0:00:05 > 0:00:10It's 10am at the Centers for Disease Control in Atlanta, Georgia.
0:00:10 > 0:00:13It has again been a busy week and there's going to be
0:00:13 > 0:00:16a lot of issues that we need to address today, so some of the
0:00:16 > 0:00:20priority issues are going to be thinking about staffing for Senegal.
0:00:20 > 0:00:23We look forward to deploying more staff next week.
0:00:23 > 0:00:24Chief Science Officer?
0:00:24 > 0:00:29We've started to tackle the issue of the potential mutation of the virus.
0:00:29 > 0:00:31At the daily briefing,
0:00:31 > 0:00:35American officials are tracking the spread of the deadly Ebola virus.
0:00:35 > 0:00:39The outbreak is bad and it's getting worse.
0:00:39 > 0:00:43This is the worst Ebola epidemic there's ever been...
0:00:43 > 0:00:45A couple of weeks ago, it has surpassed
0:00:45 > 0:00:48all previously recorded cases of Ebola.
0:00:48 > 0:00:52..and efforts to contain the outbreak are failing.
0:00:52 > 0:00:55Do you feel that we're winning against this Ebola outbreak?
0:00:55 > 0:00:59I think we're learning from this Ebola outbreak.
0:00:59 > 0:01:02And we hope that we will win
0:01:02 > 0:01:05but I think we have a lot of work ahead of us.
0:01:05 > 0:01:08But there is hope.
0:01:08 > 0:01:11I feel so lucky to be alive,
0:01:11 > 0:01:15and there's a lot of people dying elsewhere
0:01:15 > 0:01:18that are not as fortunate as me.
0:01:18 > 0:01:22I believe you all have heard about the outbreak in West Africa.
0:01:22 > 0:01:28If we succeed, we would be able to control certain kinds of situations.
0:01:30 > 0:01:34Horizon meets the medics fighting Ebola on the front line...
0:01:34 > 0:01:38Luckily, in a protective suit, no-one can see if you're crying
0:01:38 > 0:01:39and so no-one can tell.
0:01:39 > 0:01:43People are very fearful of health care workers and I can understand.
0:01:43 > 0:01:45I mean, can you imagine?
0:01:45 > 0:01:47They take one of your loved ones away
0:01:47 > 0:01:50only to return with the loved one in a body bag.
0:01:50 > 0:01:53..and follows the scientists racing to find a cure
0:01:53 > 0:01:56for one of the most dangerous killers on Earth.
0:01:58 > 0:02:03To scale this up to make 1,000 doses, or 5,000 doses,
0:02:03 > 0:02:08that's like trying to get a little hybrid to compete with a Maserati.
0:02:10 > 0:02:14This is an extraordinary story of bravery and determination
0:02:14 > 0:02:16against a deadly enemy.
0:02:30 > 0:02:33Sunday night, two and a half weeks ago.
0:02:33 > 0:02:36An RAF plane flew into London from Sierra Leone.
0:02:38 > 0:02:41On-board, a British nurse suffering from Ebola.
0:02:43 > 0:02:45There were moments on the flight
0:02:45 > 0:02:49when I was feeling quite unwell and was afraid.
0:02:49 > 0:02:52My temperature went up quite quickly.
0:02:52 > 0:02:53It was a scary time.
0:02:54 > 0:02:57I first heard in the middle of the night
0:02:57 > 0:03:00and began to put the plan into operation.
0:03:00 > 0:03:02By the next day, it was in full flow.
0:03:03 > 0:03:07In the ambulance, I remember I had a nurse,
0:03:07 > 0:03:12I remember her telling me about the police bikes doing relays,
0:03:12 > 0:03:16shutting the road off as we drove along.
0:03:16 > 0:03:18This is our business, this is what we do.
0:03:18 > 0:03:21So, 24 hours a day, seven days a week,
0:03:21 > 0:03:25we are here for exactly these sorts of problems.
0:03:25 > 0:03:29Will Pooley was about to receive an experimental treatment called ZMapp.
0:03:30 > 0:03:34Getting into hospital was...
0:03:34 > 0:03:36yeah, a great comfort to me.
0:03:38 > 0:03:41The world's attention may temporarily have been
0:03:41 > 0:03:45on Britain's first Ebola patient, but the story of the outbreak
0:03:45 > 0:03:50began nine months ago, when fear and devastation came to West Africa.
0:03:59 > 0:04:03On 6th December last year, a child, much like this one,
0:04:03 > 0:04:06living in a remote village in Guinea, West Africa,
0:04:06 > 0:04:08died from a mysterious fever.
0:04:10 > 0:04:13The boy's symptoms included severe diarrhoea,
0:04:13 > 0:04:16vomiting and internal bleeding.
0:04:16 > 0:04:19His painful death went unnoticed by the outside world,
0:04:19 > 0:04:21and we don't even know his name.
0:04:23 > 0:04:26But epidemiologists call the boy "patient zero" -
0:04:26 > 0:04:28the first suspected case of what has now become
0:04:28 > 0:04:32the largest outbreak of Ebola the world has ever seen.
0:04:38 > 0:04:42Within days, the boy's mother, sister and grandmother
0:04:42 > 0:04:46all died after suffering the same horrific symptoms.
0:04:46 > 0:04:50Then, two local nurses who had treated the family also died.
0:04:50 > 0:04:52The epidemic had begun.
0:04:57 > 0:05:00How might patient zero have caught Ebola?
0:05:00 > 0:05:03Scientists aren't sure, but they think the virus is carried
0:05:03 > 0:05:08by African fruit bats, that are not affected by the disease.
0:05:08 > 0:05:10Many people in Guinea eat these bats and other bush meat
0:05:10 > 0:05:13that could potentially be infected
0:05:13 > 0:05:16and that may be how the virus jumps to humans.
0:05:18 > 0:05:21But there had never been an outbreak of Ebola in Guinea before,
0:05:21 > 0:05:25so patient zero's symptoms were not identified.
0:05:29 > 0:05:32Undiagnosed, the virus swept into a neighbouring village,
0:05:32 > 0:05:36probably taken there by mourners who had attended the first funerals.
0:05:39 > 0:05:41And then it was taken into another village,
0:05:41 > 0:05:43and then another, and another.
0:05:45 > 0:05:48And so the chain of infection spread ever wider.
0:05:53 > 0:05:55So far, in the current outbreak,
0:05:55 > 0:05:59every single victim can be traced back to patient zero.
0:06:07 > 0:06:09It wasn't until 14 weeks after the first deaths
0:06:09 > 0:06:12that the epidemic was confirmed.
0:06:14 > 0:06:18At the Centers for Disease Control in Atlanta, Dr Inger Damon believes
0:06:18 > 0:06:21this delay has made the outbreak harder to contain.
0:06:24 > 0:06:28There was a delay in being able to effectively recognise it
0:06:28 > 0:06:31and then to respond to it, and the delay in response,
0:06:31 > 0:06:34you see additional generations of cases develop
0:06:34 > 0:06:35as people don't know what to do
0:06:35 > 0:06:39to protect themselves or protect their communities.
0:06:40 > 0:06:43- RADIO:- 'Scientists in France have identified the Ebola virus
0:06:43 > 0:06:46'as the source of an outbreak of haemorrhagic fever in Guinea
0:06:46 > 0:06:48'which is believed to have...'
0:06:48 > 0:06:51- RADIO:- '..vingt-trois infectes par la fievre Ebola.'
0:06:51 > 0:06:56But in late March, as news of the Ebola outbreak was first reported,
0:06:56 > 0:06:58the epidemic was already out of control.
0:07:04 > 0:07:07This is one of the few treatment centres in Guinea.
0:07:07 > 0:07:09It's run by Medecins Sans Frontieres,
0:07:09 > 0:07:12the international medical aid agency.
0:07:12 > 0:07:15It's a haven of humanity and compassion
0:07:15 > 0:07:18for those struck down by this terrible disease.
0:07:18 > 0:07:23The medical staff work in conditions most would find hard to imagine.
0:07:23 > 0:07:27It's very difficult to interact with people through three pairs of gloves.
0:07:27 > 0:07:31I try to touch people and stroke people, because they won't have
0:07:31 > 0:07:34had any physical contact with anybody since they've been in there.
0:07:38 > 0:07:40When I look in their eyes
0:07:40 > 0:07:44and people still don't understand the situation, I see a lot of fear.
0:07:45 > 0:07:51If they haven't become confused, I quite often see despair.
0:07:51 > 0:07:53SHE SOBS
0:07:57 > 0:07:59Ebola is an especially virulent disease.
0:08:01 > 0:08:03This is what the virus looks like.
0:08:06 > 0:08:10When it enters the body, it courses through the bloodstream,
0:08:10 > 0:08:14hijacking the victim's own cells to reproduce as fast as it can.
0:08:16 > 0:08:20Then its progeny rampage on, damaging cells
0:08:20 > 0:08:23and replicating in ever greater numbers.
0:08:24 > 0:08:28It infects the endothelial cells that line blood vessels
0:08:28 > 0:08:31and the patient starts bleeding on the inside.
0:08:33 > 0:08:37They start to bleed from their gums, from their nose,
0:08:37 > 0:08:40they have terrible bloody diarrhoea, vomiting.
0:08:40 > 0:08:42They feel terrible.
0:08:44 > 0:08:46In the current outbreak,
0:08:46 > 0:08:50almost half the patients managed to fight off the virus.
0:08:50 > 0:08:52But for those whose immune system isn't strong enough,
0:08:52 > 0:08:55their vital organs quickly start to fail.
0:09:00 > 0:09:03Quite often when you see the blood, or they start to hiccup,
0:09:03 > 0:09:05you know that the end is coming quite soon.
0:09:05 > 0:09:08You know they've got maybe one or two days left.
0:09:12 > 0:09:14Most patients die within 12 days,
0:09:14 > 0:09:18but the dead body of a victim is still contagious.
0:09:19 > 0:09:23So, those preparing the deceased for burial are at a very high risk
0:09:23 > 0:09:26of catching and then spreading the virus.
0:09:31 > 0:09:33It's a bit like erasing somebody.
0:09:33 > 0:09:35You put their body and seal it in a body bag,
0:09:35 > 0:09:38you take all their possessions, and you burn then
0:09:38 > 0:09:41and then you clean away their blood and their faeces,
0:09:41 > 0:09:43and then the next patients come.
0:09:47 > 0:09:49We allow relatives to come and view the bodies
0:09:49 > 0:09:53before we seal the bags, so we bring the bodies to the fence.
0:09:53 > 0:09:57I would always try and put flowers or toys around the face of the child
0:09:57 > 0:09:59to make it look pleasanter, if we could,
0:09:59 > 0:10:00and then the relatives would come and see.
0:10:00 > 0:10:02It was always a very hard moment.
0:10:10 > 0:10:15And when Ebola sweeps through a village, it leaves fear
0:10:15 > 0:10:17and suspicion in its wake.
0:10:17 > 0:10:21People are very fearful of health care workers and I can understand.
0:10:21 > 0:10:25Can you imagine - a car entering your village with people
0:10:25 > 0:10:29who are speaking a language that isn't necessarily your own,
0:10:29 > 0:10:31covered from head to toe.
0:10:34 > 0:10:37And they take one of your loved ones away,
0:10:37 > 0:10:41only to return the loved one in a body bag.
0:10:41 > 0:10:45It can be really difficult for people to understand that
0:10:45 > 0:10:46we're here to help.
0:10:50 > 0:10:54Ebola is a terrible disease, spreading fear and panic.
0:10:54 > 0:10:58There has never been a more urgent need to find a cure.
0:10:58 > 0:11:01Scientists have been trying to understand how Ebola works
0:11:01 > 0:11:03and how it's spread.
0:11:05 > 0:11:10It was first identified less than 40 years ago and the extraordinary
0:11:10 > 0:11:13story of its discovery begins a long way from tropical Africa...
0:11:16 > 0:11:18..in the city of Antwerp, Belgium.
0:11:20 > 0:11:23In 1976, a package containing a sample of blood
0:11:23 > 0:11:26arrived at Antwerp's Institute of Tropical Medicine,
0:11:26 > 0:11:29where Peter Piot was working as a young scientist.
0:11:31 > 0:11:35One day, we received a blue Thermos which contained two vials.
0:11:35 > 0:11:39Actually, one was broken.
0:11:39 > 0:11:42And in some ice, was swimming in there in water and ice,
0:11:42 > 0:11:44and it came from Kinshasa.
0:11:46 > 0:11:50The scientists in Antwerp had heard reports of a frightening new disease
0:11:50 > 0:11:55that had swept through a remote mission station in Central Africa.
0:11:55 > 0:11:59The specimen of blood came from a Belgian nun who had died there.
0:11:59 > 0:12:01After preparation,
0:12:01 > 0:12:05the sample was studied under an electron microscope.
0:12:05 > 0:12:08When we saw these worm-like structures coming
0:12:08 > 0:12:11out of the electron microscope, we were all a bit breathless,
0:12:11 > 0:12:14frankly, and said, "What the hell is this?"
0:12:16 > 0:12:18There was only one way to find out.
0:12:20 > 0:12:24Go to the source of this mysterious epidemic,
0:12:24 > 0:12:25the Congo.
0:12:29 > 0:12:31I really couldn't sleep. I was so excited.
0:12:31 > 0:12:34We left at five o'clock in the morning.
0:12:34 > 0:12:39I didn't know what to think. Central Africa is overwhelming.
0:12:39 > 0:12:43It's like flying over a green sea with a river in the middle.
0:12:44 > 0:12:49I was just very impatient to get there and to start working.
0:12:53 > 0:12:56So, after several hours of flight,
0:12:56 > 0:13:01so the plane goes down and lands on this red airstrip
0:13:01 > 0:13:04and we're landing and first of all,
0:13:04 > 0:13:07the pilots never stopped the engines
0:13:07 > 0:13:12because they were so scared and wanted to drop us
0:13:12 > 0:13:15and go back to Kinshasa.
0:13:17 > 0:13:22The team filmed their expedition, as this rare footage shows.
0:13:22 > 0:13:25From the airstrip, they headed off to their final destination -
0:13:25 > 0:13:27the ravaged mission station.
0:13:29 > 0:13:31And so, we arrived there.
0:13:31 > 0:13:37We stopped and we saw three Flemish nuns there and a priest.
0:13:37 > 0:13:39I said, "I'm Peter Piot.
0:13:39 > 0:13:44"I'm from the Institute of Tropical Medicine and we're coming here to
0:13:44 > 0:13:47"stop the epidemic and to help you."
0:13:47 > 0:13:50At 27, you think you can really save the world.
0:13:50 > 0:13:54And they said, "No, don't come near, don't come
0:13:54 > 0:13:58"near because we're all going to die."
0:13:58 > 0:14:0015 nuns and nurses
0:14:00 > 0:14:03and an unknown number of villagers had already been struck down.
0:14:04 > 0:14:08The team decided to name the mystery virus after the Ebola river
0:14:08 > 0:14:10that flowed nearby.
0:14:10 > 0:14:15Their first priority was to work out how the virus was being spread.
0:14:15 > 0:14:19They travelled to nearby villages, looking for clues.
0:14:19 > 0:14:21It was already rainy season.
0:14:21 > 0:14:27Some villages, we could not reach by road, and some we had to walk to.
0:14:27 > 0:14:30And some, we went by canoe.
0:14:32 > 0:14:36And when they found people who had contracted the virus,
0:14:36 > 0:14:38many were beyond help.
0:14:40 > 0:14:45They had this look in their eyes, staring at us,
0:14:45 > 0:14:49often in excruciating pain, particularly abdominal pain.
0:14:54 > 0:14:59They were coughing. Several of them had blood coming out of their nose.
0:15:09 > 0:15:13The scientists noticed that many carriers of the disease were
0:15:13 > 0:15:16young women who had visited the mission station hospital.
0:15:18 > 0:15:23What we found was that this was a hospital with no doctor, basically.
0:15:23 > 0:15:26The nuns and local nurses were running it, frankly,
0:15:26 > 0:15:28in a heroic way.
0:15:28 > 0:15:33But they had a major shortage of materials, including syringes
0:15:33 > 0:15:34and needles,
0:15:34 > 0:15:39and so we found that the antenatal consultation was very popular.
0:15:39 > 0:15:43And at the consultation, they would get an injection, and every morning,
0:15:43 > 0:15:47five needles and syringes were given to the antenatal consultations.
0:15:47 > 0:15:50And they were reused and reused and reused.
0:15:50 > 0:15:55The needles weren't sterilised and it quickly became clear
0:15:55 > 0:15:59that this was how the virus was being spread from person to person.
0:15:59 > 0:16:04But then, what we also found was that about one week after a funeral
0:16:04 > 0:16:10of someone with Ebola infection, you could see another outbreak.
0:16:11 > 0:16:15It wasn't just reusing the unsterilized needles.
0:16:15 > 0:16:18The scientists soon realised that the ritual of washing
0:16:18 > 0:16:22bodies before burial was also helping to spread the disease.
0:16:24 > 0:16:27The team had made a significant breakthrough.
0:16:27 > 0:16:30Ebola clearly wasn't an airborne virus,
0:16:30 > 0:16:33but was only spread through physical contact and bodily fluids.
0:16:43 > 0:16:46Ebola was identified at a time when suspicion
0:16:46 > 0:16:50and distrust between the West and the Soviet Union ran deep.
0:16:50 > 0:16:52It was the Cold War.
0:16:52 > 0:16:54What might happen
0:16:54 > 0:16:57if an enemy tried to use the virus in a biological weapon?
0:16:59 > 0:17:02Could a treatment, or even a vaccine, be developed?
0:17:04 > 0:17:08At Porton Down, Britain's military research base, scientists
0:17:08 > 0:17:12took a close interest in the new disease, as Horizon reported.
0:17:14 > 0:17:17'The most dangerous viruses from around the world are sent
0:17:17 > 0:17:21'here for identification and new ones keep turning up.
0:17:22 > 0:17:27'It wasn't until 1976 that this virus was identified. It's called Ebola.'
0:17:31 > 0:17:3340 years later,
0:17:33 > 0:17:37this part of Porton Down is no longer attached to the military.
0:17:37 > 0:17:40It's now a public health laboratory
0:17:40 > 0:17:43and it's home to a store of live Ebola virus.
0:17:43 > 0:17:46Dr Tim Brooks look after it.
0:17:50 > 0:17:53So what you're doing is you're taking the separated
0:17:53 > 0:17:55plasma from the whole blood.
0:17:55 > 0:17:58'The more we know about how this virus is put together,
0:17:58 > 0:18:00'how it interacts with cells,
0:18:00 > 0:18:02'how it affects cells in living animals,'
0:18:02 > 0:18:07the easier it is for us to work out how to control the disease and to
0:18:07 > 0:18:11begin to develop both vaccines and drugs that might cure the disease.
0:18:13 > 0:18:16Part of our work here, then, is to provide the front line diagnostic
0:18:16 > 0:18:19service for the United Kingdom for a whole range of unpleasant
0:18:19 > 0:18:23diseases that can be brought back here, one of which is Ebola.
0:18:25 > 0:18:29In the field, diagnosing patients quickly is an important
0:18:29 > 0:18:31part of trying to contain the outbreak.
0:18:32 > 0:18:36So Porton Down scientists have been sent to the front line to help
0:18:36 > 0:18:38the relief effort.
0:18:40 > 0:18:43I was in Guinea, at the epicentre, in Gueckedou.
0:18:43 > 0:18:47And I was there testing for the patient samples.
0:18:47 > 0:18:50The samples would come to us double-contained in a bleach bucket
0:18:50 > 0:18:52to make sure they were safe,
0:18:52 > 0:18:55and then we would test them for the virus.
0:18:58 > 0:19:02Outside of these labs, there was a perimeter fence where patients would
0:19:02 > 0:19:07be allowed to walk around and sit outside in the sun or in the shade.
0:19:07 > 0:19:09So you would see some people who were very sick,
0:19:09 > 0:19:13who would just want some fresh air, and would be sitting down,
0:19:13 > 0:19:16and would need help in and out of the ward.
0:19:18 > 0:19:21- RADIO:- 'The World Health Organisation says the current
0:19:21 > 0:19:25'outbreak of the deadly Ebola virus in West Africa is
0:19:25 > 0:19:27'one of the most challenging it has ever faced.'
0:19:31 > 0:19:35By early April, Ebola was spreading from Guinea to neighbouring
0:19:35 > 0:19:39Sierra Leone and Liberia,
0:19:39 > 0:19:43where there is one doctor for every 71,000 people, compared to
0:19:43 > 0:19:48Britain, which has approximately one doctor to every 350 people.
0:19:53 > 0:19:57Local health facilities had been completely overwhelmed.
0:20:01 > 0:20:05The health workers from MSF visited one hospital in Monrovia.
0:20:07 > 0:20:10There was supposed to be a doctor in there, who I'd heard had died
0:20:10 > 0:20:13the day before, and I couldn't find him on any of the beds.
0:20:13 > 0:20:15So then I checked the latrines,
0:20:15 > 0:20:21and the poor man had died in the toilet and was still there.
0:20:21 > 0:20:23They hadn't moved him.
0:20:23 > 0:20:26And apparently, he was there for another two days after that,
0:20:26 > 0:20:28before the burial team came and took him away.
0:20:30 > 0:20:33There were a lot of people in the confirmed area who
0:20:33 > 0:20:37were in great pain and groaning, or being sick, or calling out.
0:20:37 > 0:20:40If Dante had written a tenth Circle of Hell,
0:20:40 > 0:20:43this would have been it, I think.
0:20:43 > 0:20:45You try to be efficient. Um...
0:20:47 > 0:20:50Luckily, in a protective suit, no-one can see if you're crying,
0:20:50 > 0:20:52so no-one can tell.
0:20:57 > 0:21:00The British nurse Will Pooley was already
0:21:00 > 0:21:03working as a volunteer in Sierra Leone.
0:21:03 > 0:21:06As the outbreak spread, he went to one of the worst affected
0:21:06 > 0:21:10areas of the country to help at a hospital where several nurses
0:21:10 > 0:21:14had already died after contracting Ebola from their patients.
0:21:17 > 0:21:20Everyone is aware that it could be them next.
0:21:20 > 0:21:25And as you're providing that care for those colleagues,
0:21:25 > 0:21:28you might be risking infection.
0:21:29 > 0:21:36And so the team, they soldier on. But everyone... There's fear.
0:21:37 > 0:21:41And then one night, Will went to bed with a sore throat.
0:21:41 > 0:21:43I woke up in the morning feeling very fatigued.
0:21:43 > 0:21:49My body was aching all over. I had a headache and a temperature.
0:21:49 > 0:21:53At lunchtime, I went and spoke to the doctors
0:21:53 > 0:21:59and they recommended that I have a blood test to test for Ebola.
0:21:59 > 0:22:02Later that day, the results came through.
0:22:02 > 0:22:07When the doctor told me that I was positive for Ebola...
0:22:07 > 0:22:13Obviously, having seen what Ebola does to people, it was worrying.
0:22:13 > 0:22:19I remember my very first concern was having to tell my parents.
0:22:19 > 0:22:21Of course, I was scared.
0:22:22 > 0:22:28It feels like you're hosting a really malevolent force
0:22:28 > 0:22:31inside your body.
0:22:32 > 0:22:37Also, the knowledge that however I was feeling,
0:22:37 > 0:22:41especially in the early stages, that the virus could,
0:22:41 > 0:22:46or likely would, get stronger
0:22:46 > 0:22:50and I would have more of it inside me.
0:22:50 > 0:22:58And knowing the consequences for my body of that increasing viral load.
0:22:58 > 0:23:01The prospect of that was very frightening.
0:23:04 > 0:23:09But for all the fear about Ebola, it is in fact a very rare disease.
0:23:12 > 0:23:17Since 1976, in all the previous recorded outbreaks before this
0:23:17 > 0:23:22one, a total of around 1,700 people have died.
0:23:22 > 0:23:25So this current epidemic is worse than all the previous
0:23:25 > 0:23:26outbreaks put together.
0:23:28 > 0:23:32And as spring turned to summer, the death toll rose higher and higher.
0:23:36 > 0:23:40- RADIO:- 'The World Health Organisation has reported a sharp increase in
0:23:40 > 0:23:42'the number of people dying
0:23:42 > 0:23:45'from Ebola disease in West Africa.'
0:23:45 > 0:23:48As the number of cases increased, there was
0:23:48 > 0:23:53an even greater risk of the disease being spread further afield.
0:23:53 > 0:23:57Ebola captures people's imagination because it springs up
0:23:57 > 0:24:01in the human population unexpectedly and unpredictably.
0:24:01 > 0:24:05And when it does so, it has potentially devastating consequences.
0:24:05 > 0:24:07And it is the stuff of movies.
0:24:09 > 0:24:13In London, the high-level isolation ward at the Royal Free Hospital
0:24:13 > 0:24:16was on stand-by should an infected carrier arrive in Britain.
0:24:18 > 0:24:21The unit is run by Dr Michael Jacobs.
0:24:23 > 0:24:27This is one of our very special isolation beds.
0:24:27 > 0:24:29And when a patient arrives in the hospital,
0:24:29 > 0:24:32we bring the patient into this unit wearing personal protective
0:24:32 > 0:24:37equipment and clothing, and we then help the patient into this bed.
0:24:37 > 0:24:40And once they're in the bed, the whole area becomes
0:24:40 > 0:24:45separated from the outside, with a controlled airflow going through it.
0:24:45 > 0:24:49Then in July, the nightmare scenario that health workers feared
0:24:49 > 0:24:50became a reality.
0:24:55 > 0:24:58Not in Britain, but Lagos, Nigeria.
0:24:58 > 0:25:01A city of over 17 million people.
0:25:04 > 0:25:08On 20th July, a Liberian American called Patrick Sawyer
0:25:08 > 0:25:10collapsed in the Arrivals terminal of Lagos Airport.
0:25:12 > 0:25:15He had just landed...
0:25:15 > 0:25:18on a flight from Monrovia.
0:25:18 > 0:25:20Five days later, he was dead.
0:25:24 > 0:25:28Within a month, four people who he had come into contact with died,
0:25:28 > 0:25:30and 16 others were infected.
0:25:31 > 0:25:34There was now a new front in the Ebola crisis.
0:25:36 > 0:25:40If an ill passenger could carry the disease from Liberia to Lagos,
0:25:40 > 0:25:44they could just as easily take it to anywhere on Earth.
0:25:44 > 0:25:48FOREIGN-LANGUAGE NEWS REPORTS
0:26:03 > 0:26:07In Atlanta, the implications of the Sawyer case were clear.
0:26:09 > 0:26:13It was a turning point in terms of showing, sort of, the effect that
0:26:13 > 0:26:18one could see travel then through air and spread to a distant country.
0:26:21 > 0:26:25Previous Ebola outbreaks have mostly been confined to remote
0:26:25 > 0:26:29areas of tropical Africa and to people who don't travel far,
0:26:29 > 0:26:35but this epidemic has spread to big cities and to people who do.
0:26:35 > 0:26:38Add the fact that Ebola can incubate in the body for up
0:26:38 > 0:26:42to 21 days before the victim shows any symptoms and suddenly,
0:26:42 > 0:26:46the incentive to find a treatment becomes even more intense.
0:26:49 > 0:26:51And so a network of doctors
0:26:51 > 0:26:55and scientists from around the world have joined a quest.
0:26:55 > 0:26:57They're all following different paths,
0:26:57 > 0:27:02but all hoping to arrive at the same destination - a cure for Ebola.
0:27:05 > 0:27:08One of those paths started in Uganda.
0:27:08 > 0:27:12Before this epidemic, the biggest outbreak of Ebola was here,
0:27:12 > 0:27:14in the year 2000.
0:27:14 > 0:27:19It was centred around the town of Gulu, in the north of the country.
0:27:19 > 0:27:22425 people were infected.
0:27:22 > 0:27:25But almost half of them managed to fight off the disease.
0:27:29 > 0:27:32These are four of the survivors.
0:27:36 > 0:27:40Caroline worked as a nurse, treating some of the first patients.
0:27:59 > 0:28:02Walter became ill after he visited a friend, Obedi,
0:28:02 > 0:28:04who was dying in hospital.
0:28:38 > 0:28:41Abraham, a teacher, caught it from his neighbour.
0:29:24 > 0:29:26All the doctors could do was to try to ease their pain.
0:29:40 > 0:29:44With no treatment available, over half the patients died.
0:29:44 > 0:29:46But Caroline survived
0:29:46 > 0:29:49because her immune system managed to fight off the virus on its own.
0:30:20 > 0:30:23These survivors are of great interest to doctors
0:30:23 > 0:30:25and scientists because their immune systems
0:30:25 > 0:30:28are clearly strong enough to defeat the virus,
0:30:28 > 0:30:31so now they each play a crucial role in the search for a cure.
0:30:45 > 0:30:48Virologist Leslie Lobel has been working with
0:30:48 > 0:30:52Dr Julius Lutwama for 12 years to study groups of Ebola
0:30:52 > 0:30:56survivors from the previous five outbreaks here.
0:30:56 > 0:30:59We're trying to discover what in their immune response
0:30:59 > 0:31:01enabled them to survive.
0:31:01 > 0:31:04We're trying to identify, which we've already done, those with a very
0:31:04 > 0:31:09successful immune response that can actually fight off the virus.
0:31:09 > 0:31:11What we call neutralise the virus.
0:31:11 > 0:31:16Today the team are heading to Gulu to take more blood samples so they
0:31:16 > 0:31:20can study how the survivors' strong immune responses work, and whether
0:31:20 > 0:31:25their encounter with Ebola has given them any form of lasting protection.
0:31:25 > 0:31:29The survivors that we follow in Gulu and in other parts of Uganda,
0:31:29 > 0:31:33we view these people as the blessed ones, those that have the
0:31:33 > 0:31:37gold in their blood that enabled them to survive this serious disease.
0:31:37 > 0:31:43However, society interestingly views them as the cursed ones, pariahs.
0:31:43 > 0:31:46So these survivors actually have a very hard time
0:31:46 > 0:31:48reintegrating into society.
0:31:53 > 0:31:55At the Gulu hospital, Caroline
0:31:55 > 0:31:58and some of the other survivors have gathered to meet the researchers.
0:32:01 > 0:32:04Good morning, ladies and gentlemen.
0:32:04 > 0:32:09This group of people, you, are the only people in the whole world
0:32:09 > 0:32:15who have been followed up after having had Ebola for a long time.
0:32:15 > 0:32:21So we have come again to find out whether your antibodies
0:32:21 > 0:32:26are still at the same level, or whether there is a decline.
0:32:26 > 0:32:30I believe by now you know what the antibodies are.
0:32:30 > 0:32:37So it is like your body goes to war with whatever foreign body has
0:32:37 > 0:32:39got into your body.
0:32:39 > 0:32:44So when we find out which ones are able to stop the enemy,
0:32:44 > 0:32:51then we will be able to use those to provide security for other people.
0:32:57 > 0:33:00Leslie and his team believe the antibodies in Caroline's blood
0:33:00 > 0:33:03and that of the other survivors could hold one of the keys to
0:33:03 > 0:33:04beating Ebola.
0:33:09 > 0:33:12The basic premise of what we're doing is to take blood
0:33:12 > 0:33:15from the survivor group, identify those with the strongest immune
0:33:15 > 0:33:18response, isolate the antibodies from the blood
0:33:18 > 0:33:20that will kill the virus.
0:33:20 > 0:33:23Reproduce it in our lab and produce a therapeutic from that.
0:33:23 > 0:33:27We're also studying the long term effects of Ebola virus on the
0:33:27 > 0:33:32immune system or the persistence of immunity in Ebola virus survivors.
0:33:33 > 0:33:35When the team began the study of survivors,
0:33:35 > 0:33:39they hoped that it could lead to a cure.
0:33:39 > 0:33:44- You got infected in the hospital? - Yes.- OK.
0:33:44 > 0:33:48We said if we get enough information, if we get enough money,
0:33:48 > 0:33:52then probably this knowledge could be used either by us
0:33:52 > 0:33:55or by some other people to come up with a vaccine
0:33:55 > 0:33:59or come up with a drug that can be used.
0:33:59 > 0:34:03Some survivors have especially strong immunity.
0:34:03 > 0:34:06At least against the strain of Ebola they caught.
0:34:06 > 0:34:09But exactly how it works is the focus of this research.
0:34:09 > 0:34:13Can it be turned into a treatment or vaccine?
0:34:13 > 0:34:17What we don't know right now is what is so special about these people.
0:34:17 > 0:34:21What is so special about their immune system that has allowed them
0:34:21 > 0:34:23to control the infection and live.
0:34:25 > 0:34:29The blood samples need to be rushed back to Entebbe, halfway
0:34:29 > 0:34:33way across the country, within 12 hours before they start to degrade.
0:34:37 > 0:34:40Back at the Uganda Virus Research Institute,
0:34:40 > 0:34:43the team begin the process of extracting the antibodies.
0:34:44 > 0:34:49They also need to understand exactly how other parts of the survivors'
0:34:49 > 0:34:52immune system have responded to the Ebola infection.
0:34:57 > 0:35:00So we're back after a 14-hour day. We have our samples here.
0:35:00 > 0:35:04The team that we have in Entebbe is now going to process these.
0:35:05 > 0:35:10We want to learn from nature what the strongest antibodies,
0:35:10 > 0:35:13or the protein molecules in their blood, that we
0:35:13 > 0:35:17know can actually prevent infection and can be used therapeutically.
0:35:19 > 0:35:24Once the antibodies are identified, they are produced in the laboratory.
0:35:24 > 0:35:27They are then tested against live Ebola in cell cultures
0:35:27 > 0:35:30and will soon be tested in infected animals.
0:35:31 > 0:35:35At this point, we've isolated a whole library of human
0:35:35 > 0:35:38antibodies from survivors of Ebola virus disease.
0:35:38 > 0:35:41In the future, maybe in three to five years,
0:35:41 > 0:35:45these can be then tested in humans, in terms of safety testing,
0:35:45 > 0:35:48so that they can be used as passive vaccines or treatments.
0:35:54 > 0:35:58The work in Africa continues, but in the United States,
0:35:58 > 0:36:00science is much closer to a cure.
0:36:01 > 0:36:04The development of a drug has been accelerated by the plight
0:36:04 > 0:36:07of two American missionaries in Liberia.
0:36:07 > 0:36:10When Ebola hit, Dr John Fankhauser was helping run the mission
0:36:10 > 0:36:14hospital in Monrovia where they worked.
0:36:15 > 0:36:19We had anywhere from two to six patients every day.
0:36:21 > 0:36:25Dr Kent Brantley was director of the Ebola unit.
0:36:25 > 0:36:30He had a deep commitment to the people of Liberia.
0:36:30 > 0:36:32He really connected with patients.
0:36:32 > 0:36:36Nancy Writebol was a nurse assistant responsible for decontaminating
0:36:36 > 0:36:38hospital staff.
0:36:38 > 0:36:42Nancy was the kind of person who had a level of energy
0:36:42 > 0:36:46and enthusiasm that really affected everyone around her.
0:36:47 > 0:36:50After treating dozens of Ebola patients,
0:36:50 > 0:36:52Dr Brantley caught the virus himself.
0:36:53 > 0:36:57Then Nancy was diagnosed with Ebola too.
0:36:57 > 0:37:02I was very surprised and then I also just had a deep sense of concern
0:37:02 > 0:37:07because I knew that Ebola was a disease in which the mortality
0:37:07 > 0:37:09was very high.
0:37:09 > 0:37:13These were two friends of mine who were facing a deadly battle.
0:37:16 > 0:37:18Then events took an extraordinary turn.
0:37:18 > 0:37:22Dr Fankhauser knew scientists had been working on experimental
0:37:22 > 0:37:23drugs that might help.
0:37:25 > 0:37:28We had, of course, heard of novel therapies for Ebola.
0:37:29 > 0:37:32A plan was starting to form.
0:37:32 > 0:37:36We were also aware that there were some doses of one of these novel
0:37:36 > 0:37:39therapies in Africa, in West Africa.
0:37:40 > 0:37:42But could they get hold of the drug?
0:37:46 > 0:37:49By an amazing stroke of luck,
0:37:49 > 0:37:52by the time the missionaries became ill in Liberia, Dr Gary Kobinger
0:37:52 > 0:37:57was nearby in Sierra Leone, helping diagnose cases of Ebola.
0:37:57 > 0:38:00For nearly a decade, he had been working on a treatment
0:38:00 > 0:38:05for the virus and he'd brought the experimental drug with him.
0:38:05 > 0:38:08The goal was to bring it there, keep it there
0:38:08 > 0:38:11and then bring it back here and then test it to see the potency.
0:38:13 > 0:38:17Dr Kobinger received a message from the missionary organisation
0:38:17 > 0:38:19Dr Brantley worked for.
0:38:19 > 0:38:22It was a request for the experimental drug called ZMapp.
0:38:24 > 0:38:30It was, from inside, a request from the heart, a request from the soul.
0:38:30 > 0:38:35Without being emotional, the request was formulated in a way that...
0:38:35 > 0:38:37anyway...
0:38:39 > 0:38:40..pinched a cord inside me.
0:38:43 > 0:38:46But ZMapp had not yet been tested in humans.
0:38:46 > 0:38:49My first reflex, and this is what I did,
0:38:49 > 0:38:52I warned against the unknown safety status of the drug.
0:38:54 > 0:38:56There were other concerns too.
0:38:58 > 0:39:01There was a lot of ethical questions. You know, why them?
0:39:01 > 0:39:05Why not the kids I have seen dying in front of me, you know?
0:39:05 > 0:39:09But you feel at one point that either you have to stand or you have
0:39:09 > 0:39:11to step aside.
0:39:11 > 0:39:14And at the time, I thought, what I had to do,
0:39:14 > 0:39:17the right thing for me to do was to step aside.
0:39:19 > 0:39:22And everyone had to weigh the risks of taking the untested
0:39:22 > 0:39:25drug against the potential benefit.
0:39:25 > 0:39:27A decision had to made and fast.
0:39:29 > 0:39:33My rationale for offering the drug was that,
0:39:33 > 0:39:36as a group of medical providers,
0:39:36 > 0:39:41with all of the medical information that we had, we had the feeling
0:39:41 > 0:39:48that it had a very high probability of being of value to Kent and Nancy.
0:39:48 > 0:39:55And then the decision to give the medications was really made
0:39:55 > 0:39:58after a discussion with Kent and Nancy.
0:39:58 > 0:40:03And after, they expressed their interest in getting the medication.
0:40:05 > 0:40:07But there was a problem.
0:40:07 > 0:40:10There were just three doses of ZMapp,
0:40:10 > 0:40:13which was a course of treatment for just one person.
0:40:13 > 0:40:15That was a very difficult moment also.
0:40:15 > 0:40:18How do you save two people with one treatment?
0:40:18 > 0:40:19Because that's all we had.
0:40:19 > 0:40:24At the mission hospital in Monrovia, there seemed an impossible choice.
0:40:24 > 0:40:28They were both willing to sacrifice the medication
0:40:28 > 0:40:32that was beneficial to them in order to help their colleague and friend.
0:40:40 > 0:40:44The story of how the ZMapp drug was developed began 15 years ago
0:40:44 > 0:40:48when Dr Kobinger was working on a gene therapy for cystic fibrosis.
0:40:52 > 0:40:56He needed a way of transporting a healthy gene into lung cells
0:40:56 > 0:40:58to replace the defective one.
0:41:00 > 0:41:04We wanted a virus that can basically be that vehicle
0:41:04 > 0:41:07that brings the healthy gene into the defective cells.
0:41:07 > 0:41:11The virus is a transport mechanism, a little shuttle.
0:41:13 > 0:41:15Dr Kobinger began looking for a virus
0:41:15 > 0:41:18that was most effective at entering cells.
0:41:18 > 0:41:20He settled on a surprising one.
0:41:21 > 0:41:25The Ebola virus is a very long virus. It's like a string.
0:41:25 > 0:41:28And it attaches to cells and it wraps into cells.
0:41:28 > 0:41:30A little bit like Velcro, if you want,
0:41:30 > 0:41:33it will stick to the other part of the Velcro.
0:41:35 > 0:41:38Like other viruses, Ebola enters cells in the body
0:41:38 > 0:41:41using spikes on its surface.
0:41:41 > 0:41:45These spikes are special proteins that bind to the cell membrane.
0:41:45 > 0:41:49When the virus latches on, the cell is forced to engulf it.
0:41:52 > 0:41:54It's swallowing the virus, if you want,
0:41:54 > 0:41:56and bringing it into the cell.
0:41:58 > 0:42:02As Dr Kobinger began using Ebola spikes to transfer genes,
0:42:02 > 0:42:04he had a startling thought.
0:42:05 > 0:42:09Perhaps the spikes of the virus could be used against itself.
0:42:11 > 0:42:14The fact that the virus is using the spike to enter cells
0:42:14 > 0:42:17and to start growing and multiplying itself,
0:42:17 > 0:42:20if you can stop that, if you can mount,
0:42:20 > 0:42:24if you can stimulate your defence to attack that same spike,
0:42:24 > 0:42:26then your defence will attack that same protein
0:42:26 > 0:42:28that allows the virus to enter the cells.
0:42:30 > 0:42:33It was an interesting theory.
0:42:33 > 0:42:35I knew it would be a long road ahead.
0:42:35 > 0:42:37And basically, at the time, everything had failed.
0:42:37 > 0:42:40Nothing had worked to protect against Ebola virus.
0:42:45 > 0:42:48In Phoenix, Arizona, another route was opening up
0:42:48 > 0:42:50that would lead to ZMapp.
0:42:50 > 0:42:55The development of the drug has been anything but conventional.
0:42:55 > 0:43:01If I had been a research director in a pharmaceutical company
0:43:01 > 0:43:03and I went up to my CEO and said,
0:43:03 > 0:43:06"You know, we should really develop a drug against Ebola,"
0:43:06 > 0:43:09they'd look at me like I was nuts.
0:43:09 > 0:43:13I mean, this is a disease which now has a few thousand cases.
0:43:13 > 0:43:16Before, it was a few hundred cases per year.
0:43:16 > 0:43:19The people who get the disease are very poor.
0:43:19 > 0:43:25I mean, there just was no return on investment for big pharma.
0:43:25 > 0:43:28Professor Charles Arntzen is a plant biologist.
0:43:28 > 0:43:34In the 1990s, he was working on a possible vaccine for hepatitis B.
0:43:34 > 0:43:39Then the world changed with the 9/11 terrorist atrocity.
0:43:39 > 0:43:439/11 brought a new interest, a focus, I guess I'd say,
0:43:43 > 0:43:47by the military on bio-terrorism.
0:43:49 > 0:43:52Ebola's included in this Category A bio threat.
0:43:52 > 0:43:55So it's sort of jumped from being
0:43:55 > 0:44:00a poorly-studied, not-much-known-about disease
0:44:00 > 0:44:03to a Category A bio threat, which meant
0:44:03 > 0:44:07there's going to be research funding available to do something.
0:44:08 > 0:44:10With the new money, Professor Arntzen teamed up
0:44:10 > 0:44:14with other researchers in the private sector to study Ebola.
0:44:15 > 0:44:17I guess we were opportunistic
0:44:17 > 0:44:21and then became infatuated with the disease and the problem.
0:44:31 > 0:44:36This is Canada's National Microbiology Laboratory in Winnipeg.
0:44:36 > 0:44:38A high-security facility that's home to
0:44:38 > 0:44:42some of the world's most deadly viruses, including Ebola.
0:44:45 > 0:44:47The one thing for sure is you don't get a second chance.
0:44:50 > 0:44:51If you have an exposure, it's because
0:44:51 > 0:44:53your barrier has been compromised.
0:44:53 > 0:44:55And for this, it means that
0:44:55 > 0:44:58you potentially have been exposed to a high dose.
0:44:58 > 0:45:02So the likelihood of having a fatal outcome
0:45:02 > 0:45:04from a lab exposure is very high.
0:45:08 > 0:45:11I will, you know, take the time to be calm before going in.
0:45:11 > 0:45:14I empty my head completely of every little preoccupation
0:45:14 > 0:45:18I may have during that day or in the past or in the future
0:45:18 > 0:45:23and I go in just concentrating on what I have to do.
0:45:24 > 0:45:28His first idea was to get the body's own immune system
0:45:28 > 0:45:30to fight the Ebola spikes.
0:45:31 > 0:45:33By exposing monkeys to the spikes,
0:45:33 > 0:45:36he found they produced antibodies against them.
0:45:36 > 0:45:38Some of which could be crucial.
0:45:40 > 0:45:43They were antibodies, interestingly,
0:45:43 > 0:45:47specifically targeting the spike of Ebola.
0:45:47 > 0:45:51So these antibodies, if you look at those antibodies in an animal
0:45:51 > 0:45:55and if you get this threshold or above,
0:45:55 > 0:45:58you can predict with 99.98% accuracy
0:45:58 > 0:46:01that the animal will survive in non-human primates.
0:46:03 > 0:46:05It was a breakthrough.
0:46:05 > 0:46:08When we started seeing that those antibodies were so important,
0:46:08 > 0:46:12then yes, for sure, then we started thinking,
0:46:12 > 0:46:15"Well, the antibodies are likely to work,
0:46:15 > 0:46:18"it's just how we're going to use them is the question."
0:46:18 > 0:46:20But the biggest question of all
0:46:20 > 0:46:23was could he use these antibodies to treat Ebola patients
0:46:23 > 0:46:26once they had become infected?
0:46:26 > 0:46:30What we call the Holy Grail of Ebola research for all these years
0:46:30 > 0:46:33was to be able to treat symptomatic animals.
0:46:33 > 0:46:35Because people in a natural outbreak,
0:46:35 > 0:46:37when they show up, they have symptoms.
0:46:37 > 0:46:39It's not because they come and they say,
0:46:39 > 0:46:42"Well, I was exposed to that person, can I get treated?"
0:46:42 > 0:46:44You know, they come and they have a fever.
0:46:44 > 0:46:48I knew this. I had gone to an outbreak already.
0:46:51 > 0:46:53At the mission hospital in Liberia,
0:46:53 > 0:46:56a momentous and potentially risky decision was made.
0:46:57 > 0:47:01The first American missionary who'd caught Ebola, Dr Brantly,
0:47:01 > 0:47:05was given a dose of ZMapp nine days after becoming ill.
0:47:06 > 0:47:09This physician at one point had to decide,
0:47:09 > 0:47:12"Am I going to really inject this thing that I don't know much of?"
0:47:12 > 0:47:15There was a lot of unknowns for that person. A lot of pressure.
0:47:15 > 0:47:19And so I think, to me, that's a hero.
0:47:19 > 0:47:24It was reported that Dr Brantly's condition dramatically improved
0:47:24 > 0:47:26after he received the drug.
0:47:27 > 0:47:30He and Nancy Writebol were brought back to Atlanta
0:47:30 > 0:47:32for further treatment with ZMapp.
0:47:32 > 0:47:36Dr Aneesh Mehta was part of the team who would treat them.
0:47:37 > 0:47:40The information we received was that the first patient
0:47:40 > 0:47:42had received a dose of an experimental medication
0:47:42 > 0:47:46and seemed to be improving after that medication.
0:47:46 > 0:47:49We did also hear that the second patient
0:47:49 > 0:47:51also had received a dose of that medication
0:47:51 > 0:47:54and seemed to be stable at that time.
0:48:03 > 0:48:06Back in the 2000s, Dr Kobinger had discovered
0:48:06 > 0:48:09there were antibodies that could defeat Ebola.
0:48:11 > 0:48:14But often after infection, the body can't produce enough of them
0:48:14 > 0:48:17because Ebola overwhelms the immune system.
0:48:17 > 0:48:20The virus is so fast that it kills you
0:48:20 > 0:48:24before you get that level of antibody that can protect you.
0:48:24 > 0:48:26So we thought that we will inject
0:48:26 > 0:48:28those antibodies as our body will do,
0:48:28 > 0:48:34but we will inject them faster, if you want, than what the body does.
0:48:35 > 0:48:38Dr Kobinger exposed mice to the Ebola spikes
0:48:38 > 0:48:40to produce different antibodies.
0:48:42 > 0:48:44The aim was to try to find a combination
0:48:44 > 0:48:48that would slow down the spread of the virus when given to monkeys.
0:48:50 > 0:48:52So we're going to put the lid on the infection
0:48:52 > 0:48:54and we're going to buy time.
0:48:56 > 0:48:58We wanted to let the host have enough time
0:48:58 > 0:49:02to build that protective immune response themselves.
0:49:04 > 0:49:07When given to monkeys, Kobinger found that the antibodies
0:49:07 > 0:49:12latched onto Ebola's spikes and stopped them sticking to cells.
0:49:12 > 0:49:16Unable to get in, the virus can't replicate.
0:49:16 > 0:49:18As the spread of the virus slows down,
0:49:18 > 0:49:21this gives the immune system time to produce its own antibodies
0:49:21 > 0:49:23to help fight the virus.
0:49:23 > 0:49:26And this turned out to be decisive.
0:49:31 > 0:49:35We saw survival when we were starting this treatment
0:49:35 > 0:49:37at 24 hours, which was very late.
0:49:38 > 0:49:42From there, we started thinking, "Well, maybe we can make it better."
0:49:42 > 0:49:45By giving the monkeys two more doses three days apart,
0:49:45 > 0:49:49the animals didn't just survive, they recovered.
0:49:49 > 0:49:51One day didn't mean anything,
0:49:51 > 0:49:53but when we were three, four, five, six days in,
0:49:53 > 0:49:56a week, two weeks in, people were coming to see them.
0:49:56 > 0:49:58They wanted to see how they looked.
0:49:58 > 0:50:00So that was a very unique moment, I think.
0:50:01 > 0:50:04The results showed that the treatment
0:50:04 > 0:50:06saved 100% of monkeys infected with Ebola.
0:50:06 > 0:50:08For sure, it was exciting.
0:50:08 > 0:50:11I can tell you of some images of people clapping
0:50:11 > 0:50:14in one another's hands in Level Four
0:50:14 > 0:50:17when we started seeing those animals.
0:50:17 > 0:50:19Not only surviving, but doing so well.
0:50:19 > 0:50:22It's like barely they were infected.
0:50:23 > 0:50:26As the cocktail of antibodies was refined
0:50:26 > 0:50:29with the help of other researchers, all of the monkeys survived,
0:50:29 > 0:50:33even when treatment started five days after infection.
0:50:33 > 0:50:38This combination of three antibodies is the drug ZMapp.
0:50:41 > 0:50:44When we saw that after symptoms had been detected
0:50:44 > 0:50:47and we could still cure 100% of them,
0:50:47 > 0:50:49to me, this was a cure, clearly. Yes, it was.
0:50:52 > 0:50:54APPLAUSE
0:50:54 > 0:50:56After finishing a course of the drug,
0:50:56 > 0:50:59both missionaries recovered.
0:51:00 > 0:51:02I am thrilled to be alive,
0:51:02 > 0:51:06to be well and to be reunited with my family.
0:51:06 > 0:51:10Amid the relief, some questions were asked.
0:51:12 > 0:51:15Why had the two Americans been given the experimental drug
0:51:15 > 0:51:18ahead of the African Ebola patients they were there to help?
0:51:20 > 0:51:23If these medications were given to an African
0:51:23 > 0:51:28by a team that was of a different culture and a different background
0:51:28 > 0:51:33and that would have led to a bad outcome,
0:51:33 > 0:51:35we'd have been harshly criticised.
0:51:37 > 0:51:41I think this was a time where we could offer these medications
0:51:41 > 0:51:44with true informed consent.
0:51:44 > 0:51:48Now, that being said, I am a complete believer
0:51:48 > 0:51:52that we need to strive for equity in this outbreak.
0:51:52 > 0:51:56That Africans should have access to the medications
0:51:56 > 0:51:58that are available to ex-patriots.
0:52:03 > 0:52:06Demand for the experimental treatment skyrocketed
0:52:06 > 0:52:08and the small supply of the drug dwindled.
0:52:11 > 0:52:14Now the race was on to produce more.
0:52:14 > 0:52:17Professor Arntzen developed the method being used to make it.
0:52:20 > 0:52:23This isn't really a greenhouse of tobacco plants.
0:52:25 > 0:52:27It's a production line for drugs.
0:52:30 > 0:52:34Any time you want to make a protein drug, a vaccine,
0:52:34 > 0:52:38you have to have a living system to manufacture it.
0:52:38 > 0:52:41So for the last five, eight years now,
0:52:41 > 0:52:46we've really focused on viruses which infect the tobacco plant.
0:52:46 > 0:52:48We take some genes out of that virus,
0:52:48 > 0:52:51put back in some genes that we want,
0:52:51 > 0:52:54then literally inject it into the leaf tissue
0:52:54 > 0:52:59so that every cell starts a viral infection.
0:52:59 > 0:53:02And as that virus replicates,
0:53:02 > 0:53:06it makes a copy of the protein that we're interested in.
0:53:07 > 0:53:11These proteins are the antibodies that go into ZMapp.
0:53:13 > 0:53:14Like all living things,
0:53:14 > 0:53:17tobacco plants produce proteins in their cells.
0:53:19 > 0:53:22Their DNA tells them which proteins to make.
0:53:22 > 0:53:25To turn the plant into a factory making antibodies for ZMapp,
0:53:25 > 0:53:30extra DNA is injected into the leaf inside a plant virus.
0:53:31 > 0:53:33The plant cell then produces the antibodies.
0:53:36 > 0:53:40Other cells make more, as they are infected in the same way.
0:53:41 > 0:53:46The actual production run that made the protein
0:53:46 > 0:53:50that was used with the individuals in Africa
0:53:50 > 0:53:54was probably about ten days in the tobacco plant
0:53:54 > 0:53:57and maybe another ten days to two weeks
0:53:57 > 0:54:00to purify the protein out of the plants.
0:54:01 > 0:54:06To scale this up to make 1,000 doses or 5,000 doses,
0:54:06 > 0:54:11that's much harder to, um...come up with a timescale for that
0:54:11 > 0:54:15because it's equipment-driven, it's people-driven.
0:54:15 > 0:54:18And to try to scale something up
0:54:18 > 0:54:22from making 50 grams, as we might do now,
0:54:22 > 0:54:25to making kilogram amounts,
0:54:25 > 0:54:31that's like trying to get a little hybrid
0:54:31 > 0:54:35to compete with a Maserati in terms of taking off on a timescale.
0:54:38 > 0:54:41As the outbreak continued, there was one further demand
0:54:41 > 0:54:44for the experimental drug ZMapp.
0:54:44 > 0:54:47Not in Africa, but in Britain.
0:54:48 > 0:54:51'William Pooley, the first person from the UK
0:54:51 > 0:54:53'to contract Ebola in West Africa...'
0:54:53 > 0:54:54'..Is in a special isolation unit
0:54:54 > 0:54:57'after being flown back to Britain by the RAF.'
0:54:57 > 0:54:59British nurse Will Pooley
0:54:59 > 0:55:02was to be offered the last available doses of ZMapp.
0:55:02 > 0:55:06Dr Jacobs very clearly told me the risks
0:55:06 > 0:55:08associated with using ZMapp
0:55:08 > 0:55:12and some of the unknowns around the use of the drug.
0:55:13 > 0:55:16It's a very unusual situation for us to use a drug
0:55:16 > 0:55:21which actually hasn't been used in humans extensively before.
0:55:21 > 0:55:24Most drugs have been through a very prolonged regulatory process
0:55:24 > 0:55:27to check their safety, as well as their effectiveness.
0:55:29 > 0:55:34I was very keen to use the drug and I said this to Dr Jacobs,
0:55:34 > 0:55:39that I want to go ahead and use it
0:55:39 > 0:55:43because the ZMapp seemed to be my only option.
0:55:45 > 0:55:51After the first infusion finished, very soon afterwards,
0:55:51 > 0:55:54we don't know whether this was due to the ZMapp or not,
0:55:54 > 0:55:59but I started feeling considerably better.
0:55:59 > 0:56:03My temperature had come down, I felt a lot more comfortable.
0:56:05 > 0:56:07We were cautiously optimistic
0:56:07 > 0:56:11once the viral load began to fall.
0:56:11 > 0:56:15He told me about what my blood results had been
0:56:15 > 0:56:18over the last few days and
0:56:18 > 0:56:20then, with a bit of a smile on his face,
0:56:20 > 0:56:23told me that my virus load
0:56:23 > 0:56:26had diminished to undetectable levels.
0:56:26 > 0:56:33So, effectively, I was free of the, er...free of the virus.
0:56:33 > 0:56:38And on telling me, obviously, I was over the moon.
0:56:38 > 0:56:40From a personal point of view,
0:56:40 > 0:56:44I was both exhausted and elated at the outcome.
0:56:47 > 0:56:52People worked so hard to get me those last doses of ZMapp.
0:56:52 > 0:56:57And I want everyone to be able to have the care that I received
0:56:57 > 0:56:59and the treatment I received
0:56:59 > 0:57:04because it makes a difference in whether you live or die.
0:57:05 > 0:57:10To know that people, just because they're living in West Africa,
0:57:10 > 0:57:14don't get that, is heartbreaking.
0:57:19 > 0:57:22Around the world, scientists are continuing their research.
0:57:23 > 0:57:25Trials for another possible vaccine
0:57:25 > 0:57:28are due to start in Oxford next week.
0:57:29 > 0:57:32We may be on the verge of a breakthrough,
0:57:32 > 0:57:36but until it comes, the disease will continue to haunt West Africa.
0:57:38 > 0:57:41Nine months into the epidemic, the death toll keeps rising.
0:57:43 > 0:57:46But health workers say many more people are dying
0:57:46 > 0:57:48than are being recorded by the official figures.
0:57:50 > 0:57:53And behind each number
0:57:53 > 0:57:54lies a human story.
0:57:57 > 0:58:00One of them was a man in his 40s.
0:58:00 > 0:58:02He was quite a character and he was called Horatio.
0:58:02 > 0:58:07His situation, it gradually deteriorated.
0:58:07 > 0:58:09He was in the most awful pain.
0:58:09 > 0:58:12Rolling on the floor and very, very distressed.
0:58:12 > 0:58:14But unfortunately, the pharmacy that was there
0:58:14 > 0:58:18didn't have much in the way of sedatives or sleeping pills
0:58:18 > 0:58:21or anything for palliative care.
0:58:21 > 0:58:25And, um...I must admit, at 10:00 at night,
0:58:25 > 0:58:27myself and the rest of the MSF team
0:58:27 > 0:58:31were going around pharmacies trying to find medicine for him.
0:58:31 > 0:58:33But he died.
0:58:33 > 0:58:36So he died on his own without any pain relief at all.