that would be needed if this thing were really to get out of control.
What was really impressive was that the Army was well-integrated into the civil- ian machinery that was actually running the response, and it was playing a role that was very well-appreciated. A number of our colleagues at CDC also reported a lot of support from the U.S. military on critical logistics, because getting to some of these infected areas was a real challenge—those Black Hawks came in real handy to rapidly get to some of the remote areas where they needed to imme- diately understand [the nature of disease.
the]
I’m sure there were some problems that I didn’t see in the civ-mil cooperation, but I really think we are moving in the right direction, which tends to be where I focus. I think we all came out of the Ebola crisis with a new, very much needed and very healthy respect for the capabilities, access and approaches of both sides.
Army AL&T: In the scale-up to the Ebola program, what did you see, and what did
you prioritize in terms of what needed to be done first?
Aylward: I think the biggest single thing that I brought to the Ebola crisis was the combination of my understanding of epidemiology and disease eradication, as well as the world of humanitarian emer- gencies in which I worked. I could kind of bridge that gap across the humanitarian world, which mainly dealt with natural disaster response and conflicts, and the public health world that dealt with infec- tious disease emergencies. Because of that background, I could also translate what are sometimes complex epidemiologic and disease control principles into some very simple approaches that could help unite a massive number of players with very diverse backgrounds to a common purpose.
I remember taking a big whiteboard [in September 2014] on one of the upper floors of the U.N. in New York, and writ- ing “70/70/60.” I said, look, our goal, with all of these assets that we have, is to get 70 percent of the dead bodies care- fully and quickly buried, and 70 percent
of the infected people quickly into medi- cal isolation, within 60 days. If we can achieve those two targets within the next 60 days, we will change the course of this epidemic and bend this exponentially growing epidemic curve.
I was really trying to take all that com- plex
epidemiology and Ebola control
knowledge and simplify it into some- thing like 70/70/60, which was a clear, concrete goal. And that ended up being, certainly in that really scary period in the second half of 2014, what drove the inter- national response.
Army AL&T: Is this a question, too, of your own personal leadership style?
Aylward: Tat’s probably the most dif- ficult question you’ve asked. Although all the people who have worked for me would probably say, “You must be joking,” I tend to believe I have a very adaptive leadership style: from demanding control when necessary—when I, rarely, think it’s very, very necessary—to providing a much more facilitative approach. I was described [in a December 2014 news
MAN IN CHARGE
Working with colleagues at the U.N.’s crisis control center in New York, Aylward lays out a strategy for getting the Ebola virus under control. Aylward had just been put in charge of WHO’s Ebola operations and saw a need for a clear, concrete, unifying goal “in that really scary period in the second half of 2014.” (Photo by Dr. David Nabarro, U.N. secretary-general special envoy on Ebola)
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CRITICAL THINKING
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