>> thousands are dead i'm lisa fletcher, and you are in the "stream." thousands are dead with no end in sight. the latest on the ebola outbreak plaguing west africa. has the world's response been adequate? ♪

my digital producer and co-host, wajahat ali is here, bringing in all of your needback. and the question was has the world response been adequate is really engaging our viewers? >> we did a segment on this about a month and a half ago, and the number was 600 deaths, now the number is about 2500. and the hashtag is still trending. it has gone viral, pardon the use of the word. and we have this info graphic from cdc. check that out real quick. huge response from our community: good question. and i have to bring this one up:

i'm sure people disagree. >> we'll talk about why that may be a naive comment. it began as an isolated case and has transformed into the worst ebola outbreak in history. there have been more than 4900 cases and close to 2500 deaths from ebola in the last six months, spanning five african countries. fear and misinformation grip the people, making it even more difficult for health workers struggling with few supplies and limited global support to contain the virus. and the medical resources that some of the affected countries do have, are dwind -- dwindling. president obama is at the cdc

today, and has a proposed $88 million plan to combat the spread. what are some of the potential global consequences if we fail to act? joining us on set is professor of microbiology and immunology, and the former chief of viral path genesis and immunology for the u.s. army medical research institute of infection diseases. he worked on ebola in the past, and helped to dent any one of the antibodies. and spokesperson and chief of crisis communities through the united nations children's fund or unicef. many of the agencies are saying things like it's moving faster than they can keep up with, and it is spreading like wildfire.

steven this isn't the first time that ebola has hit around the world. what is making this different? and why the increased magnitude of cases? >> you are right. the earlier two dozen cases were small, remote outbreaks. the biggest number of cases was in 2000 with about 420 cases. we're now at almost 5,000 and half of that in terms of fatalities. what happened here was you had a population that was naive to ebola. they had not seen it. you had exceptionally weak public health system so you did not have surveillance and detection. the first case was last december, it was not confirmed until march 22nd. you had a lot of distrust. a lot of people were running away from health facilities that were themselves extremely weak, and you had bad political

leadership on top of that. you had it migrate from the rural forest areas into the coastal capitols, and it jumped. >> and then it's where people are more tran see enth. >> right. and the population movement was very important. because in west africa, you have lots of migration. so you add in exceptional weak health infrastructure, very poor governing patterns, lots of distrust, and an epidemic driven underground, and the fact it leapt from one country to three, and into populated areas, that has created this perfect storm that we have seen. earlier in the april time frame there was a thought that the

worst had past, but in fact it had been driven underground, and when it came back with a flurry at the end of the summer, almost everyone was caught off guard. it was a great wake-up call for public health officials. and the world health organization, the w.h.o., its staff and budget had been gutted in the last three years. it was utterly incapable of responding and leading on this. msf has been the great hero in this story. it is carrying two-thirds of the case load in this region. if it wasn't for doctors without borders, it would be extraordinarily bad. >> sarah i want to bring you into the conversation. you have been on the ground. we hear the numbers, and see the reports, how much worse it is there than we're actually hearing? >> there's a no question there is a real sense of trepidation,

but there st also a real sense of resolve. i have been where the outbreak happened much earlier in the year, here in monrovia, that has the highest case load. we do see this being lead by liberiians. they do feel abandoned, and that the international response has not been enough, and has not been fast enough. every single day without the country, throughout monrovia and the other countries, people are going out, social mobilelizes, unicef, world health organization, this is entirely joined up, so at this stage we don't feel it is helpful to look back. we have to look forward, and get focused on the job at hand. and we are. we're working with communities, working with households, on

prevention messages on trying to arm them with the best means that they can have at that disposal in order to stop the spread. >> sarah here is a really bold comment: sarah is on the ground, and i'm going to be sharing some of your photos here, a ebola survivor mimics the doctors and their masks. here is another one from sarah: there's info graphic here again by the cdc, shows all of the countries where it has broken out in west africa. one in two people who get ebola who get this outbreak have died. >> because people eat the bats not because they have been bitten by the bats. >> that's right.

and here is a quote from an infection disease doctor, he says this has the potential to alter history as much as any plague has ever done, end quote. do you agree with that statement? >> i agree to the extent that it is a worst-case outcome. yes, if ebola should change its biologies from the passage to human to human to human, it could potentially -- very unlikely, but could potentially migrate to a global pandemic. it's a very remote possibility, but not a zero possibility. >> are you talking about a mutation where the virus could potentially become airborne? >> well, yes, that's -- that would be the most troubling way for the virus to begin to spread. all of these viruses mutate. this virus is -- because they

make mistakes when they copy themselves, so most of those mutations are harmless, some are lethal to the virus. some provide the virus an advantage in a new situation that it's in, in this case in the human population when the virus has well adapted to persisting in another species, presumably bats. so what we're concerned about, of course, is step by step that there will be an adaptation to respiratory or some other means of spread. >> stephen, you know, when you hear people like allan, or the acting director of the cdc use this kind of language that typically these people are very conservative with how they speak, and when they start using this kind of language, it could be the worst pandemic we have ever seen, what does that tell you about what is being said behind the scenes? >> well, there was a convergence

of opinion across the skek trum of global health leaders that this situation woutz of control. it has a reproduction rate of one to two. it is still in that form, so it has the possibility of migrating into 10 or 12 of the neighboring or nearby states, many of which are quite vulnerable themselves. so that is capturing people. what sarah was saying about the resolve of the communities in liberia that are emerging, absolutely critical that that happen. and it is also absolutely critical to summarize that when the defense minister was here ten years ago in new york, it was a message of utter desperation. when the president sent the letter to our president, it was we need to take extraordinary measures to rescue this

situation from an existential threat. >> that's something we're going to get into after the break. you just mentioned the spread to ore countries. sa recent study says ebola virus could hit 15 additional countries. we're joining by the third u.s. doctor currently undergoing treatment for ebola. his story up next. ♪ josh rushing reports, on al jazeera america

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welcome back. not a day goes by without new and even more disturbing information emerging about the ebola virus in west africa, and the speed with which it is spreading. >> alan, absent a vaccine, why can't it be stopped or contained? >> well, i think the main reason it has not been stopped are the combination of the poverty and the relatively weak medical structure, and the cultural unfamiliarity of the virus lead to what was referred to as the exponential spread, and the

outbreak is growing, so the public health containment measures, is going to be intended to bring that number down to less than 1, and i hear some optimism that the community there is beginning to accept that that's the behavioral issues about how you come in to close contact with persons who are infected or who have died of virus needs to be reversed. vaccines and therapies have an important role in all of this, especially in protecting medical workers and contacts of those who have been infected, but the main prevention, the way to bend that curve is going to be isolation and quarantine, and

identification of cases. >> alan how much risk is there to the general population when infected individuals are brought into the u.s. for treatment? >> when the virus has not changed from the virus we have always known as ebola virus, the risk is just negligible. so close to zero -- because the person is brought in known to be infected, all protected measures are in place. everybody in contact with that person unprotected is well-known, and we could easily distinguish the virus as we know this virus would not spread in the u.s. >> so donald trump putting out a tweet saying we have enough problems, implying it is foolish of the president to send 300

members of the military to be a place where they would be exposed and then come home, that's an unfounded fear on his part? >> lots of donald trump's fears are unfounded. >> in one moment i want to bring you in sarah, but i want to bring in george, the team heard for liberia response for sudan interior mission. one of his colleagues is being treated for ebola here in the united states. george, i want to get your opinion on something, the world health organization received to let dr. buk out of sierra leone for treatment, and she died. why are they making distinctions from doctors who have been flown out and doctors are from these

countri countries ravaged by the disease. >> well, that's a tough question. i know our government is very concerned about the welfare of our people, so they will go to any pressure they need to get the people out to get the best possible care. i don't know what the world health organization's methodology would have been for that. >> we are want to get our commune three in on this. and sarah going back to your twitter profile. check this out, those are literally garbage bags on the hands of the patients. what is your response to the international response? the u.s. has spent $100 million. it is requesting $88 million from congress. the dod already has $500 million. they are going to send 3,000

ground troops. what should be done? what needs to be done? >> well, it's all very important and very useful, the country and the region needs all of the help it can get. i think it's important to focus on the job at hand, and not get caught up in the psychosis of fear because it can be paralyzing. unicef has been here for many, many decades, throughout the war and peacetimes, and yes, it's a fragile health system, but liberia did reduce child mortality -- had the fastest decline in child mortality on the african continent. and communities are taking matters into their own hands and doing what they can in their own xh -- communities. so out there this program training that unicef is doing with all of its different

partners, and this is very much a great effort by all sorts of different agencies, but it needs a kind of army of volunteers and people going out, and liberiians are doing it with very little pay as well. >> i i'm -- because you just for a second sarah. i want to bring area back into the conversation. does there need to be a more centralized response? does there need to be, maybe the u.n. commanding what is going on? >> well, there's two sides to this equation. one is what is happening on the ground at the community level, which sarah eloquently pointed to, the initiatives underway. at a higher level, is how do you break the isolation, the collapse of the air bridges into the region? how do you compensate for that? how do you create the security environment?

order to be able to standing up very rapidly the field hospitals, the mobile laboratories that are required, and be able to inject several thousand health workers who are understandably going to be very reluckant to jump into this setting, unless they feel like they have the proper equipment, and also that the places they are working aren't completely swamped -- >> so yes, on a more coordinated response? >> yes, and the president's announcement today is pushing towards having a flag officer be in control of the u.s. operation. we have a team on the ground, sarah can talk about that, but we're moving towards the us-africa command being the surge capacity in this conversation. >> all right. got to get to break. still ahead, how close are we to

an approved vaccine in and even if prom missing drugs are on the horizon, does the world have the time to wait?

>> sharks like affection >> spot on... >> don't try this at home... >> tech know, only on al jazeera america ♪ my name is aaron brown and i'm in writer, and i'm in "the

stream." >> welcome back, scientists estimate there have been more person the person transmissions of the ebola virus in the last four months than the last 500 years. with no known cure, several western doctors have been treated with experimental drugs and have survived. alan, talk about the experimental serums they are using and whether we even know they are working or these people are getting better maybe on their own. >> well, we don't know whether they are working, because at least half of the people recover from ebola infection without treatment and probably a higher proportion if they are healthy and well treated. so we don't know whether these are working. emery and omaha are centers because they are specifically

set set up ahead of time for containment of patients that have diseases exactly like this. so they are pre-positioned for the highest levels of patient care. we have multiple vaccines in the pipeline. i can think of at least six, there are probably seven or eight that are pre-positioned ready to be tested, but it will be a while before we know whether they are actually going to work, and it's not a great experimental situation in which to find out whether they work, because we're going to do everything we can to protect even vaccinated people with barrier gloves, masks, gowns, et cetera. >> alan that's the exact question we asked our community, should ebola patients be given experimental treatments:

stephen what is your response to that? >> first of all you need to distinguish between vaccines which you give to healthy people in hopes of protecting them against a future threat, versus giving a therapy to someone who is at risk of dying eminently. so you have two quite different situations, and there is a humane flexibility in under dire circumstances in providing therapies to people that you know have a very high chance of dying, and you are simply trying whatever you can. whereas with vaccines, before you start giving healthy people vaccines, you have to be completely confident that the safety and efficacy have all been proven. the point to emphasize here for

this current crisis of the next nine to 18 months, right now we have no vaccine tested and ready to go with proven efficacy. the therapies same thing. and there's an accelerated effort now to bring those forward, but you can't determine, you can't anticipate too well what the schedule is going to be in bringing forward ones that you want to use in this population and that can be produced on scale in an affordable level on time and delivered. so there's no quick fix to this. one thing you are going to see, though is greater emphasis in innovation, i believe in drawing the antibodies from the populations of survivors and using those as a serum of antibodies, specific to ebola and doing experimentation and rejecting those. sarah? >> george we have got about a minute left in the show.

wrap this up for us. give us the latest on how your colleague is doing, and your final thoughts, please. >> yeah, thanks for asking. rick is progressing steadily. every day seems to be better than the day before. his outgoing personality is back in full force, and he's even helping communicate with the people on the ground in liberia and contributing to some of the medical efforts they are trying to put forward. they are doing a lot of work in the blood serum front specifically as well as dealing with body fluids and different approaches to try to help these people. we have seen some tremendous strides in improving the health of people who have contracted ebola. so there's some hope out there. >> thanks so all of our guests. we appreciate your time until. until next time, waj and i will see you online at

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