Battle won, but the war goes on

Professor Peter Piot says the battle against the Ebola outbreak could go on for another year. Photo / AP

Professor who discovered Ebola tells how it got away, and what we must do next .

In 1976, when young Belgian microbiologist Peter Piot was sent to investigate an outbreak of a mysterious virus in a remote part of the Democratic Republic of the Congo (then Zaire), he could never have predicted how the new pathogen that he viewed through his microscope would change his life -- nor the devastation it would cause nearly 40 years later.

Piot and his team named the virus Ebola, after a nearby river.

"I was convinced there would always be Ebola outbreaks, because there is a reservoir, in bats," he says now. "But I couldn't imagine it would get out of control."

Nearly 40 years after his discovery, made when he was 27, Professor Piot is one of the foremost experts in the never-ending war against infectious disease. Having identified one deadly new virus, he went on to devote much of his life to the fight against another, HIV. He was the founding director of Unaids, the joint United Nations Programme on HIV/Aids, a position he held from 1995 to 2008.

Few people better understand the fraught interplay between health and politics that can mean the difference between life and death for millions.

As director of the London School of Hygiene and Tropical Medicine, he remains at the vanguard of research and activism in global health -- and has been one of the sternest critics of the world's response to this year's Ebola crisis.

Speaking hours after returning to London from Sierra Leone, where he has been touring treatment centres, he said that while the outbreak itself was unavoidable, it need never have wrought such devastation.

"Because Ebola had never been detected in West Africa, I can understand why it took three months to diagnose it, particularly in a country [Guinea, where the outbreak began] where health systems are so poorly developed.

"But in March, all the stops should have been pulled out. There was a slow response locally, out of ignorance and under-estimation, and the international community also was slow."

It took, as Piot grimly observed at the time, "a thousand dead Africans and two Americans who were repatriated" for the rest of the world to wake up.

Now, finally, after medico-military interventions by the US in Liberia, France in Guinea and the UK in Sierra Leone, and a major international investment in healthcare workers, logistics and experimental treatments, Piot believes that the end may be in sight. "The effort is paying off now," he said.

Based on "something in between intuition and a reading of the figures", he suspects the outbreak may have peaked in Sierra Leone.

Transmission seems to have slowed down in Liberia, and remains low in Guinea.

But the worst thing that could happen now would be for complacency to set in, Piot said.

"Ending it is going to be really tough. We need to be prepared for quite a long effort. It could be the whole of 2015."

That long effort will require current levels of international commitment to continue long into the new year, he said, as well as continued education and a social effort to remove stigma around the disease -- familiar territory for a veteran of the fight against HIV/Aids.

"The stigma is real. Some survivors' families don't want their family member back.

"The stigma is also there for healthcare workers. Some of them can't go back to their families."

As for the question of how the virus he discovered 40 years ago could so suddenly get out of control, Piot believes a "perfect storm" of factors were responsible, including poorly developed health systems, traditional burial customs and a slow international response.

Now was also the time to test experimental therapies.

"There is an opportunity to make sure that this is the last Ebola epidemic where all we have to beat it is quarantine."

- Independent