In fighting Ebola, Canadian credited with energizing WHO response

After months of regularly delivering bad news about the Ebola outbreak in West Africa, Dr. Bruce Aylward allowed himself a broad smile Monday.

The news was not uniformly good. New Ebola cases are being reported in western Sierra Leone at an astronomical rate and the contagion there is still out of control. But the epidemic has slowed in Liberia and Guinea, and the World Health Organization is meeting the target it set two months ago of isolating 70 percent of infected people so they can’t spread the disease and burying 70 percent of the dead in a way that doesn’t further the contagion.

The low-key Aylward declared progress. “This was a very different place 60 days ago,” he said.

For Aylward, a Canadian physician and epidemiologist, the heroes of the battle against Ebola are the medical workers who’ve risked their own health to treat the sick, the political leaders of the countries where the disease rages and the members of the communities who’ve suffered through the disease.

For many other experts, however, Aylward is a key figure himself, the person who helped turn the tide by working to organize the response in the field.

On Monday, Aylward said there was still much to be done. And progress also brings a risk: that the world will ease up on its push against the disease. “We’ve reached an important milestone along the way, but that is not going to get you to zero” new cases, Aylward said.

Only at zero can the world be assured that the outbreak has been beaten. And zero, he argued, will come only when 100 percent of the infected people have been isolated and are receiving treatment, when 100 percent of burials are safe and when health workers can trace 100 percent of those who’ve had contact with sick people.

“The rigor to get to zero will not come through” if the global effort slackens, he said.

Insiders give the 51-year-old Aylward, who’s written more than 100 peer-reviewed scientific articles and book chapters, credit for providing strategic vision that was lacking for many months after the outbreak was officially reported to the WHO in March.

“Bruce took over like a general,” said a health diplomat who spoke to McClatchy only on the condition of anonymity because of the sensitivity of the subject. For months, the WHO’s response had been consistent with protocol but there was no urgency, “no command,” as the diplomat put it. By the time Aylward took control, the epidemic was raging out of control. Aylward set goals and insisted on results, the diplomat said.

“When Bruce took the head seat, things started moving immediately,” the diplomat said.

Trained as a physician at the Memorial University of Newfoundland before undertaking specialist training in internal medicine in Vancouver, and later at the London School of Hygiene and Tropical Medicine and the Johns Hopkins Bloomberg School of Public Health, Aylward is the WHO’s assistant director-general for polio and emergencies.

The agency “could not get traction” as the epidemic worsened, the diplomat said. Another diplomat here, who also insisted on anonymity, said the WHO’s response had been hobbled by cutbacks in global financial contributions that had forced hundreds of layoffs.

Aylward’s focused approach, enormous energy and low-key style made the difference.

“Bruce is indefatigable,” said David Heymann, a professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine.

Heymann traces the turnaround in the WHO’s response to a meeting in June when Aylward made the case that the epidemic deserved far more attention than it was getting. He effectively took over the fight from an Africa office whose response has been described as unfocused.

For Heymann, Aylward’s leadership in combating Ebola was familiar. For the last 15 years, Heymann had watched Aylward lead the WHO’s global effort to eradicate polio. Heymann, who led the successful WHO response to the 2003-04 SARS outbreak and the 1995 Ebola outbreak in the Democratic Republic of the Congo, was Aylward’s boss when he assumed that role in 1998.

“He speaks with ease, conviction and competence about both operational activities and complicated scientific issues,” Heymann said. “He’s a tireless strategist, interpreter of data and evidence-based scientist.”

Known for informality – he once gave this reporter a ride home after a radio interview on the back of his motor scooter – Aylward is also known for his optimism. A senior WHO official who asked to remain anonymous because he didn’t want to speak publicly about a colleague called Aylward a “glass 80-percent full person.”

“He’s someone who has very strong self-belief and encourages others to share their self-belief,” he said.

Still, the Ebola crisis has been a difficult one, added to Aylward’s other responsibilities of eradicating polio and delivering lifesaving medical aid in war zones in Syria, Iraq, Somalia and the Central Africa Republic. Aylward recently acknowledged that he often gets only two hours of sleep per night.

That makes some of his staff recognize “the danger of burnout,” said Sona Bari, who’s worked with Aylward for the past 10 years. Few, however, think that will be a problem. “He has incredible reserves of energy,” Bari said.

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