0:00:00.648,0:00:05.222
You may never heard of Kenema,[br]Sierra Leone, or Arua, Nigeria,

0:00:05.222,0:00:09.965
but I know them as two of the most[br]extraordinary places on Earth.

0:00:09.965,0:00:14.934
In hospitals there, there's a community[br]of nurses, physicians, and scientists

0:00:14.934,0:00:17.581
that have been quietly battling[br]one of the deadliest threats

0:00:17.581,0:00:21.389
to humanity for years: Lassa virus.

0:00:21.389,0:00:23.339
Lassa virus is a lot like Ebola.

0:00:23.339,0:00:27.147
It can cause a severe fever[br]and can often be fatal.

0:00:27.147,0:00:30.676
But these individuals,[br]they risk their lives every day

0:00:30.676,0:00:33.625
to protect the individuals[br]in their communities,

0:00:33.625,0:00:37.363
and by doing so protect us all.

0:00:37.363,0:00:39.546
But one of the most extraordinary things[br]I learned about them

0:00:39.546,0:00:42.472
on one of my first visits out there[br]many years ago

0:00:42.472,0:00:44.631
was that they start each morning,

0:00:44.631,0:00:49.879
these challenging, extraordinary days[br]on the front lines, by singing.

0:00:49.879,0:00:53.152
They gather together[br]and they show their joy.

0:00:53.152,0:00:54.731
They show their spirit,

0:00:54.731,0:00:58.446
and over the years, from year after year[br]as I've visited them and they visited me,

0:00:58.446,0:01:00.977
I get to gather with them and I sing

0:01:00.977,0:01:03.090
and we write and we love it,

0:01:03.090,0:01:06.852
because it reminds us that we're not[br]just there to pursue science together.

0:01:06.852,0:01:09.800
We're bonded through a shared humanity.

0:01:09.800,0:01:13.748
And that, of course, as you can imagine[br]becomes extremely important,

0:01:13.748,0:01:17.022
even essential, as things begin to change,

0:01:17.022,0:01:19.367
and that changed a great deal

0:01:19.367,0:01:21.480
in March of 2014

0:01:21.480,0:01:24.986
when the Ebola outbreak[br]was declared in Guinea.

0:01:24.986,0:01:26.820
This is the first outbreak in West Africa,

0:01:26.820,0:01:29.211
near the border[br]of Sierra Leone and Liberia,

0:01:29.211,0:01:32.834
and it was frightening,[br]frightening for us all.

0:01:32.834,0:01:35.806
We had actually suspected for some time[br]that Lassa and Ebola

0:01:35.806,0:01:38.499
were more widespread than thought,[br]and we thought it could one day

0:01:38.499,0:01:39.939
come to Kenema.

0:01:39.939,0:01:42.470
And so members of my team[br]immediately went out

0:01:42.470,0:01:44.977
and joined Dr. Humarr Khan[br]and his team there,

0:01:44.977,0:01:46.510
and we set up diagnostics to be able[br]to have sensitive molecular tests

0:01:46.510,0:01:52.175
to pick up Ebola if it came[br]across the border and into Sierra Leone.

0:01:52.175,0:01:55.983
We'd already set up this kind capacity[br]for Lassa virus. We knew how to do it.

0:01:55.983,0:01:57.817
The team is outstanding.

0:01:57.817,0:02:01.184
We just had to give them to tools in place[br]to survey for Ebola.

0:02:01.184,0:02:03.018
And unfortunately, that day came.

0:02:03.018,0:02:07.918
On May 23, 2014, a woman checked in[br]to the maternity ward at the hospital,

0:02:07.918,0:02:11.818
and the team ran[br]this important molecular test,

0:02:11.818,0:02:16.346
and they identified the first confirmed[br]case of Ebola in Sierra Leone.

0:02:16.346,0:02:18.482
This was exceptional work that was done.

0:02:18.482,0:02:20.433
They were able to diagnose[br]the case immediately,

0:02:20.433,0:02:22.801
to safely treat the patient,

0:02:22.801,0:02:25.843
and to begin to do contact tracing[br]to follow what was going on.

0:02:25.843,0:02:27.839
It could've stopped something,

0:02:27.839,0:02:30.626
but by the time that day came,

0:02:30.626,0:02:33.249
the outbreak had already[br]been breeding for months.

0:02:33.249,0:02:36.756
With hundreds of cases, it had already[br]eclipsed all previous outbreaks,

0:02:36.756,0:02:40.169
and it came into Sierra Leone[br]not as that singular case

0:02:40.169,0:02:42.235
but as a tidal wave.

0:02:42.235,0:02:44.487
We had to work[br]with the international community,

0:02:44.487,0:02:48.272
with the Ministry of Health, with Kenema,[br]to begin to deal with the cases,

0:02:48.272,0:02:50.130
as the next week brought 31,

0:02:50.130,0:02:52.873
then 92, then 147 cases,

0:02:52.873,0:02:55.706
all coming to Kenema, one of the only[br]places in Sierra Leone

0:02:55.706,0:02:57.378
that could deal with this.

0:02:57.378,0:03:00.768
And we worked around the clock[br]trying to do everything we could,

0:03:00.768,0:03:04.018
trying to help the individuals,[br]trying to get attention,

0:03:04.018,0:03:06.015
but we also did one other simple thing:

0:03:06.015,0:03:10.357
from that specimen that we take[br]from a patient's blood to detect Ebola,

0:03:10.357,0:03:12.377
we can discard it, obviously.

0:03:12.377,0:03:14.885
The other thing we can do is actually[br]we can put in a chemical

0:03:14.885,0:03:17.700
and deactivate it, so just a simple[br]place it into a box

0:03:17.700,0:03:19.929
and ship it across the ocean,[br]and that's what we did.

0:03:19.929,0:03:22.112
We sent it to Boston where my team works,

0:03:22.112,0:03:26.454
and we also worked around the clock[br]doing shift work day after day,

0:03:26.454,0:03:30.726
and we quickly generated 99 genomes[br]of the Ebola virus.

0:03:30.726,0:03:33.559
This is the blueprint.[br]The genome of a virus is the blueprint.

0:03:33.559,0:03:36.740
We all have one. It says everything[br]that makes up us,

0:03:36.740,0:03:38.644
and it tell us so much information.

0:03:38.644,0:03:42.150
The results of this kind of work[br]are simple and they're powerful.

0:03:42.150,0:03:44.959
We could actually take[br]these 99 different viruses,

0:03:44.959,0:03:46.468
look at them and compare them,

0:03:46.468,0:03:49.231
and we could see actually[br]compared to three genomes

0:03:49.231,0:03:52.296
that had been previously[br]published from Guinea,

0:03:52.296,0:03:55.826
we could show that the outbreak[br]emerged from Guinea months before,

0:03:55.826,0:03:57.869
once into the human population,

0:03:57.869,0:04:00.214
and from there had been transmitting[br]from human to human.

0:04:00.214,0:04:03.488
Now, that's incredibly important[br]when you're trying to figure out

0:04:03.488,0:04:06.553
how to intervene, and the important thing[br]is contract tracing.

0:04:06.553,0:04:09.760
We also could see that as the virus[br]was moving between humans,

0:04:09.760,0:04:11.316
it was mutating,

0:04:11.316,0:04:13.452
and each of those mutations[br]are so important,

0:04:13.452,0:04:15.727
because the diagnostics, the vaccines,

0:04:15.727,0:04:17.260
the therapies that we were using

0:04:17.260,0:04:20.720
are all based on that genome sequence[br]fundamentally.

0:04:20.720,0:04:23.250
That's what drives it,[br]so global health experts

0:04:23.250,0:04:26.083
would need to respond,[br]would have to develop,

0:04:26.083,0:04:28.660
to recalibrate everything[br]that they were doing.

0:04:28.660,0:04:31.888
The way that science works,[br]the position that I was in at that point

0:04:31.888,0:04:35.603
is I had that data and I could have worked[br]in a silo for many, many months,

0:04:35.603,0:04:37.809
analyzed the data carefully, slowly,

0:04:37.809,0:04:41.826
submitted the paper for publication,[br]gone through a few back-and-forths,

0:04:41.826,0:04:44.914
and then finally when the paper came out,[br]might release that data.

0:04:44.914,0:04:47.305
That's the way the status quo works.

0:04:47.305,0:04:49.859
Well, that was not going to work[br]at this point. Right?

0:04:49.859,0:04:51.345
We had friends on the front lines,

0:04:51.345,0:04:54.712
and to us it was just obvious[br]that what we needed is help,

0:04:54.712,0:04:55.827
lots of help.

0:04:55.827,0:04:59.379
So the first thing we did was,[br]as soon as the sequences

0:04:59.379,0:05:01.701
came off the machines,[br]we published it to the web.

0:05:01.701,0:05:05.695
We just released it to the whole world[br]and said, "Help us." And help came.

0:05:05.695,0:05:08.899
Before we knew it, we were being contacted[br]from people all over,

0:05:08.899,0:05:11.708
surprised to see the data[br]out there and released.

0:05:11.708,0:05:13.659
Some of the greatest[br]viral trackers in the world

0:05:13.659,0:05:15.981
were suddenly part of our community.

0:05:15.981,0:05:18.326
We were working together[br]in this virtual way,

0:05:18.326,0:05:21.344
sharing, regular calls, communications,

0:05:21.344,0:05:24.618
trying to follow the virus[br]minute by minute

0:05:24.618,0:05:27.103
to see ways that we could stop it.

0:05:27.103,0:05:31.003
And there are so many ways[br]that we can form communities like that.

0:05:31.003,0:05:35.531
Right? Everybody, particularly when[br]the outbreak started to expand globally,

0:05:35.531,0:05:39.362
was reaching out to learn,[br]to participate, the engage.

0:05:39.362,0:05:41.406
Everybody wants to play a part.

0:05:41.406,0:05:44.308
The amount of human capacity[br]out there is just amazing,

0:05:44.308,0:05:45.957
and the Internet connects us all,

0:05:45.957,0:05:48.882
and could you just imagine that instead[br]of being frightened of each other,

0:05:48.882,0:05:52.202
that we all just said, "Let's do this,[br]let's work together,

0:05:52.202,0:05:53.897
and let's make this happen."

0:05:53.897,0:05:56.289
But the problem is that the data[br]that all of us are using,

0:05:56.289,0:06:00.654
Googling on the Web, is just too limited[br]to do what we need to do.

0:06:00.654,0:06:03.324
And so many opportunities[br]get missed when that happens.

0:06:03.324,0:06:05.437
So in the early part[br]of the epidemic from Kenema,

0:06:05.437,0:06:08.433
we'd had 106 clinical records[br]from patients,

0:06:08.433,0:06:11.196
and we once again made that[br]publicly available to the world.

0:06:11.196,0:06:14.911
And in our own lab, we could show[br]that you could take those 106 records,

0:06:14.911,0:06:18.626
we could train computers to predict[br]the prognosis for Ebola patients

0:06:18.626,0:06:20.506
to near 100 percent accuracy,

0:06:20.506,0:06:22.364
and we made an app that could release that

0:06:22.364,0:06:24.895
to make that available[br]to health care workers in the field.

0:06:24.895,0:06:28.494
But 106 is just not enough, right,[br]to make it powerful,

0:06:28.494,0:06:29.748
to validate it.

0:06:29.748,0:06:32.325
So we were waiting for more data[br]to release that,

0:06:32.325,0:06:34.647
and the data has still not come.

0:06:34.647,0:06:36.992
We are still waiting, tweaking away,

0:06:36.992,0:06:40.150
in silos rather than working together.

0:06:40.150,0:06:42.402
We can't accept that.

0:06:42.402,0:06:45.606
Right? You, all of you,[br]cannot accept that.

0:06:45.606,0:06:47.371
It's our lives on the line,

0:06:47.371,0:06:49.285
and in fact, actually,

0:06:49.285,0:06:52.234
many lives were lost,[br]many health care workers,

0:06:52.234,0:06:54.022
including beloved colleagues of mine,[br]five colleagues,

0:06:54.022,0:06:57.899
Mbalu Fonnie, Alex Moigboi,

0:06:57.899,0:06:59.478
Dr. Humarr Khan, Alice Kovoma,

0:06:59.478,0:07:02.009
and Mohamed Fullah.

0:07:02.009,0:07:04.331
These are just five[br]of many health care workers

0:07:04.331,0:07:05.933
at Kenema and beyond

0:07:05.933,0:07:09.114
that died while the world waited[br]and while we all worked

0:07:09.114,0:07:11.250
quietly and separately.

0:07:11.250,0:07:14.779
See, Ebola, like all threats to humanity,[br]it's fueled by mistrust

0:07:14.779,0:07:16.916
and distraction and division.

0:07:16.916,0:07:20.631
When we build barriers amongst ourselves,[br]and we fight amongst ourselves,

0:07:20.631,0:07:22.604
the virus thrives.

0:07:22.604,0:07:24.485
But unlike all threats to humanity,

0:07:24.485,0:07:27.155
Ebola is one where[br]we're actually all the same.

0:07:27.155,0:07:29.059
We're all in this fight together.

0:07:29.059,0:07:32.078
Ebola on one person's doorstep[br]could soon be on ours.

0:07:32.078,0:07:35.003
And so in this place[br]with the same vulnerabilities,

0:07:35.003,0:07:37.325
the same strengths,[br]the same fears, the same hopes,

0:07:37.325,0:07:40.947
I hope that we work together with joy.

0:07:40.947,0:07:45.521
A graduate student of mine[br]was reading a book about Sierra Leone,

0:07:45.521,0:07:49.422
and she discovered that the word Kenema,[br]the hospital that we work at,

0:07:49.422,0:07:51.326
the city where we work in Sierra Leone,

0:07:51.326,0:07:55.552
is named after the Mende word[br]for clear like a river, translucent,

0:07:55.552,0:07:57.502
and open to the public gaze.

0:07:57.502,0:08:00.103
And that was really profound for us,[br]because without knowing it,

0:08:00.103,0:08:04.306
we'd always felt that to honor[br]the individuals in Kenema where we worked,

0:08:04.306,0:08:09.112
we had to work openly, we had to share,[br]and we had to work together.

0:08:09.112,0:08:11.945
And we have to do that.[br]We all have to demand that

0:08:11.945,0:08:15.776
of ourselves and others,[br]to be open to each other

0:08:15.776,0:08:18.632
when an outbreak happens,[br]to fight in this fight together.

0:08:18.632,0:08:21.325
Because this is not the first[br]outbreak of Ebola,

0:08:21.325,0:08:23.159
it will not be the last,

0:08:23.159,0:08:25.737
and there are many other microbes[br]out there that are lying in wait,

0:08:25.737,0:08:27.757
like Lassa virus and others,

0:08:27.757,0:08:31.402
and the next time this happens,[br]it could happen in a city of millions,

0:08:31.402,0:08:32.633
it could start there.

0:08:32.633,0:08:35.140
It could be something[br]that's transmitted through the air.

0:08:35.140,0:08:37.439
It could even be disseminated[br]intentionally.

0:08:37.439,0:08:40.318
And so I know that that is frightening,[br]I understand that,

0:08:40.318,0:08:43.104
but I know also,[br]and this experience shows us,

0:08:43.104,0:08:46.262
that we have the technology,[br]and we have the capcity

0:08:46.262,0:08:47.795
to win this thing,

0:08:47.795,0:08:50.883
to win this and have[br]the upper hand over viruses,

0:08:50.883,0:08:53.507
but we can only do it[br]if we do it together

0:08:53.507,0:08:55.132
and we do it with joy.

0:08:55.132,0:08:59.172
So for Dr. Khan and for all of those[br]who sacrificed their lives

0:08:59.172,0:09:02.957
on the front lines in this fight[br]with us always,

0:09:02.957,0:09:05.836
let us be in this fight with them always,

0:09:05.836,0:09:08.413
and let us not let the world[br]be defined by the destruction

0:09:08.413,0:09:10.038
wrought by one virus,

0:09:10.038,0:09:12.546
but illuminated by billions[br]of hearts and minds

0:09:12.546,0:09:14.079
working in unity.

0:09:14.079,0:09:15.820
Thank you.

0:09:15.820,0:09:24.378
(Applause)