Osterholm: Focus on West Africa, not Dallas: The Effort in Africa Now, is a 'Travesty'
October 17, 2014 • 8:29AM

Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, was interviewed Thursday by MPR News in St. Paul, Minn. Excerpts follow. "The Ebola epidemic is raging in West Africa. How do we keep it there and how do we make progress in ending it there?" he asked.

"That I think is really the zillion-dollar question, and really the important point: do not take your eye off the real ball here: it is West Africa. It is still a travesty that we have responded so inadequately to that outbreak.

"When we talked about this way back in July, we talked about the opportunity here to intervene in an aggressive way to try to stop this from spreading, and we have not done that. We still have not constructed one single hospital bed in West Africa — we being the United States — even though we promised weeks and weeks ago, we would do so. Everything is moving in bureaucratic or program time while the outbreak is moving in virus time.

"The WHO [World Health Organization] predicted that the next month we'd have 10,000 new cases in just those three affected countries. I think that's a good estimate.

"We had the Liberian health care workers, people from Liberia, go on strike, because 80 percent of them did not have gloves, gowns, or masks to provide care. We can move iPhones from Asia in days, but we can't move gloves, gowns, and masks to West Africa in months?

"It's a travesty. And I think that's what the whole world has to understand. For the World Health Organization, Ebola will be their 9/11. For the world, West Africa is our global Katrina.

"I think that's the message we have to get across, and every time we divert to Dallas or places like that, we're missing the point: why has the global response been so absolutely inadequate? That's where the real issue is.

"So how do we marshal that response?

"It's only going to be a matter of days before this virus starts to march eastward. When you look at the 20 million people who live in those three affected countries, you realize that's a very important issue, particularly to the capital cities and the slums there.

"If this virus moves east into Nigeria, into Nairobi, into Kinshasa, to cities like that, you're going to see an absolute explosion of cases. There are more people living in the slums of Kinshasa than live in all the slums combined of the three countries that are now impacted. We can't fight adequately in one front, how are we going to do it in multiple fronts?


"Ultimately, we need a vaccine, that's going to be the ultimate answer. We've got to fast-track vaccine, research and development, approval, manufacturing and distribution. That's one of the things our group is working on right now, trying to develop that plan, basically a Manhattan Project on Ebola vaccine.

"In the end. that's going to be the fire hose that will put out that infectious disease forest fire there, which in turn is throwing out these sparks, these embers, that are going around the world that are causing the Dallas-like situations. If we want to make sure that we don't have more Dallas-like situations, we want to make sure that we put the forest fire out in Africa right now. That's critical.

MPR: "A month ago in a New York Times editorial, 'What We're Afraid to Say About Ebola,' you mentioned a dire scenario: the possible mutation of the disease. What's the concern about that and is it a real possibility?"

Osterholm: "A lot of what we think we may know about Ebola is really based on a very limited experience.

"One thing we do know is this virus has been transmitted from subhuman primates, or monkeys, to each other by the respiratory tract.

"All we have proposed, is that we at least need to consider that because of this, we start to see respiratory transmission like we have seen in monkeys. It's not as much a forecast that it will happen, but it means that we don't want to keep getting caught by surprise like we did in Dallas."