as, in the sad case of 4-year-old Pin Pin, chemotherapy

JENNY BOWEN: She has cancer in both of her eyes?

WOMAN: Yes, and eight times chemo.

JENNY BOWEN: Eight times chemo.

FRED DE SAM LAZARO: For the weeks or months Pin Pin will spend here, a teacher will help her adjust to the loss of her sight.

JENNY BOWEN: You need to have a teacher, because you have a lot of things you have to learn. We don’t just worry about your eyes. We have to worry about your brain, huh?  Yes.

MAN: Maya Bowen!

(CHEERING AND APPLAUSE)

FRED DE SAM LAZARO: Maya Bowen plans to become an elementary teacher. She

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JEFFREY BROWN: The director of the U.S. Centers for Disease Control just returned from surveying the situation in West Africa. And in a press conference this afternoon, he too added strong words and warnings. Dr. Thomas Frieden joins us now from Atlanta.

And, Dr. Frieden, there was a level of urgency and concern put forward today that I don’t think we have heard from you and other officials so far. Have we entered a new and frightening phase in all this?

DR. THOMAS FRIEDEN, Director, Centers for Disease Control and Prevention: Well, unfortunately, the situation is bad.

It’s worse than I and others had feared. The number of cases is increasing rapidly. The human tragedy is heartbreaking. And we anticipate that, in the next few weeks, we’re going to see significant further increases in cases and in the places where it’s spreading.

So, this is definitely an epidemic and really the world’s first epidemic of Ebola, meaning spreading widely. And it’s spiraling out of control.

What’s really important to understand is that we know how to under — we know how to control it. And there is this window of opportunity that’s closing, but it’s not too late. We have to act now. Urgency couldn’t be higher. Speed is of the essence.

JEFFREY BROWN: Well, tell us — you use this kind of language, the window of opportunity is closing, the challenge is so great. You said today the epidemic is so overwhelming that it now requires an overwhelming response.

What specifically did you see on your trip and are you getting from responses from health officials around the world that is so alarming now?

DR. THOMAS FRIEDEN: Well, I will tell you an example.

Doctors Without Borders, MSF, is doing phenomenal work. They’re working an extraordinarily difficult situation and trying to really do whatever they can to help patients and stop the outbreak, but they’re overwhelmed by the number of patients. So they’re opening new hospital beds as fast as they can, but only safety — they have a terrific track record of safety for the people working in the Ebola treatment units.

But in order to do that, they can’t open them as fast as the patients are requesting hospitalization. What that means is that patients are not being hospitalized, and they are spreading Ebola in communities, including in urban communities, where it can spread quite widely.

JEFFREY BROWN: Well, so you said today and you just said to us again that, in essence, we know how to contain Ebola, but then why the lack of success?  What are the greatest impediments and what do you most need right now?

DR. THOMAS FRIEDEN: It’s fundamentally about speed and scale. Every day we delay in getting the proven treatments and prevention out there, it spreads more widely and we have more of it.

One of the encouraging things I did see was people throughout the region willing to help, willing to really work to make a difference. Ninety percent of the staff at the Doctors Without Borders hospitals are local staff who have been rigorously trained and are working hard to stop the outbreak and care for patients, but the challenges really are enormous, and the urgency is so great.

The sooner we increase beds, the sooner we make burials safer, the sooner we help health care workers be safer from infections, we are going to be better off in terms of beginning to turn this outbreak around. Time is lives here.

JEFFREY BROWN: One of the things you said today really jumped out at me. You were talking about as the world isolates itself from these countries, it is having an adverse effect.

It’s harmful to the countries and it’s ultimately harmful to the rest of the world, including us, and you said, like it or not, we are connected. So explain that. Should we not be isolating those countries?

DR. THOMAS FRIEDEN: The fact is, people are going to move around the world, and the only way to really protect ourselves from this is to stop it at the source.

It’s not dissimilar to the dynamic that’s happened within these countries. Frankly, against the advice of many, some of the countries enforced quarantines in some areas. And the — as Dr. Liu from MSF said earlier on your program, that’s really counterproductive, because it drives patients underground, it increases hostility. And it’s not a way to help.

What we need to do is to get services to patients, to families, get people into care and isolation quicker, so they stop spreading disease and so they have a better chance of survival, because early treatment does improve survival.

JEFFREY BROWN: But given the interconnectedness that you’re talking to, what about the potential for a spread in the U.S.?  And given this new alarm of how quickly this is spreading, what do you tell people tonight who are afraid here in this country?

DR. THOMAS FRIEDEN: Well, given the large increase in cases that we’re seeing and think we’re likely see in the coming weeks, I would be surprised if we didn’t see other cases in other parts of Africa.

For the U.S., it’s certainly possible we will get someone here who develops symptoms of Ebola and may have Ebola. That’s a possibility. That’s why we have asked doctors working in emergency departments and elsewhere to be on the lookout for people who have been in an area with Ebola in the past three weeks, and, if they have fever or other symptoms consistent with Ebola, to isolate and test them.

That’s also why we have worked with about 10 states from around the country to have tests for Ebola up and available, so that they can be tested in a regional approach, so we’re prepared in this country.

Ebola doesn’t spread through casual contact. It doesn’t spread through the air naturally. The way it spreads is by physical contact with a sick person or their body fluids or someone who’s died from Ebola with their body fluids.

And standard infection control in hospitals has prevented spread of five cases of hemorrhagic fevers that have been in the U.S. in the past decade.

JEFFREY BROWN: I just want to ask you in our last minute about one other frightening scenario that you raised today, which was the possibility that Ebola might become easier to spread through genetic mutation.

You said you didn’t see signs of it yet, but it’s — the possibility is not zero, I think is the way you put it. Explain that, because that would be a quite frightening new step.

DR. THOMAS FRIEDEN: Well, the genetic material of the virus has been quite stable for 40 years. So we don’t think of this as a virus that changes much.

But the longer it spreads and the more people it spreads to, the more what’s called selective pressure that might favor strands that do spread more easily. And that’s a concern. It’s something we will be tracking for.

But the bottom line here is, we have to surge our response and act now. By bringing down the number of cases, we will protect ourselves, we will protect West Africa, we will reduce the humanitarian crisis, insecurity that’s there, and we will make it less likely that there are patients traveling to other parts of the world, and less likely that we could get that kind of a mutation.

JEFFREY BROWN: All right, Dr. Thomas Frieden of the CDC, thank you so much.

DR. THOMAS FRIEDEN: Thank you.

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GWEN IFILL: Adding to the difficulty, a different strain of Ebola has appeared in the Democratic Republic of Congo, causing 13 deaths so far. 

Here at home, the National Institutes of Health announced today it will start testing an experimental Ebola vaccine next week.

For more on that development, I’m joined by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at NIH.  He will oversee those trials.

Dr. Fauci, thanks for joining us again.

What would trials like this look like?

DR. ANTHONY FAUCI, Director, National Institute of Allergy and Infectious Diseases: Well, first of all, it’s an early phase one trial.

And by phase one, we mean this is the first time this vaccine has been put in humans.  So safety is paramount, so you take a very small number of people, 20 in total, three at a time, and you use the vaccine to determine if there are untoward effects, any inflammation, any idiosyncratic or hypersensitivity reactions, pain or anything that might be a red flag about safety.

And also you learn whether it induces the kind of response in a person that you would hope would be protective against Ebola infection.  The reason why we chose this vaccine is that it showed very favorable results in an animal model, a monkey model, in which it protected monkeys very well against a challenge with lethal Ebola.

So this is a first, because it’s the first time this has been in a human, in now what will be a series of steps to ultimately develop it to determine if, in fact, it is effective.

GWEN IFILL: This has been in development for some time.  You called this an uncontrolled outbreak in West Africa.  Dr. Tom Frieden for the CDC said it will get worse before it gets better.  Is it this West African outbreak which is moving this from development to trial?

DR. ANTHONY FAUCI: We have been working on an Ebola vaccine for a number of years now.  This has been one of the priorities of the hemorrhagic fevers, of which Ebola is actually the worst of those.

This is kind of the culmination of an iterative process of developing it.  It was certainly accelerated by what we’re seeing now with this extraordinary outbreak in certain West African countries.  So we were on the track of an Ebola vaccine, but we accelerated it.  We didn’t cut corners, but we really put the afterburners on to get things done much more quickly, so that we could get to the point where, next week, we will put this first time in a human, in a normal volunteer right here in our clinical center in Bethesda.

GWEN IFILL: We have spent a lot of time trying to figure out ZMapp, the small dosage which has been experimented on humans in this latest outbreak.

This plan that you’re talking about developing would be working with a large drug company, GlaxoSmithKline.  Does that make a difference in the timetable, how quickly we would see it come to market if it worked?

DR. ANTHONY FAUCI: Gwen, it makes an extraordinary amount of difference.  It really is the game-changer in that.

When you have a company like GlaxoSmithKline, who partners fully with the NIH, with our science and their capability of producing this, that’s how you get things done.  And, in fact, one of the reasons why we had not gotten the vaccine up to now or even drugs is that there was relatively little interest on the part of many pharmaceutical companies for either drugs or vaccines.

And I think the extraordinary, dramatic situation which we’re going through right now is going to really get people’s attention and we will see a lot more interest in that, which I’m very pleased about because we really do need a vaccine and some therapeutics.

GWEN IFILL: Because Ebola is such a dangerous virus, how do you ensure the safety not only for those taking it in the trial, but also for those handling the virus?

DR. ANTHONY FAUCI: Well, that’s a good question, Gwen.

And it’s important to point out there’s no chance at all of the vaccine giving Ebola to anyone, because we’re not giving them the Ebola virus.  We’re giving them a vaccine that has a very small component of the genetic material from Ebola that will make a protein that is again an important component of the virus, but not a virus that can actually replicate.

So there’s no chance.  When we say safety, which is the first part of phase one, we’re not talking about safety of giving someone Ebola.  We’re talking about safety of an adverse reaction to the vaccine itself.  That’s an important difference.

GWEN IFILL: If we’re talking about the possibility of 20,000 cases before this thing begins to subside, how do we know the vaccines are the right solution, or even are they the right solution?

DR. ANTHONY FAUCI: Well, again a great question, because the solution, right now, is what we know can stop an outbreak, and that is the ability and the infrastructure to deliver infection control by isolation, by quarantine, by contact tracing, and by protecting the health care workers with proper personal protective equipment.

The difficulty in those West African countries is, they don’t have that kind of infrastructure in place, and it’s truly a struggle to be able to do that kind of infection control.  Historically, under other circumstances, there have been now about 24 outbreaks of Ebola, usually in geographically-restricted areas, where it was much easier to contain it.

You can contain it with good hospital and infection control capabilities.

GWEN IFILL: Dr. Anthony Fauci at the National Institutes of Health, thank you very much.

DR. ANTHONY FAUCI: You’re quite welcome.

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