Science
12 September 2014 vol 345, issue 6202, pages 1209-1416
http://www.sciencemag.org/current.dtl

Editorial
Ebola’s perfect storm
Peter Piot
Peter Piot is director and professor of Global Health at the London School of Hygiene & Tropical Medicine, London, UK.
The devastating Ebola epidemic in West Africa is the result of a perfect storm: dysfunctional health services as the result of decades of war, low public trust in government and Western medicine, traditional beliefs and even denials about the cause or existence of the virus, and burial practices that involve contact with contagious Ebola-infected corpses. There are now five affected West African countries: Guinea, Liberia, Nigeria, Sierra Leone, and most recently, Senegal. Ebola has killed around 2000 and infected more than 3500, with over 40% of cases occurring within the past few weeks. The World Health Organization (WHO) predicts that 20,000 may become infected. This fast pace of Ebola’s spread is a grim reminder that epidemics are a global threat and that the only way to get this virus under control is through a rapid response at a massive global scale—much stronger than the current efforts.

In Depth
Infectious Disease
Ebola vaccines racing forward at record pace
Jon Cohen
Experimental Ebola vaccines started human tests last week and beginning in November may be rolled out to as many as 10,000 people in West Africa. The two vaccines being tested first must prove safe and capable of stimulating relevant immune responses in small trials taking place in four countries. No vaccine has ever moved more quickly into widespread use. Many issues remain on how to determine whether the vaccines actually protect people from Ebola. Because the vaccines are in short supply, they also will only be offered to health care workers and other first-line responders. One vaccine is being manufactured by a collaboration between the U.S. National Institute of Allergy and Infectious Diseases and GlaxoSmithKline, and the other is being made by NewLink Genetics.

In Depth
Interview
Ebola: ‘Wow, that is really tough’
Leslie Roberts
The news out of West Africa is grim. By early this week, Ebola cases had topped 4000 and deaths exceeded 2000, and the World Health Organization (WHO) had warned that thousands more should be expected in Liberia alone in the next few weeks. In an interview with Science on 4 September, WHO’s Bruce Aylward, an assistant director-general who is running operations as part of WHO’s new $600 million Ebola emergency plan, talked about why the international community has been slow to respond to the unprecedented epidemic and described the huge gap between the number of cases and the capacity in countries to deal with them. Governments are now keen to help, he says, but are having trouble mobilizing. Relief organizations are used to dealing with wars and natural disasters, not dangerous pathogens, and few have any experience in running the many treatment centers that are required. WHO’s just-released plan calls for stopping the outbreak in 6 to 9 months. That goal is still possible, Aylward says, but only if the international community takes immediate action.

Special Issue: Global Health
Perspectives
Putting women and girls at the center of development
Melinda French Gates
Science 12 September 2014: 1273-1275.

The state of global health in 2014
Jaime Sepúlveda and Christopher Murray
Science 12 September 2014: 1275-1278.

Getting essential health products to their end users: Subsidize, but how much?
Pascaline Dupas
Science 12 September 2014: 1279-1281.

Models of education in medicine, public health, and engineering
Patricia Garcia, Robert Armstrong, and Muhammad H. Zaman
Science 12 September 2014: 1281-1283.
Abstract
Prioritizing integrated mHealth strategies for universal health coverage
Garrett Mehl and Alain Labrique
Science 12 September 2014: 1284-1287.
Abstract
How to transform the practice of engineering to meet global health needs
Deb Niemeier, Harry Gombachika, and Rebecca Richards-Kortum
Science 12 September 2014: 1287-1290.

Strengthening the evidence base for health programming in humanitarian crises
A. Ager, G. Burnham, F. Checchi, M. Gayer, R. F. Grais, M. Henkens, M. B. F. Massaquoi,
R. Nandy, C. Navarro-Colorado, and P. Spiegel
Science 12 September 2014: 1290-1292.

Emerging, evolving, and established infectious diseases and interventions
M. Elizabeth Halloran and Ira M. Longini Jr.
Science 12 September 2014: 1292-1294.

Virus sharing, genetic sequencing, and global health security
Lawrence O. Gostin, Alexandra Phelan, Michael A. Stoto, John D. Kraemer, and K. Srinath Reddy
Science 12 September 2014: 1295-1296.

Monitoring parasite diversity for malaria elimination in sub-Saharan Africa
Anita Ghansah, Lucas Amenga-Etego, Alfred Amambua-Ngwa, Ben Andagalu, Tobias Apinjoh,
Marielle Bouyou-Akotet, Victoria Cornelius, Lemu Golassa, Voahangy Hanitriniaina ndrianaranjaka, Deus Ishengoma, Kimberly Johnson, Edwin Kamau, Oumou Maïga-Ascofaré, Dieudonne Mumba, Paulina Tindana, Antoinette Tshefu-Kitoto, Milijaona Randrianarivelojosia,
Yavo William, Dominic P. Kwiatkowski, and Abdoulaye A. Djimde
Science 12 September 2014: 1297-1298.

Antibiotic effectiveness: Balancing conservation against innovation
Ramanan Laxminarayan
Science 12 September 2014: 1299-1301.

Creating a global observatory for health R&D
Robert F. Terry, José F. Salm Jr., Claudia Nannei, and Christopher Dye