The news that Time magazine has named responders to the Ebola crisis as their "Person of the Year" casts an overdue light on an underutilized strength in the battle: individuals who have been infected and survived.
Indeed, such survivors -- several of whom were featured by Time -- may be uniquely situated to be leaders in the ongoing response, since they might retain antibodies that protect them from subsequent infection with a similar strain of Ebola.
Survivors of Ebola are thus, in effect, perhaps the only people in the world who have been functionally "vaccinated" against the virus. This would give them a critical role to play within the often crowded and desperately poor environments prevailing in West Africa.
In the current issue of the International Journal of Epidemiology, we identify the variety of reasons that survivors may be decisive in overcoming the current outbreak. These might include the ability of survivors to:
• Care for the sick, since they are highly unlikely to be re-infected;
• Work in both public and home-care settings, given their cultural and linguistic knowledge of local conditions;
• Donate blood plasma that may help the newly infected to fight off the virus;
• Contribute to a more effective and sustained community-based grassroots response; and
• Be paid for their work through the use of international donor funds, thereby directly aiding them as well as the larger community.
Despite the many advantages of mobilizing survivors, a major obstacle persists, one that is only too familiar to us as HIV/AIDS behavioral researchers: stigma. Indeed, rather than being recognized for their ability to make valuable contributions, all too many Ebola survivors suffer ongoing suspicion and rejection by the very communities that they could be mobilized to serve.
More than 40 years after the advent of the AIDS epidemic, people with HIV also continue to be stigmatized. Yet successful campaigns have been waged to show solidarity and support, rather than fear or condemnation, of those living with HIV. These campaigns have been as varied as t-shirts reading "HIV-Positive," such as those donned by Nelson Mandela in South Africa, or the wearing of Red Ribbons for remembrance and awareness, or the myriad of events that occur around December 1 each year to mark World AIDS Day.
Over 70 years ago, Mahatma Gandhi in India began a campaign to de-stigmatize members of the Dalit or "untouchable" caste by bestowing upon them the title of "harijan" or "children of God." Today, a similar honorific should be established for survivors of Ebola. Concurrently, public health campaigns should be mounted to spread the word that survivors pose no threat to others but, rather, have a crucial role in controlling the epidemic and caring for the sick.
Engaging, training, and deploying immune Ebola survivors has the potential to save untold thousands of lives and curb the spread of new infections to currently unaffected areas. Survivors can also provide hope and emotional support by demonstrating that life can go on after Ebola infection.
This article was co-authored with Drs. Zena Stein, Jack Tocco, and Joanne Mantell of the HIV Center for Clinical and Behavioral Studies at Columbia University and the New York State Psychiatric Institute.