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You may never heard of Kenema,
Sierra Leone, or Arua, Nigeria,
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but I know them as two of the most
extraordinary places on Earth.
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In hospitals there, there's a community
of nurses, physicians, and scientists
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that have been quietly battling
one of the deadliest threats
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to humanity for years: Lassa virus.
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Lassa virus is a lot like Ebola.
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It can cause a severe fever
and can often be fatal.
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But these individuals,
they risk their lives every day
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to protect the individuals
in their communities,
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and by doing so protect us all.
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But one of the most extraordinary things
I learned about them
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on one of my first visits out there
many years ago
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was that they start each morning,
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these challenging, extraordinary days
on the front lines, by singing.
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They gather together
and they show their joy.
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They show their spirit,
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and over the years, from year after year
as I've visited them and they visited me,
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I get to gather with them and I sing
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and we write and we love it,
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because it reminds us that we're not
just there to pursue science together.
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We're bonded through a shared humanity.
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And that, of course, as you can imagine
becomes extremely important,
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even essential, as things begin to change,
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and that changed a great deal
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in March of 2014
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when the Ebola outbreak
was declared in Guinea.
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This is the first outbreak in West Africa,
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near the border
of Sierra Leone and Liberia,
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and it was frightening,
frightening for us all.
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We had actually suspected for some time
that Lassa and Ebola
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were more widespread than thought,
and we thought it could one day
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come to Kenema.
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And so members of my team
immediately went out
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and joined Dr. Humarr Khan
and his team there,
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and we set up diagnostics to be able
to have sensitive molecular tests
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to pick up Ebola if it came
across the border and into Sierra Leone.
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We'd already set up this kind capacity
for Lassa virus. We knew how to do it.
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The team is outstanding.
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We just had to give them to tools in place
to survey for Ebola.
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And unfortunately, that day came.
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On May 23, 2014, a woman checked in
to the maternity ward at the hospital,
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and the team ran
this important molecular test,
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and they identified the first confirmed
case of Ebola in Sierra Leone.
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This was exceptional work that was done.
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They were able to diagnose
the case immediately,
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to safely treat the patient,
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and to begin to do contact tracing
to follow what was going on.
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It could've stopped something,
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but by the time that day came,
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the outbreak had already
been breeding for months.
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With hundreds of cases, it had already
eclipsed all previous outbreaks,
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and it came into Sierra Leone
not as that singular case
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but as a tidal wave.
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We had to work
with the international community,
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with the Ministry of Health, with Kenema,
to begin to deal with the cases,
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as the next week brought 31,
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then 92, then 147 cases,
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all coming to Kenema, one of the only
places in Sierra Leone
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that could deal with this.
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And we worked around the clock
trying to do everything we could,
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trying to help the individuals,
trying to get attention,
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but we also did one other simple thing:
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from that specimen that we take
from a patient's blood to detect Ebola,
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we can discard it, obviously.
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The other thing we can do is actually
we can put in a chemical
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and deactivate it, so just a simple
place it into a box
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and ship it across the ocean,
and that's what we did.
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We sent it to Boston where my team works,
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and we also worked around the clock
doing shift work day after day,
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and we quickly generated 99 genomes
of the Ebola virus.
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This is the blueprint.
The genome of a virus is the blueprint.
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We all have one. It says everything
that makes up us,
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and it tell us so much information.
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The results of this kind of work
are simple and they're powerful.
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We could actually take
these 99 different viruses,
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look at them and compare them,
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and we could see actually
compared to three genomes
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that had been previously
published from Guinea,
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we could show that the outbreak
emerged from Guinea months before,
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once into the human population,
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and from there had been transmitting
from human to human.
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Now, that's incredibly important
when you're trying to figure out
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how to intervene, and the important thing
is contract tracing.
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We also could see that as the virus
was moving between humans,
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it was mutating,
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and each of those mutations
are so important,
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because the diagnostics, the vaccines,
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the therapies that we were using
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are all based on that genome sequence
fundamentally.
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That's what drives it,
so global health experts
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would need to respond,
would have to develop,
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to recalibrate everything
that they were doing.
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The way that science works,
the position that I was in at that point
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is I had that data and I could have worked
in a silo for many, many months,
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analyzed the data carefully, slowly,
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submitted the paper for publication,
gone through a few back-and-forths,
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and then finally when the paper came out,
might release that data.
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That's the way the status quo works.
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Well, that was not going to work
at this point. Right?
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We had friends on the front lines,
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and to us it was just obvious
that what we needed is help,
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lots of help.
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So the first thing we did was,
as soon as the sequences
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came off the machines,
we published it to the web.
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We just released it to the whole world
and said, "Help us." And help came.
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Before we knew it, we were being contacted
from people all over,
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surprised to see the data
out there and released.
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Some of the greatest
viral trackers in the world
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were suddenly part of our community.
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We were working together
in this virtual way,
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sharing, regular calls, communications,
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trying to follow the virus
minute by minute
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to see ways that we could stop it.
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And there are so many ways
that we can form communities like that.
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Right? Everybody, particularly when
the outbreak started to expand globally,
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was reaching out to learn,
to participate, the engage.
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Everybody wants to play a part.
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The amount of human capacity
out there is just amazing,
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and the Internet connects us all,
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and could you just imagine that instead
of being frightened of each other,
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that we all just said, "Let's do this,
let's work together,
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and let's make this happen."
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But the problem is that the data
that all of us are using,
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Googling on the Web, is just too limited
to do what we need to do.
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And so many opportunities
get missed when that happens.
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So in the early part
of the epidemic from Kenema,
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we'd had 106 clinical records
from patients,
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and we once again made that
publicly available to the world.
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And in our own lab, we could show
that you could take those 106 records,
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we could train computers to predict
the prognosis for Ebola patients
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to near 100 percent accuracy,
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and we made an app that could release that
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to make that available
to health care workers in the field.
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But 106 is just not enough, right,
to make it powerful,
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to validate it.
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So we were waiting for more data
to release that,
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and the data has still not come.
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We are still waiting, tweaking away,
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in silos rather than working together.
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We can't accept that.
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Right? You, all of you,
cannot accept that.
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It's our lives on the line,
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and in fact, actually,
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many lives were lost,
many health care workers,
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including beloved colleagues of mine,
five colleagues,
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Mbalu Fonnie, Alex Moigboi,
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Dr. Humarr Khan, Alice Kovoma,
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and Mohamed Fullah.
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These are just five
of many health care workers
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at Kenema and beyond
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that died while the world waited
and while we all worked
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quietly and separately.
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See, Ebola, like all threats to humanity,
it's fueled by mistrust
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and distraction and division.
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When we build barriers amongst ourselves,
and we fight amongst ourselves,
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the virus thrives.
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But unlike all threats to humanity,
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Ebola is one where
we're actually all the same.
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We're all in this fight together.
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Ebola on one person's doorstep
could soon be on ours.
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And so in this place
with the same vulnerabilities,
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the same strengths,
the same fears, the same hopes,
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I hope that we work together with joy.
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A graduate student of mine
was reading a book about Sierra Leone,
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and she discovered that the word Kenema,
the hospital that we work at,
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the city where we work in Sierra Leone,
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is named after the Mende word
for clear like a river, translucent,
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and open to the public gaze.
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And that was really profound for us,
because without knowing it,
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we'd always felt that to honor
the individuals in Kenema where we worked,
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we had to work openly, we had to share,
and we had to work together.
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And we have to do that.
We all have to demand that
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of ourselves and others,
to be open to each other
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when an outbreak happens,
to fight in this fight together.
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Because this is not the first
outbreak of Ebola,
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it will not be the last,
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and there are many other microbes
out there that are lying in wait,
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like Lassa virus and others,
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and the next time this happens,
it could happen in a city of millions,
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it could start there.
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It could be something
that's transmitted through the air.
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It could even be disseminated
intentionally.
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And so I know that that is frightening,
I understand that,
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but I know also,
and this experience shows us,
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that we have the technology,
and we have the capcity
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to win this thing,
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to win this and have
the upper hand over viruses,
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but we can only do it
if we do it together
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and we do it with joy.
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So for Dr. Khan and for all of those
who sacrificed their lives
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on the front lines in this fight
with us always,
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let us be in this fight with them always,
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and let us not let the world
be defined by the destruction
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wrought by one virus,
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but illuminated by billions
of hearts and minds
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working in unity.
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Thank you.
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(Applause)