WEBVTT 00:02.000 --> 00:04.433 align:left position:10%,start line:77% size:80% HARI SREENIVASAN: Next: After the containment of the Ebola outbreak, scientists are looking 00:04.433 --> 00:08.266 align:left position:10%,start line:83% size:80% around the corner for the next serious threat to global threat. 00:08.266 --> 00:13.266 align:left position:10%,start line:71% size:80% Judy Woodruff recently sat down with Liberian-Born Dr. Raj Panjabi at Spotlight Health in Aspen, 00:14.833 --> 00:17.833 align:left position:20%,start line:77% size:70% Colorado, to discuss the challenges of preventing the next pandemic. 00:17.833 --> 00:21.166 align:left position:10%,start line:83% size:80% Warning: Some of the images in this report may be disturbing. 00:21.166 --> 00:26.166 align:left position:20%,start line:77% size:70% JUDY WOODRUFF: Dr. Raj Panjabi, thank you very much for joining us. 00:28.300 --> 00:31.133 align:left position:20%,start line:71% size:70% What do you think the world learned from the last Ebola outbreak of just a couple of years 00:31.133 --> 00:35.066 align:left position:10%,start line:77% size:80% ago, and do you think we're ready, the world is ready for the next one? 00:35.066 --> 00:37.166 align:left position:40%,start line:89% size:50% DR. 00:37.166 --> 00:39.300 align:left position:10%,start line:77% size:80% RAJ PANJABI, Last Mile Health: You know, I think there are many lessons that have been 00:39.300 --> 00:42.133 align:left position:10%,start line:77% size:80% learned from the crisis and still are, but probably one of the most central, fundamental 00:42.133 --> 00:47.133 align:left position:10%,start line:77% size:80% lessons is this basic notion that illness is universal and access to care isn't, and 00:48.766 --> 00:52.066 align:left position:10%,start line:83% size:80% that that actually places all of us at greater risk. 00:52.066 --> 00:57.066 align:left position:10%,start line:71% size:80% We have known this from even the first boy who died in the Ebola crisis, Emile, a 2-year-old 00:58.600 --> 01:01.733 align:left position:10%,start line:89% size:80% in the rain forest in Guinea. 01:01.733 --> 01:06.733 align:left position:10%,start line:77% size:80% He died after having vomiting, fever and diarrhea in December of 2013. 01:08.700 --> 01:11.333 align:left position:10%,start line:77% size:80% It took three months for the world to realize that this was an outbreak. 01:11.333 --> 01:16.333 align:left position:10%,start line:77% size:80% He lived in a forest community that -- in rural parts of West Africa where the forest 01:17.533 --> 01:19.700 align:left position:20%,start line:83% size:70% is dense, but health workers are sparse. 01:19.700 --> 01:24.700 align:left position:10%,start line:77% size:80% And so the virus spread during that time out of control, led to tens of thousands of people 01:26.233 --> 01:28.266 align:left position:40%,start line:89% size:50% dying. 01:28.266 --> 01:30.933 align:left position:10%,start line:77% size:80% JUDY WOODRUFF: One of the things you did was employ what you call community health workers 01:30.933 --> 01:33.266 align:left position:20%,start line:83% size:70% to go out and do what you're talking about. 01:33.266 --> 01:34.733 align:left position:10%,start line:89% size:80% What exactly did they do? 01:34.733 --> 01:36.800 align:left position:40%,start line:89% size:50% DR. 01:36.800 --> 01:40.400 align:left position:10%,start line:77% size:80% RAJ PANJABI: Well, community health workers are people from villages like Emile's where 01:40.400 --> 01:45.400 align:left position:10%,start line:71% size:80% a middle- to high school-educated person would be trained for a matter of months and equipped 01:47.633 --> 01:51.066 align:left position:10%,start line:83% size:80% to provide medical care door to door to their neighbors. 01:51.066 --> 01:55.100 align:left position:10%,start line:77% size:80% Those workers are critical, in addition to nurses and doctors, because nurses and doctors 01:55.100 --> 01:56.533 align:left position:10%,start line:89% size:80% are concentrated in cities. 01:56.533 --> 01:58.033 align:left position:10%,start line:89% size:80% They don't reach rural areas. 01:58.033 --> 02:00.400 align:left position:20%,start line:83% size:70% When I first came back, I grew up in Liberia. 02:00.400 --> 02:01.966 align:left position:10%,start line:89% size:80% I fled during the civil war. 02:01.966 --> 02:04.100 align:left position:30%,start line:83% size:60% I came back as a medical student. 02:04.100 --> 02:08.100 align:left position:10%,start line:77% size:80% And what I found is that there were just 51 doctors for four million people. 02:08.100 --> 02:12.266 align:left position:10%,start line:77% size:80% It would be like the city of San Francisco having just 10 physicians for the entire city. 02:12.266 --> 02:16.233 align:left position:10%,start line:83% size:80% So, if you got sick in the city, you might stand a chance. 02:16.233 --> 02:18.300 align:left position:10%,start line:89% size:80% But, in rural areas, you didn't. 02:18.300 --> 02:23.166 align:left position:10%,start line:77% size:80% So, community health workers have been critical to providing health care, where doctors don't 02:24.366 --> 02:26.666 align:left position:20%,start line:83% size:70% reach, and linking patients to care. 02:26.666 --> 02:30.733 align:left position:10%,start line:77% size:80% What we did, for instance, when an outbreak happened in a rural part of the country, was 02:30.733 --> 02:35.733 align:left position:10%,start line:77% size:80% to train and equip health workers from those communities to go door to door to work with 02:37.666 --> 02:40.033 align:left position:10%,start line:77% size:80% doctors and nurses to find the sick and get them into treatment units. 02:40.033 --> 02:43.433 align:left position:10%,start line:77% size:80% JUDY WOODRUFF: We have been hearing about community health workers for a long time. 02:43.433 --> 02:47.400 align:left position:20%,start line:77% size:70% What's different about how they work now, the role that they play? 02:47.400 --> 02:49.966 align:left position:40%,start line:89% size:50% DR. 02:49.966 --> 02:53.400 align:left position:10%,start line:71% size:80% RAJ PANJABI: I think what's new now is a recognition that this is perhaps one of the most undervalued 02:54.600 --> 02:57.333 align:left position:20%,start line:83% size:70% labor assets in the health work force. 02:57.333 --> 02:59.633 align:left position:10%,start line:83% size:80% Long-term, they have been treated as volunteers. 02:59.633 --> 03:02.700 align:left position:10%,start line:83% size:80% So, in other words, they don't get paid to do their work. 03:02.700 --> 03:06.833 align:left position:10%,start line:83% size:80% Most are underequipped and many have been barely trained. 03:06.833 --> 03:11.833 align:left position:10%,start line:77% size:80% What's different now is the recognition, as in the case of Liberia, after the Ebola crisis, 03:13.800 --> 03:17.433 align:left position:10%,start line:77% size:80% taking a former volunteer community health work force and upgrading it, hiring those 03:19.466 --> 03:22.900 align:left position:20%,start line:71% size:70% workers, employing them, training them, equipping them with the right gear and medicines to 03:24.100 --> 03:25.500 align:left position:20%,start line:83% size:70% go door to door and provide health care. 03:25.500 --> 03:28.600 align:left position:10%,start line:83% size:80% JUDY WOODRUFF: A larger question of epidemic pandemics. 03:28.600 --> 03:33.500 align:left position:10%,start line:77% size:80% It seems we pay a lot of attention to them when we're in the middle of the crisis and 03:33.500 --> 03:35.933 align:left position:20%,start line:83% size:70% it's on everybody's mind, people are dying. 03:35.933 --> 03:36.933 align:left position:10%,start line:89% size:80% It's a very visual thing. 03:36.933 --> 03:38.233 align:left position:10%,start line:89% size:80% But then we quickly forget. 03:38.233 --> 03:39.233 align:left position:30%,start line:89% size:60% We move on. 03:39.233 --> 03:41.333 align:left position:10%,start line:89% size:80% Our attention span is short. 03:41.333 --> 03:46.000 align:left position:10%,start line:77% size:80% How confident are you that the world is truly prepared for the next pandemic and the one 03:46.600 --> 03:47.466 align:left position:30%,start line:89% size:60% after that? 03:47.466 --> 03:49.500 align:left position:40%,start line:89% size:50% DR. 03:49.500 --> 03:52.133 align:left position:10%,start line:77% size:80% RAJ PANJABI: Well, we have done more to become prepared after the Ebola crisis. 03:52.133 --> 03:55.600 align:left position:10%,start line:77% size:80% We're not yet close to where we need to be to be prepared for the next epidemic. 03:55.600 --> 03:57.600 align:left position:20%,start line:89% size:70% The data shows this. 03:57.600 --> 04:02.500 align:left position:10%,start line:77% size:80% We know that the cost of inaction is larger than the cost of action; $6 trillion is the 04:04.466 --> 04:08.266 align:left position:10%,start line:83% size:80% estimated potential economic loss of a pandemic. 04:08.266 --> 04:13.266 align:left position:10%,start line:77% size:80% But we're only spending 50 cents per person per year in providing surveillance and preparedness 04:15.800 --> 04:17.866 align:left position:20%,start line:83% size:70% against preventing the next epidemic. 04:17.866 --> 04:22.733 align:left position:10%,start line:77% size:80% JUDY WOODRUFF: We know that this is one of the things that funding by the United States 04:24.066 --> 04:24.833 align:left position:10%,start line:83% size:80% can make a big difference, as to your point. 04:24.833 --> 04:25.833 align:left position:40%,start line:89% size:50% DR. 04:25.833 --> 04:28.333 align:left position:20%,start line:89% size:70% RAJ PANJABI: Yes. 04:28.333 --> 04:30.566 align:left position:10%,start line:71% size:80% JUDY WOODRUFF: The legislation that is moving through the Congress right now, or what appears 04:30.566 --> 04:34.600 align:left position:10%,start line:77% size:80% to be moving through the Congress, could make some significant cuts in that area. 04:34.600 --> 04:35.600 align:left position:40%,start line:89% size:50% DR. 04:35.600 --> 04:36.800 align:left position:20%,start line:89% size:70% RAJ PANJABI: Yes. 04:36.800 --> 04:37.600 align:left position:20%,start line:83% size:70% JUDY WOODRUFF: What effect would that have? 04:37.600 --> 04:39.600 align:left position:40%,start line:89% size:50% DR. 04:39.600 --> 04:41.633 align:left position:10%,start line:77% size:80% RAJ PANJABI: Well, I think, make no mistake, the cuts would be devastating. 04:41.633 --> 04:45.466 align:left position:10%,start line:77% size:80% And one of the untold stories of U.S. foreign aid is that it's had such a dramatic impact, 04:48.300 --> 04:53.300 align:left position:10%,start line:77% size:80% largely because of investments in health care systems like Liberia's and poor countries. 04:55.200 --> 04:58.333 align:left position:10%,start line:77% size:80% If there had not been an effort to invest U.S. foreign aid before, during and now after 05:00.433 --> 05:04.433 align:left position:20%,start line:71% size:70% the Ebola crisis, you wouldn't have been able to surge front-line local health workers who 05:05.866 --> 05:07.866 align:left position:10%,start line:83% size:80% went door to door to find the sick and get them into care. 05:07.866 --> 05:12.533 align:left position:10%,start line:77% size:80% At that very moment when the CDC told us that there could be as many as 1.4 million cases 05:14.500 --> 05:18.433 align:left position:10%,start line:77% size:80% of Ebola in Liberia and Sierra Leone, in the country I grew up and the one next to it, 05:20.433 --> 05:23.633 align:left position:10%,start line:77% size:80% that very week, in Dallas, Texas, America diagnosed its first case of Ebola. 05:26.066 --> 05:28.900 align:left position:10%,start line:71% size:80% So it's not a theory that epidemics that happen to people across the world can impact us at 05:33.066 --> 05:35.166 align:left position:20%,start line:89% size:70% home quite literally. 05:35.166 --> 05:39.733 align:left position:10%,start line:77% size:80% So I think this is the real story about foreign aid is, it's actually not aid. 05:39.733 --> 05:41.066 align:left position:30%,start line:89% size:60% It's investment. 05:41.066 --> 05:42.766 align:left position:30%,start line:89% size:60% It's a win-win. 05:42.766 --> 05:46.466 align:left position:20%,start line:77% size:70% It saves lives abroad and it keeps us safer at home in America. 05:46.466 --> 05:49.600 align:left position:20%,start line:77% size:70% And that's something we should all be proud of, actually, as Americans. 05:49.600 --> 05:53.800 align:left position:10%,start line:77% size:80% JUDY WOODRUFF: Dr. Raj Panjabi with Last Mile Health, thank you very much. 05:53.800 --> 05:54.800 align:left position:40%,start line:89% size:50% DR. 05:54.800 --> 05:54.933 align:left position:10%,start line:89% size:80% RAJ PANJABI: Thank you, Judy.