Watch former President Barack Obama speak at the event on Wednesday.

Former President Barack Obama spoke at the Bill and Melinda Gates Foundation Goalkeepers event in New York on Wednesday to measure the progress of global health over the past 25 years.

This event is timed to the U.N. General Assembly and the release of a report by Bill and Melinda Gates, which measures the world’s health according to 18 indicators. These include infant mortality, AIDS, vaccine use and smoking rates.

Other speakers at the event include Bill and Melinda Gates, Prime Minister Trudeau, will.i.am, Malala and Stephen Fry.

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JUDY WOODRUFF: Turning a corner, after decades of health warnings, cigarette sales have fallen sharply in the United States and Europe, but multinational tobacco corporations are targeting huge new markets in the developing world, including countries in Asia. In a report produced with Global Health Frontiers, Hari Sreenivasan explains that in the Philippines, anti-smoking activists are now pushing back.

ACTIVISTS: We want the pictures now! Pictures save lives!

HARI SREENIVASAN: On the streets in Manila, demonstrators march against tobacco.

ACTIVIST: We want to make our voices heard.

HARI SREENIVASAN: Their cause is supported by the medical profession here.

DR. TONY LEACHON, Philippine College of Physicians: Smoking’s the number one killer in the Philippines.

HARI SREENIVASAN: Dr. Tony Leachon is the president of the Philippine College of Physicians.

DR. TONY LEACHON: For the young Filipinos, smoking is considered a macho image for men.

SMOKER: I know it’s bad — it’s bad for our health, but this is to relax myself out from work.

RACHEL ROSARIO, Philippine Cancer Society: Culturally, smoking seems to be an accepted mode of socialization, an accepted mode of relaxation.

HARI SREENIVASAN: Rachel Rosario is with the Philippine Cancer Society.

RACHEL ROSARIO: There is that vision of holding a cigarette and smoking with makeup — it seems to be something that we have to fight against.

SMOKER: It’s really hard to kick the habit. I try to lessen it down, cut it, but then you always have that urge.

HARI SREENIVASAN: The fight against smoking here won a major victory four years ago when the Philippine Congress passed what is called the “Sin Tax Law”, imposing a tax that effectively doubled the price of cigarettes.

MAN (through translator): It’s expensive. It’s five pesos a stick.

SMOKER (through translator): The effect on me is I’m smoking less. It’s more expensive.

SMOKER: I used to be a pack a day, now I’m like half.

HARI SREENIVASAN: Dr. Maria Encarnita Limpin leads the framework convention on Tobacco Control Alliance Philippines.

DR. ENCARNITA BLANCO-LIMPIN, Framework Convention on Tobacco Control Alliance: From 1990 to 2008, the rate of smoking in the country has never really gone below 30 percent. The latest survey that we did in the country showed dramatic drop in the prevalence rate of smoking. This time, it is going down from above 31 percent to 25 percent. That’s a big deduction.

HARI SREENIVASAN: Private held leaders say a major reason why the sin tax law was passed was the grassroots campaign organized by cancer survivor Emer Roxas.

EMER ROJAS, Cancer Survivor: I started smoke can at the age of 17. And at the age of 44, I got stage 4 throat cancer, and that was 12 years ago. They removed my vocal cords so that the cancer would go away.

HARI SREENIVASAN: Before cancer, Rojas was a successful engineer, businessman and radio broadcaster.

ERIKA ROJAS, Emer’s Daughter: I still remember that voice when he was singing. Before, he used to sing a lot whenever there was a birthday party.

EMER’S WIFE: He loves to sing “I Left My Heart in San Francisco.”

EMER ROJAS: That’s my favorite song.

EMER’S WIFE: Yes, I know.

HARI SREENIVASAN: Rojas says he felt he was given a second life, and he decided he would commit his life to making people aware of what happened to him because of smoking, and his family has joined him.

ACTIVIST: All of us in the family, we’re volunteers.

ACTIVIST: I want to save lives of other people. I don’t want for them to experience what we experience with Emer.

HARI SREENIVASAN: With rallies, speeches, and messaging on radio and television, Rojas developed the new voice association as a powerful advocate against smoking, especially to protect children.

DR. ENCARNITA BLANCO-LIMPIN: All of the strategies of the tobacco companies, particularly their advertising strategy. They’re all geared to hook the young children into starting smoking at an earlier age. And since of the adults would actually grow old and eventually die. And therefore, they need new market.

ACTIVIST: The children agree that cigarette smoking is really bad, right, kids? Cigarette smoking is bad.

STUDENTS: Cigarette smoking is bad.

HARI SREENIVASAN: Another new law, following examples in other countries, requires health warnings and graphic pictures on cigarette packaging.

DR. TONY LEACHON: The graphic health warnings have been helpful in other countries, and basically we’re going to use this for the young population, of course, to women as well.

SMOKER: I’ve been to some airports and they do sell those packs with pictures of throat cancer, your lungs are all wrecked up, I guess it made you think a bit, but at the end of the day, I’m, like, where’s my pack of cigarettes?

ACTIVIST: Pictures save lives!

HARI SREENIVASAN: After months of delay, and rallies like this, the law requiring graphic health warnings is now in effect. But public health advocates say they’ve not yet won the war against tobacco. Millions of Filipinos still face lifelong addiction, and the benefits from the sin tax and graphic warnings won’t be clearly evident for decades.

ACTIVIST: One, two, three —

STUDENTS: Do not smoke!

ACTIVIST: Very good!

HARI SREENIVASAN: For the “PBS NewsHour”, I’m Hari Sreenivasan.

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GWEN IFILL: Next: As we have seen with recent pandemics, emerging diseases like Zika and Ebola can cross continents and oceans with uncontrolled speed.

Scientists are identifying areas where new infectious diseases are most likely to emerge, where there are high risks of animal viruses passing to humans. One of those areas is Southern China.

Hari Sreenivasan brings us this report, which was produced in collaboration with Global Health Frontiers.

DR. PETER DASZAK, President, EcoHealth Alliance: We’re in Guilin in Southern China, in one of the most beautiful parts of China with these amazing limestone hills and valleys and very scenic and picturesque.

HARI SREENIVASAN: Peter Daszak is the president of EcoHealth Alliance, a nonprofit organization based in New York dedicated to protecting wildlife and public health from the emergence of disease.

DR. PETER DASZAK: The reason we’re here is, we’re interested in the risk of new diseases emerging out of the wildlife trade in China, just like SARS did a few years ago and just like ultimately HIV did in Africa 40-odd years ago.

If we can get to the source of where they come from and reduce the risk, we could solve a huge problem and save millions of lives, rather than waiting for them to emerge and try to mop it up afterwards.

HARI SREENIVASAN: At markets across China, like this one, people come in daily to buy chickens and ducks.

DR. PETER DASZAK: It increases the risk of a pathogen like avian flu from spreading, because you have got live chickens. If one of them is infected, it brings the virus in, and it spreads to this flock over a few hours, and then those animals are taken to all distant parts of the region.

Now, you could see this activity anywhere in the world. This is just like what happens in rural America and rural parts of Europe. But the difference is, here, we’re in a hot zone for emerging diseases. This is a place where we have repeatedly seen outbreaks from poultry moving into people and spreading globally.

HARI SREENIVASAN: Natural habitats can also contribute to the spread of viruses.

DR. PETER DASZAK: We have got people fishing in the river. We have got people washing in the river. We know there is sewage coming directly from the houses into the river. There is not much wildlife here, but wild ducks will come down to this river as well and mix in and migrate with the viruses and spread them backwards and forwards into this mix.

It’s a big mixing vessel for pathogens.

HARI SREENIVASAN: At a goose farm, Daszak and his team are looking for signs of avian flu.

DR. PETER DASZAK: The idea is that, if we can catch the viruses they carry here, we can prevent them going to market and potentially spreading the disease.

OK, ready.

We take swabs from the mouth, and we take cloacal swabs. We put them in viral transport medium and then ship them in liquid nitrogen to the lab for testing. Avian flu is a virus that’s common in many types of birds. But especially in poultry and waterfowl, it’s a real killer.

And some of these strains can also jump directly into people. So that’s the problem.

HARI SREENIVASAN: Viruses that can cross over and infect humans have led to previous pandemics, including the most devastating in recorded world history, the 1918 flu, which killed more people than the First World War, more than 500 million infected worldwide, and as many as 100 million deaths over a two-year period.

DR. PETER DASZAK: We’re trying to say, where is the next avian flu going to come from? Can we see it before it becomes a pandemic problem and stop it?

There you go.

I look at this a little bit like earthquakes. We know earthquakes can be devastating. We know they’re pretty rare, and we know where they happen.

So, this is the same for pandemics. We know that this is a hot spot for pandemics. We know why it happens, but what we’re not doing with pandemics that we are doing with earthquakes is reducing the damage initially. This has been going on for 5,000 years.

HARI SREENIVASAN: Working with EcoHealth Alliance in this part of China is field operations manager Dr. Guangjian Zhu, a biologist trained in the ecology of bats, which are known to be the source of the SARS virus.

DR. GUANGJIAN ZHU, Field Operations Manager: It’s really urgent to teach people how to deal with the virus and just change our normal behavior to decrease the risk of virus transfer.

DR. PETER DASZAK: This is a big tourist cave. Shall we go?

HARI SREENIVASAN: Daszak is concerned about a bat cave that is a popular tourist destination.

DR. PETER DASZAK: You have got the Rhinolophus horseshoe bats right here in this cave with all these tourists going through.

DR. GUANGJIAN ZHU: Yes.

DR. PETER DASZAK: Yes.

The bats here in this cave are the same bats that carry SARS virus. Bats live in the cave all day long, because they’re nocturnal. And when they’re up there, they urinate and defecate, right on top of the tourists that are walking through.

And all you have got to do is be that one person to breathe in at the wrong time, and suddenly you have been infected with a virus that is not only potentially lethal to people. It could cause a future pandemic.

We sent you the samples from these bats.

HARI SREENIVASAN: Daszak and his team have used mathematical models to try to understand what is driving these diseases.

DR. PETER DASZAK: We went back to every known example of emerging disease, HIV, Ebola, West Nile virus, SARS, plotted where it originated. And we said, what are the things that are going on in those places?

The two big drivers are growing human populations, land use change, and high wildlife diversity.

HARI SREENIVASAN: Rapid global response to disease outbreaks is essential to stopping transmission and saving lives. But Daszak and his team of virus hunters believe that forecasting where outbreaks are most likely to occur is a critical part of a defensive strategy needed to prevent outbreaks before they emerge.

For the “PBS NewsHour,” I’m Hari Sreenivasan.

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Sharon Ezeamaka plays Princess, a pregnant and HIV-positive women, who learns how she can avoid transmitting the virus to her baby. Photo courtesy of “MTV Shuga”

“MTV Shuga,” a TV show airing in Kenya and Nigeria, aims to dispel stereotypes about people with HIV. Sharon Ezeamaka, a Nigerian actress who plays Princess on the show, never thought she’d be one of those educated.

“I’ve never been someone who judges other people, but ‘Shuga’ has made me even more accepting,” the 23 year old said recently by phone. “I learned a lot about HIV and AIDS, and how you can live with it.”

The show, which began in 2009 in Kenya, and continued in Nigeria, portrays real-life scenarios of people who either have or are involved with someone who has HIV. The prevailing theme is to get tested for the virus to know for sure, and then take appropriate steps to protect yourself and your partner.

One of the main characters Princess learned the hard way. She’s a “naïve girl who wants to grow up really fast and live on her own,” described Ezeamaka. “She came to Lagos (Nigeria’s largest city), and wants to be cool and so she makes a lot of bad decisions. She starts sleeping with a man much older than she. They have unprotected sex.”

Princess contracts HIV — and learns she is pregnant.

“It’s fictional but it’s based on true stories,” said Georgia Arnold, the London-based executive producer of “MTV Shuga” (“shuga” is a slang term for sugar daddy). “We try to keep it as true to life as possible because we want the audience to be able to identify with the storylines.”

In other storylines, Femi, is a music producer who is HIV-positive and seriously dating Sheila, who is HIV-free. They take a chance and make public his HIV-status to preempt a jealous man from revealing it on his own. Meanwhile, Weki, who was born with HIV, tries — unsuccessfully — to keep it under wraps.

The characters Sheila and Femi are dating and grappling with the social stigma of HIV. Photo courtesy of “MTV Shuga”

The show’s writers live in the countries where the series is taped, and they confer with local youth who provide their perspectives and experiences.

The result is music-infused episodes set in clubs and bars, student hangouts and an HIV call center, which helps dispel the myths surrounding HIV — both on the show and, hopefully, among viewers. Local TV stations can air the show for free.

The production company, MTV Staying Alive Foundation, launched the show in Kenya, thanks partly to U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) funds.

Arnold said the company then wanted to move production to Nigeria, because it is the most populous African country and has one of the highest numbers of HIV-infected people in the world.

“We felt like if we could get it right in Nigeria, then that would be a pretty big achievement,” she said. The foundation next has set its sights on South Africa with its high rate of HIV for the next round of episodes, if it can get funding.

“In order for us to go into any country, we need funders to be interested in that country and in the issue, a government open to the behavior change campaign, and an audience eager to see it,” she said.

The show is constructed to engage the audience. During each episode, a message pops up on screen, asking viewers to text their responses to a question, such as “Who is to blame for what happened to Mary?”

In the show, Mary was lured into spending time with a sugar daddy, Nii. Her parents, against the association at first, come around after he pays her tuition fees. Nii ends up beating Mary when she refuses his advances.

The character Mary, right, talks to her friend about her “sugar daddy.” Photo courtesy of “MTV Shuga”

When asked in the poll who was to blame, most viewers said Mary (41 percent), followed by her parents (35 percent). Only 24 percent said Nii was to blame for his violence against Mary.

In Nigeria, “one of the big issues generally is domestic violence,” said Arnold. “It’s embedded in the culture.” So when the responses skewed toward blaming Mary, it showed how far education needs to go. “MTV ‘Shuga’ has many wins. On this issue, it’s really difficult for us to move the dial.”

The producers use the audience feedback to tailor the information on its website when it appears the message isn’t getting across from just the program.

The foundation also takes the show on the road, literally, by holding viewing parties of the episodes, and hosting other public events with the cast.

Participants at the public events are able to get tested for HIV if they want, and counselors educate them about treatments. MTV Staying Alive Foundation partnered with the Elton John Foundation to train the testers and counselors.

The private testing gives people an alternative to walking into a clinic in their hometowns, where they might be recognized. In Nigeria during four months in 2015, 48,000 youth were tested through 140 peer educators, said Arnold.

As part of the outreach, Ezeamaka talked to HIV-positive and pregnant women in a hospital that specializes in their care. If women are put on antiretroviral drugs in time, they can give birth to healthy babies.

“It makes Princess a lot more real for me, meeting people actually living it,” Ezeamaka said. “It made it more intense. I felt like I had to tell their stories.”

You can watch all of the episodes here.

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JUDY WOODRUFF: U.S. health officials put out new guidance today about the Zika virus. For the first time, they recommended that men who have traveled to an area with Zika should use condoms if they have sex with a pregnant woman for the entire duration of the pregnancy. The CDC also says those men may want to consider abstaining from sex with women who are trying to get pregnant.

While the disease is overwhelmingly spread by mosquitoes, questions about three possible cases of sexual transmission led to these new guidelines.

In Brazil, Zika has been found in the saliva and urine of two people. And more than one million people there are said to be infected with Zika.

Our science correspondent, Miles O’Brien, is covering the story. He joins me now from Recife, Brazil, where Carnival celebrations are beginning.

So, Miles, this is a country that’s hardest-hit. It also happens to be you’re there at the time of this big annual holiday.

MILES O’BRIEN: Yes, Judy. Here we are in the middle of this public health crisis and this celebration, this national holiday begins on this night, Carnival.

What’s interesting about Carnival is that at the very core the philosophy is, forget your troubles and party like there is no tomorrow. That’s how the Brazilians view it and that’s why in most cases the party has gone on.

I talked to a lot of public health officials and doctors and scientists who have been involved in this hurt for some action and some way to control the Zika outbreak, and many of them express misgivings about it, frankly, but the show is going on.

JUDY WOODRUFF: Now, Miles, we know the Centers for Disease Control said today that the cooperation with Brazil is getting better. That’s the CDC here in the U.S. But they also have some expressed some frustration about not getting enough data from down this. What do you know about that?

MILES O’BRIEN: We heard a lot about this when we spoke to some of the scientists on the front lines here, some of the epidemiologists and the virologists who are working on this scientific riddle.

This is a virus that has presented a whole new problem for them, and it’s a virus, like so many things these days, that instantly become a global problem. The problem is, there is legislation, there is law in this land which makes it all but impossible for them to share samples with their colleagues in Atlanta or Glasgow or elsewhere In Europe.

And so they have been frustrated by that inability to share their data. Having said that, in a briefing today, the head of the CDC, Tom Frieden, said that is improving. But it’s a reminder that when you’re in a situation like this with a fast-moving virus, it’s time to bring all kinds of borders and privileges and scientific prerogatives down and try to fight the problem.

JUDY WOODRUFF: And, Miles, for the medical profession, I know you’re talking to physicians there, researchers. You were saying this has to be very frustrating for them, that they don’t feel, you said, that they have the tools in the toolbox that they need.

MILES O’BRIEN: I spoke to a gynecologist today who’s dealt with several mothers who have had to contend with this, and she’s so frustrated.

She said: “I feel like I’m in the Stone Age. I can see this coming, I see the problem developing, and I have no tools in my toolbox to help these women.”

It’s an unfortunate case. They have got this virus that came out of the blue, and they really don’t have a way of coping with it right now.

JUDY WOODRUFF: And, Miles, in terms of the science of it and dealing with the mosquitoes who are carrying this virus around, what about that front? Are they able to — I mean, are they able to project any kind of precautions that can be taken? Where are they on that front?

MILES O’BRIEN: Well, obviously, they’re telling pregnant women to be very careful and to guard against being bitten by mosquitoes. It’s worth mentioning that those are the people. It’s the pregnant women and their babies in utero that are of concern.

When an adult gets bitten by a mosquito and gets Zika, four out of five people don’t even know they have had it. So, part of it is public education. Part of it is going through and doing some spraying, which has limited efficacy.

They have got 200,000 troops in the military knocking on doors, looking for standing water, but ultimately they’re way outnumbered by the mosquitoes. We were in a lab just the other day where they’re actually genetically engineering mosquitoes, male mosquitoes, to mate with females, creating progeny which will die very quickly.

And that kind of clever approach is part of putting some tools in the toolbox to try to control how mosquitoes are carrying Zika.

JUDY WOODRUFF: But, meantime, finally, Miles, warnings going out to women and to men about the dangers of this virus.

MILES O’BRIEN: You know, Judy, it’s really a heartbreaking scenario, how this cropped up. It’s dangerous and it caught public health officials by surprise.

Today, I was with a mother with a 2-month-old son who is drastically affected by this microcephaly. And it means a lifelong problem of disability and care for this now 2-month-old child of hers. And so it’s — the danger cannot be understated for pregnant women. And that set against this Carnival offers up quite a contrast this year.

JUDY WOODRUFF: Well, it’s heartbreaking. It’s frightening.

And, Miles, I know we look forward to the reporting that you’re doing down there. And we will be having that in the days to come.

Miles O’Brien, we thank you.

MILES O’BRIEN: You’re welcome, Judy.

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The blood of a survivor of the Ebola virus is drawn as part of a study launched at Liberia’s John F. Kennedy Hospital in Monrovia, Liberia on June 17. Photo by Reuters stringer

A panel of health experts recommended a top-to-bottom restructuring of the World Health Organization on Tuesday in light of its failure to quickly respond to the Ebola crisis.

The Ebola outbreak, which began in spring 2014, has infected an estimated 27,550 people and killed 11,235 more.

“The world simply cannot afford another period of inaction until the next health crisis,” said the panel, led by Barbara Stocking, former chief executive of relief agency Oxfam.

“WHO is already moving forward on some of the panel’s recommendations including the development of the global health emergency workforce and the contingency fund to ensure the necessary resources are available to mount an initial response,” according to a statement from the organization.

The final recommendations are:

1. The WHO should come up with a plan, with related costs, for countries to develop ways to prevent, control and respond to the spread of disease as required under the International Health Regulations (2005).

2. All levels of WHO “should be strengthened” in order to identify health risks and declare health emergencies.

3. The International Health Regulations’ (2005) Review Committee for Ebola should look into incentives, including special financing, to have countries notify the WHO of public health risks.

4. The Review Committee for Ebola should consider disincentives for countries that impose restrictions on traffic and trade, such as travel bans, that go beyond what the WHO recommends.

5. The Review Committee for Ebola should consider an intermediate level response that would trigger a worldwide alert during the earlier stages of a health crisis (instead of waiting to declare a full Public Health Emergency of International Concern).

6. The U.N. Secretary-General’s High-Level Panel on the Global Response to Health Crises should put health issues at the center of the global security agenda and identify procedures to take serious health matters to the U.N. Security Council.

Survivor of the Ebola virus Stanley Juah visits his son’s grave at a cemetery for victims of Ebola in Suakoko, Liberia on March 11. Photo by James Giahyue/Reuters

7. The WHO has no core funds for emergency response, the panel said. So the United Nations’ member states should think about increasing contributions based on countries’ ability to pay by 5 percent.

8. Member states should immediately contribute to a contingency fund to support outbreak responses totaling $100 million in voluntary contributions.

9. The WHO “should be made fit for health emergency response” with member states’ support and resources.

10. The WHO “must develop an organizational culture that accepts its role in emergency preparedness and response.”

11. The WHO should establish a Center for Emergency Preparedness and Response to develop a new organizational structure and procedures.

12. The WHO director-general should create a board to oversee the center.

13. The WHO must “adopt a new approach to staffing in country offices” that takes more fully into account the conditions of each country. The WHO country representative should have an independent voice and be assured of the full support of the regional director and director-general, if challenged by the country’s government.

14. The WHO “must reestablish itself as the authoritative body communicating on health emergencies” and fulfill its role.

15. The WHO and its partners must ensure community engagement in health emergencies.

16. The WHO should play a central role in research and development efforts for future emergencies, including developing vaccines.

17. The WHO should “maintain high alert levels” in the current Ebola crisis, because it’s not over yet.

A member of the French Red Cross disinfects the area around a person suspected of carrying the Ebola virus in Forecariah in southwestern Guinea on Jan. 30. Photo by Misha Hussain/Reuters

18. The WHO should consider how to coordinate its own emergency grades and alerts to improve interagency coordination.

19. The WHO “should ensure that its staff and stand-by partners have a better understanding of the humanitarian system.”

20. The U.N. Secretary-General’s High-Level Panel on the Global Response to Health Crises should inform the greater United Nations system about the nature of health risks and the implications of declaring a full-on public health emergency.

21. The U.N. Secretary-General should consider appointing a special representative when a health crisis escalates to a high-level global threat.

The same panel of health specialists released a preliminary report in May that said the world body was “slow” in its response to the Ebola outbreak.

The panel said in both reports that the WHO should continue to coordinate the international response to health emergencies because it would only complicate matters to put another entity in charge.

The WHO has issued its own annual strategic plans (2014 and 2015) to battle Ebola, which include the objectives of stopping the transmission of the disease, preventing new outbreaks, reactivating essential health services, accelerating Ebola research and development, and coordinating the national and international Ebola responses.

The agency said the Ebola outbreak was “unprecedented in its scale, severity and complexity” and despite the progress made, “there is still a considerable effort required” to halt the virus.

“This is the largest emergency operation the organization has ever undertaken,” the WHO said.

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Teacher Janneke van den Heuvel leads her 8-year old students in a group discussion during Spring Fever week in the Netherlands. NewsHour photo by Saskia de Melker

“Who here has been in love?” Anniek Pheifer asks a crowd of Dutch elementary school students.

It’s a Spring morning in Utrecht, and the St. Jan de Doper elementary school gym is decked in heart-shaped balloons and streamers. Pheifer and Pepijn Gunneweg are hosts of a kids television program in the Netherlands, and they’re performing a song about having a crush.

Kids giggle at the question. Hands — little and bigger — shoot up.

Welcome to “Spring Fever” week in primary schools across the Netherlands, the week of focused sex ed classes… for 4-year olds.

Of course, it’s not just for 4-year-olds. Eight-year-olds learn about self-image and gender stereotypes. 11-year-olds discuss sexual orientation and contraceptive options. But in the Netherlands, the approach, known as “comprehensive sex education,” starts as early as age 4.

Kindergarteners attend the opening assembly for Spring Fever week at the St Jan de Doperschool in Utrecht, the Netherlands. NewsHour photo by Saskia de Melker

You’ll never hear an explicit reference to sex in a kindergarten class.In fact, the term for what’s being taught here is sexuality education rather than sex education. That’s because the goal is bigger than that, says Ineke van der Vlugt, an expert on youth sexual development for Rutgers WPF, the Dutch sexuality research institute behind the curriculum. It’s about having open, honest conversations about love and relationships.

By law, all primary school students in the Netherlands must receive some form of sexuality education. The system allows for flexibility in how it’s taught. But it must address certain core principles — among them, sexual diversity and sexual assertiveness. That means encouraging respect for all sexual preferences and helping students develop skills to protect against sexual coercion, intimidation and abuse. The underlying principle is straightforward: Sexual development is a normal process that all young people experience, and they have the right to frank, trustworthy information on the subject.

“There were societal concerns that sexualization in the media could be having a negative impact on kids,” van der Vlugt said. “We wanted to show that sexuality also has to do with respect, intimacy, and safety.”

Beyond risk prevention

The Dutch approach to sex ed has garnered international attention, largely because the Netherlands boasts some of the best outcomes when it comes to teen sexual health. On average, teens in the Netherlands do not have sex at an earlier age than those in other European countries or in the United States. Researchers found that among 12 to 25 year olds in the Netherlands, most say they had  “wanted and fun” first sexual experiences. By comparison, 66 percent of sexually active American teens surveyed said they wished that they had waited longer to have sex for the first time. When they do have sex, a Rutgers WPF study found that nine out of ten Dutch adolescents used contraceptives the first time, and  World Health Organization data shows that Dutch teens are among the top users of the birth control pill. According to the World Bank, the teen pregnancy rate in the Netherlands is one of the lowest in the world, five times lower than the U.S. Rates of HIV infection and sexually transmitted diseases are also low.

There are multiple factors that likely contribute to these numbers. Easy access to contraception is one. Condoms, for example, are available in vending machines, and the birth control pill is free for anyone under age 21. But there’s also a growing body of research that specifically credits comprehensive sexuality education. A recent study from Georgetown University shows that starting sex ed in primary school helps avoid unintended pregnancies, maternal deaths, unsafe abortions and STDs.

Courtesy of Rutgers WPF

Proponents of the Dutch model argue that their approach extends beyond those risks. Their brand of sex ed reflects a broader emphasis on young people’s rights, responsibility and respect that many public health experts say is the foundation of sexual health.

A 2008 United Nations report found that comprehensive sex ed, when taught effectively, allows young people to “explore their attitudes and values, and to practice the decision-making and other life skills they will need to be able to make informed choices about their sexual lives.” Students who had completed comprehensive sex education in the Netherlands were also found to be more assertive and better communicators, according to an independent health research agency that conducted a study of the Dutch programs.

“We have to help young people navigate all the choices they face and stand up for themselves in all situations, sexual and otherwise,” said Robert van der Gaag, a health promotion official at Central Holland’s regional public health center.

‘Little butterflies in my stomach’

At the St. Jan de Doper school, a group of kindergartners sit in a circle, as their teacher, Marian Jochems, flips through a picture book. The pages contain animals like bears and alligators hugging.

“Why are they hugging?” she asks the class.

“Because they like each other,” one girl answers.

Jochems asks them to think about who they like the most. Several kids say their mom or dad. One girl names her little sister. A few name other children at school.

“How does it feel when that person hugs you?” Jochems asks.

“I feel warm from the inside,” one boy replies. “It’s like there are little butterflies in my stomach.”

Lessons like this are designed to get kids thinking and talking about the kind of intimacy that feels good and the kind that doesn’t. Other early lessons focus on body awareness. For example, students draw boys’ and girls’ bodies, tell stories about friends taking a bath together, and discuss who likes doing that and who doesn’t. By age seven, students are expected to be able to properly name body parts including genitals. They also learn about different types of families, what it means to be a good friend, and that a baby grows in a mother’s womb.

CLICK HERE TO READ A LESSON PLAN taught to Dutch kindergarten and first graders. Courtesy of Rutgers WPF

“People often think we are starting right away to talk about sexual intercourse [with kindergartners],” van der Vlugt says. “Sexuality is so much more than that. It’s also about self image, developing your own identity, gender roles, and it’s about learning to express yourself, your wishes and your boundaries.”

That means the kindergartners are also learning how to communicate when they don’t want to be touched. The goal is that by age 11, students are comfortable enough to navigate pointed discussions about reproduction, safe sex, and sexual abuse.

Let’s not talk about sex

In the United States, sexual education varies widely from state to state. Fewer than half of U.S. states require schools to teach sex ed, according to the Guttmacher Institute, a global nonprofit that researches sexual and reproductive health. Just last month Congress extended the Personal Responsibility Education Program (PREP), which funds comprehensive adolescent sexual health initiatives across the country. At the same time they increased funding for programs that promote sexual abstinence until marriage to $75 million a year. And Deb Hauser, president of Advocates for Youth, a nonprofit dedicated to sexuality education, says that sex ed in the U.S. still overwhelmingly focuses on minimizing the risk of pregnancy and STDs from heterosexual intercourse.

And nearly four in 10 millennials report that the sex education they received was not helpful, according to a survey by the Public Religion Research Institute.

“We have failed to see that sexual health is far more than simply the prevention of disease or unplanned pregnancy,” says Hauser. That narrow focus, she says, leaves young people with few skills to cope with their feelings and make decisions in sexual encounters.

Not everyone agrees.  In fact, comprehensive sex ed has yet to take hold in most parts of the country. Utah, for example, requires that abstinence be the dominant message given to students. It bans discussing details of sexual intercourse and advocating for homosexuality, the use of contraceptives or sexual activity outside of marriage.

Utah state representative Bill Wright has further tried to restrict sex ed. In 2012, he proposed a bill requiring that abstinence only be taught and that it be an optional subject. It passed but was vetoed by the governor.

Sex ed is “not an important part of our curriculum,” Wright said. “ It is just basically something out there that takes away from the character in our schools and takes away from the character of our students.”

Utah is far from alone. Half of U.S. states require that abstinence be stressed. “We have created generations of people who are not comfortable with their own sexuality,” says Dr. David Satcher, the former U.S. Surgeon General. That extends to parents and teachers, he says.

In other places, the tide is shifting toward an approach closer to that of the Dutch. Two of the largest school districts in the country — Chicago Public Schools and Florida’s Broward County — have recently mandated sex education for elementary school students. Chicago Public Schools requires at least 300 minutes a year of sex education for kindergarten through fourth grade students and twice as much time for fifth through twelfth graders. In 2014,  schools in Broward County began teaching sex education at least once a year in every grade, and the curriculum includes information about topics like body image, sexting and social media.

Courtesy of Rutgers WP

In the Netherlands, schools aim to educate parents too. Parents nights are held to give parents tools to talk to their kids about sex. Public health experts recommend that parents take cues from their kids and make it an ongoing conversation, rather than one awkward, all-encompassing “birds and the bees” talk. For example, they advise, if you walk in on your child masturbating, don’t react shocked; don’t punish or scold them. Have a talk about where it is appropriate for such behavior to occur.

“We talk about [sex] over dinner,” said one father at a Spring Fever Parents Night. Another said he recently answered questions about homosexuality posed by his twin 6-year-olds during bath time.

Lessons in love

Sabine Hasselaar teaches 11-year-olds. In a recent class, Hasselaar posed a series of hypothetical situations to her students: you’re kissing someone and they start using their tongue which you don’t want. A girl starts dancing close to a guy at a party causing him to get an erection. Your friend is showing off pornographic photos that make you feel uncomfortable.

The class discusses each scenario. “Everyone has the right to set their own limits and no one should ever cross those limits,” Hasselaar says.

There is an anonymous ‘Question Box.’ in her class during “Spring Fever” week. Students submit questions that teachers later address in class. “Nothing is taboo,” Hasselaar says. One of her students, for example, wrote: “I think I am lesbian. What should I do?”
Hasselaar addressed the issue in class: “It’s not strange for some girls to like other girls more than boys. It’s a feeling that you can’t change, just like being in love. The only difference is that it’s with someone that is the same sex as you.”

And in fact, most of the questions from her students aren’t about sex at all. “Mostly they are curious about love. I get a lot of questions like, “What do I do if I like someone?” or ‘How do I ask someone to go out with me?’”

Questions like these are taken just as seriously as the ones about sex.

“Of course we want kids to be safe and to understand the risks involved with sex, but we also want them to know about the positive and fun side of caring for someone and being in a healthy relationship,” van der Vlugt says.

That’s why you’ll find teachers discussing the difference between liking someone (as a friend) and liking someone. There’s even a lesson on dating during which a teacher talked about how to break up with someone in a decent way: “Please, do not do it via text message,” the teacher said.

After elementary school, these students will likely go on to receive lessons from a widely-used curriculum called Long Live Love.

“In the U.S., adults tend to view young people as these bundles of exploding hormones. In the Netherlands, there’s a strong belief that young people can be in love and in relationships,” says Amy Schalet, an American sociologist who was raised in the Netherlands and now studies cultural attitudes towards adolescent sexuality, with a focus on these two countries.

“If you see love and relationships as the anchor for sex, then it’s much easier to talk about it with a child,” Schalet says. “Even a young one.”

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Women draw drinking water next to the well in the Al-Wazia directorate of Yemen’s southwestern city of Taiz February 12, 2015. Researchers say diseases spread by unclean water and poor sanitation are the fifth biggest killers of women around the world. Photo by Mohamed al-Sayaghi/REUTERS.

Dirty water and poor sanitation kill more women across the globe than diabetes, HIV or breast cancer, researchers said this week.

Diseases linked to the lack of clean water and toilets kill nearly 800,000 women worldwide every year, making them the fifth leading cause of death for women, according to WaterAid, an international non-governmental organization.

“This completely unacceptable situation affects women and girls’ education, their health, their dignity and ultimately, in too many cases, results in an early and needless death,” WaterAid CEO Barbara Frost said in a statement.

More than 370 million women do not have access to clean drinking water and more than one billion live without access to a safe toilet, according to WaterAid.

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It comes amid prior criticism of the administration, along with the WHO and of other countries, for not doing more and for not getting it done faster.

We turn back to two who have been closely watching this and speaking with government officials in recent days.

Laurie Garrett of the Council on Foreign Relations, she has written widely about Ebola, including the books “Betrayal of Trust” and “The Coming Plague,”and Lawrence Gostin of Georgetown University.  He’s the director of the O’Neill Institute for National and Global Health Law.

And we welcome you — welcome both of you back to the program.

Laurie Garrett, to you first.  What is your assessment of the president’s plan that he outlined today?

LAURIE GARRETT, Council on Foreign Relations: Well, it’s a bold step forward.  I’m delighted it’s actually taking place.

But I think everything depends on the haste with which we can mobilize.  And I am afraid a lot of people don’t understand that committing troops and saying you’re going to build a hospital are all very good steeps, but it takes weeks to execute these things.  And, in the meantime, the epidemic is doubling every 10 to 20 days.  We don’t have a lot of time.  We’re racing against a clock.

JUDY WOODRUFF: Lawrence Gostin, do you have the same concerns?  What’s your assessment?

LAWRENCE GOSTIN, Georgetown Law: I think Laurie is right about timing.

First of all, I am very proud of my country.  I mean, we have stepped forward when no one else would or could.  But there are major unanswered questions.  It’s not just timing, but also command-and-control.  There’s chaos on the ground.  It’s uncoordinated.

I was very pleased to see the president say that we have a command post, but how are we going to command Chinese or Cuban workers?  I do think we need a U.N. Security Council resolution to actually have the kind of international legitimacy that we need.

JUDY WOODRUFF: So going beyond what the U.S…

LAWRENCE GOSTIN: Yes, the U.S. can’t do it alone.

JUDY WOODRUFF: Well, let me just go further here with what the U.S. is doing.  You said you’re proud of your country.  What specifically do you think is going to make the most difference here?

LAWRENCE GOSTIN: Well, I think the most difference will be training health workers, although — and building health facilities in the community, contact tracing.  All of those things are very important.

JUDY WOODRUFF: Meaning going back and finding out where…

LAWRENCE GOSTIN: Meaning going back, finding out who has been in contact with whom, and quickly isolating them in safe conditions.

One of the big problems, though, is, is that even once we have built these treatment facilities, it’s going to be handed over eventually to the Ministry of Health in Liberia.  And they just don’t have the health workers.  The doctors and the nurses have been decimated.  And so we really do have a huge infrastructure task.

JUDY WOODRUFF: Laurie Garrett, you laid out your concerns, but of what has been announced, how do you see this unfolding and making any difference?

LAURIE GARRETT: Well, first of all, we don’t have any commercial flights landing in the area now.  And so just getting doctors on the ground, getting medical supplies, keeping stocks in place of such simple things as latex gloves to protect you from infection have all proven daunting, in the absence of real solidarity from neighboring countries and the willingness to have planes land and commercial flights.

So one huge role for the U.S. military is going to be helping Ghana, which has very kindly and generously agreed to be the air bridge for all supplies and human movement into the area, to extend their runway, build their airport up, have logistic and supply operations in place, and then to have smaller flights go from Ghana into specific targeted areas carrying supplies with them as needed.

But Larry points out a crucial problem with all of this.  We don’t have a central command, which means we don’t even have a centralized list of what’s needed.  Who needs latex gloves where?  Is the situation more dire in this county in Sierra Leone or in this county in Liberia?  Where do we need to deploy people first?

We don’t have that kind of operation in place.  And our U.S. military is not going to play that role.  We will have a central command, but it will be commanding U.S. military personnel, not people from other countries and certainly not the Liberians themselves.

And we also see that the response is not a regional one.  We are, unfortunately, dividing our response according to kind of old colonial ties.  So the French are focusing on Guinea, which used to be a French colony.  The United Kingdom is focused on Sierra Leone, which is settled by the descendants of British slaves who came from the Caribbean, and we’re focused on Liberia, which is settled by former American slaves.

And so there’s this sort of distasteful neocolonial feel to things, and it means that the responses are not unified.  They are very divided by country.  So you have heard of 165 Cuban responders and 59 Chinese.  They’re all going to Sierra Leone, where they will be under we don’t know what kind of command, loosely coordinated by the Sierra Leone government.

JUDY WOODRUFF: And, Lawrence Gostin, this is sounding like a very complicated effort, which we already knew, but it sounds even more complicated listening to the two of you.

What about the timing of this?  How long is it going to take to begin to make a difference, to begin to get to the people who need treatment and are not receiving it?

LAWRENCE GOSTIN: Well, first of all, we are very late to the game.  The fire has nearly burned the house down, and we have arrived.  The cavalry has arrived.

It will take a long time, I think, to build the kind of facilities that we want.  I mean, the whole idea, for example, that we’re sending 500,000 home kits suggests that we can’t get people into hospitals quick enough to treat them and isolate them, and people who…

JUDY WOODRUFF: These are self-testing kits?

LAWRENCE GOSTIN: These are self-testing kits or self-protecting kits.  I’m not sure the community will know what to do with them when they get them.

And so this is a — this is a makeshift response to a huge humanitarian crisis.  I don’t think it had to come to this, but now that we’re there, I’m really glad the see the United States military involved.

JUDY WOODRUFF: So, Laurie Garrett, should we be pleased that this is happening or more worried because it’s not the holistic response that I heard you describing that’s necessary?

“…if we can’t get a response on the ground immediately, effectively, across the region … then we’re talking about something equivalent to the Black Death’s impact on Tuscany and Florence in 1346. “

LAURIE GARRETT: Look, I’m delighted, like Larry, to see my country step up to the plate and play a role.  And I’m hoping that we can save lots and lots and lots of lives and bring this epidemic under control.

But I agree completely we’re late to the game.  And if you just do the math, based on the statement made today by WHO, a doubling time every 10 to 21 days, and you take the number of actually identified and suspected cases existing now and do your math, you can see that if we can’t get a response on the ground immediately, effectively, across the region, we will be looking at a quarter of a million cases by Thanksgiving, and 400,000 by Christmas if this is not abated and brought under control.

And then we’re talking about something equivalent to the Black Death’s impact on Tuscany and Florence in 1346.

JUDY WOODRUFF: Sobering, sobering any which way you look at it.  We appreciate both of you joining us.

Laurie Garrett, Lawrence Gostin, thank you.

LAWRENCE GOSTIN: Thank you.

JUDY WOODRUFF: And one country in West Africa that has had relative success in controlling this virus so far is Nigeria.

While this nation has had 21 confirmed and suspected cases of the Ebola virus, including seven deaths, it has not had an explosive surge and spread since its first victim was reported in late July.

Our special correspondent, Fred de Sam Lazaro, is on assignment in Lagos, and he checked in with us earlier today.

FRED DE SAM LAZARO: Nigeria is Africa’s most populous country.  It has the largest economy on the continent and its commercial capital, Lagos, has 20 million inhabitants, all of which have raised concerns that an Ebola outbreak would be catastrophic.

But that hasn’t happened, in part due to an early break, and in large part due the a good public health response, experts say.  The virus was first brought to Nigeria by a Liberian traveler who fell ill at the airport, and, in a peculiar twist of fate, medical doctors were on strike when he was taken in for health care.

That exposed far fewer health workers to the virus, and health care workers have been especially hard-hit during this epidemic.  They have contracted the virus and they have passed it on to their patients.  Despite its reputation for chaos and dysfunction, Nigeria has launched a very sophisticated response to Ebola.

Everyone entering the country, including this reporter when we arrived yesterday at the airport, is screened for any symptoms.  Those with an elevated fever, for example, are taken in for secondary screening to make sure it’s not related to Ebola.

There’s a call center where people can report suspected cases, and a concerted public awareness campaign that has kept fear from turning into panic.  And a sophisticated surveillance system has enabled this country to trace and keep track of all cases and people with whom they came into contact.

All of these cases have been directly traced to that original index case, the Liberian traveler.  This is reassuring, but at a time when there’s so much travel and when the virus is running amuck in other parts of West Africa, Nigeria is nowhere near being able to declare victory.  A lot of fingers are still crossed tightly here.

JUDY WOODRUFF: And we will have more of Fred’s reporting from Nigeria in the coming days.

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PRESIDENT BARACK OBAMA: If the outbreak is not stopped now, we could be looking at hundreds of thousands of people infected, with profound political and economic and security implications for all of us.

JUDY WOODRUFF: The president traveled to Atlanta this afternoon and the U.S. Centers for Disease Control and Prevention to announce the ramped-up American effort.

BARACK OBAMA: And our forces are going to bring their expertise in command-and-control, in logistics, in engineering.  And our Department of Defense is better at that, our armed services are better at that than any organization on earth.

JUDY WOODRUFF: The focus is on helping overwhelmed local health care systems across West Africa.  Under the president’s plan, U.S. forces will build 17 new treatment facilities in the region, each with 100 beds.

The U.S. military is also establishing an instruction facility to train up to 500 medical workers a week, deploying 65 officers to staff a hospital for treating health care workers, and airlifting hundreds of thousands of home health kits to the affected nations.

While the president laid out that plan, top federal health officials appeared at a Senate hearing on the Ebola threat.

DR. BETH BELL, Centers for Disease Control and Prevention: There is a window of opportunity to control the spread of this disease, but that window is closing.  If we do not act now to stop Ebola, we could be dealing with it for years to come, affecting larger areas of Africa.

JUDY WOODRUFF: In all, the virus has infected nearly 5,000 people across five countries and left more than half dead.

In Geneva today, the World Health Organization issued a stark new warning.

DR. BRUCE AYLWARD, Assistant Director General, World Health Organization: With 5,000 now infected, twice the number when we met a couple of weeks ago, over 2,500 dead, nearly twice the number of when we met a couple of weeks ago, you start to get a sense of the rapid escalation now we’re seeing of the virus at it moves from what was a linear increase in cases to now almost an exponential increase in cases.

JUDY WOODRUFF: The grim forecast envisions the number of cases doubling every three weeks.  And from medical supplies to health worker salaries to burial costs, the WHO estimates it will take nearly $1 billion to contain the outbreak.  That’s a nearly 10-fold increase from a month ago.

DR. DAVID NABARRO, UN Coordinator for Ebola: The reason for that is the outbreak in last months has doubled in size.  And we realize, because it’s going to go on doubling in that sort of frequency if we don’t deal with it, the amounts requested have increased dramatically.

JUDY WOODRUFF: In addition to the U.S. response, China today dispatched a mobile laboratory and 59 medical experts to Sierra Leone to help speed up testing.

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Tonight’s episode of “Frontline” on PBS takes an intimate and harrowing look at all this on the ground in Sierra Leone. In the following scene, “Frontline” cameras travel with a group of health workers who go to remote villages, searching for Ebola’s victims.

NARRATOR: They’re heading to a village where Ebola has already killed an old man. Everyone they encounter, even those who look healthy, could be infectious.

The team used to wear protective clothing, but the suits terrified the villagers, who ran, hid and sometimes even attacked them. Manjo now relies on keeping his distance from everyone he meets.

MANJO: My name is Manjo, and this is Ishata (ph) from the World Health Organization.

NARRATOR: A young woman is clearly unwell.

MANJO: What’s wrong with you?

NARRATOR: Kadiatu Jusu (ph) is 25 years old, the mother of four children.

WOMAN: Do you have a fever?

WOMAN: Yes, I have temperature, diarrhea and I’m vomiting.

NARRATOR: Her husband, Fallah (ph), is a farmer. He’s 35. It was his father who died two weeks ago. Ishata Conteh (ph) can see Kadiatu is almost certainly infected.

WOMAN: She actually fits into the case definition, because she was the one taking care of the old man, feeding him, cleaning where the old man was vomiting, and there was direct physical contact.

MANJO: I’m going to spray this area.

NARRATOR: Manjo disinfects Kadiatu’s home with chlorine. Everything she touched could have been contaminated. Ishata notes the names of everyone who’s been in close contact with Kadiatu. Her children and husband are at the top of the list.

WOMAN: Seventeen. All these 17 people here. If anyone gets a fever or the cough or feels like they have malaria or pain all over their body or is vomiting or going to the toilet a lot, any of those symptoms, you must call us. They are all at risk. We need to monitor them for the next 21 days.

WOMAN: She, too, is going with the same thing.

NARRATOR: Fallah can’t risk touching his wife to say goodbye.

JUDY WOODRUFF: And that’s from a “Frontline” episode airing tonight.

As we reported earlier, the number of Ebola deaths in this latest outbreak now tops 2,300.

To find out what the U.S. is doing to combat the deadly epidemic, I’m joined by Nancy Lindborg. She’s assistant administrator at the United States Agency for International Development, which has been heading up the government’s response to this growing crisis.

Nancy Lindborg, thank you for joining us.

Again, how typical would you say that scene is that we just watched?

NANCY LINDBORG, U.S. Agency for International Development: I think that scene was, unfortunately, very typical, and what we’re seeing is an unprecedented outbreak that is occurring across West Africa, but particularly focused in countries that are only recently emerging from decades of civil war.

So they had very fragile health systems to begin with. And they also have practices that are enhancing the spread. You heard about the burial practices that involve touching the dead. So we are working on a strategy across the U.S. government that involves USAID, Centers for Disease Control, and DOD, State Department to work with the global community and countries on the ground to help stop the transmission, to expand treatment, and to stand up greater capacity at the local level to do exactly what you saw, be able to address this.

JUDY WOODRUFF: It’s clear that this is an epidemic that is much worse than was thought just a few — a matter of certainly a few months ago, even a few weeks ago.

What is the U.S. responsibility in all this?  At this point, there is not an Ebola patient in the U.S., except those who have been transported to the U.S. from West Africa. But what is the U.S. responsibility in this?

NANCY LINDBORG: Our responsibility as a global leader is to do what we can to contribute to that stopping of the transmission and the provision of the treatment and helping these countries stand up better systems.

We’re working closely with the global community, and this is really going to take an all-hands-on-deck kind of approach. We just announced this morning a $10 million contribution to the African Union as they mobilize a continent response. They have mobilized 100 health workers who are going in and will provide the logistical support for them to be successful.

This will — we know what it takes to stop this. We also know that it will take significant ramping up by all the various partners, and it will probably take several months to get this under control.

JUDY WOODRUFF: Ten million dollars, is that enough at this point?  Is that just a drop in the bucket?  I mean, how do you compare that to the challenge out there?

NANCY LINDBORG: That’s — that was just to support the African Union mobilization.

USAID has committed about $100 million. We have got additional commitments from the Department of Defense. They’re bring in diagnostic labs, a field hospital. We’re bringing in almost a daily airlift of supplies, the protective personal gear that you saw people wearing, the backpack sprayers, household kits, so that households have what they need to take care of loved ones and keep themselves safe, food, a whole variety of supplies.

JUDY WOODRUFF: What — is the U.S. able to understand and to — I mean, is — do you now have a list somewhere that says, OK, here are all the things that are needed, and we’re going to provide these things, or are you still figuring this out as you go along?

NANCY LINDBORG: We have a very clear strategy that we’re pursuing, in coordination with the World Health Organization, with the local countries and their health systems and with our partners, the Europeans and the African Union.

There is — it’s stop the transmission, expand the treatments, and set up local systems, and also help the home health care strategy, so that people are not continuing to handle the dead the way that they do and to — and practice the kind of daily health practices that can change forever the way this is transmitted.

JUDY WOODRUFF: But that means getting more people on the ground to spread the word, doesn’t it?

NANCY LINDBORG: Absolutely. Absolutely.

Well, both to spread the word and to help with the setting up of the treatment facilities.

JUDY WOODRUFF: And as you — as you — at this point, is this a matter of resources, or is it a matter of time, people?  What is it that’s needed the most to bring this raging epidemic under control?

NANCY LINDBORG: It’s really all of the above.

It’s surging in the supplies. It’s surging in the people who are trained to have the very rigorous protocols required to provide the treatment. It’s activating all the ways that we can provide the information to people in the communities. We are — we have surged about 100 people into the region of USAID.

JUDY WOODRUFF: Americans?

NANCY LINDBORG: Of American, USAID, CDC, Department — the DOD, all parts of the U.S. government on the ground to get us moving ahead and further identify how to plug in, how to activate a coordination system on the ground.

JUDY WOODRUFF: How much are you concerned?  What are the odds, the chances that Ebola could spread to the United States?

NANCY LINDBORG: You know, part of what we have done is brought in a lot of those thermometers that you saw the health workers using, and set up the kind of screening that is done at the airports, so that there’s that additional control.

There’s — we always want to be concerned about global epidemics, but this — this is controllable and this is — what we have seen is, as it’s spread to places like Senegal, that they have the systems to do the tracing, the treatment, and they’re able to keep it from spreading.

Ultimately, there needs to be strengthening of the health systems, so that when these kinds of cases appear, there can be the kind of immediate response that keeps it from becoming the kind of really terrible outbreak that we’re seeing right now.

JUDY WOODRUFF: An enormous task.

Nancy Lindborg with the U.S. Agency for International Development, we thank you.

NANCY LINDBORG: Thank you.

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JUDY WOODRUFF: The U.N.’s nuclear watchdog conceded that its progress investigating Iran’s nuclear program has hit a wall. The latest confidential report by the International Atomic Energy Agency was obtained by several news media outlets.

It said the IAEA had satellite imagery showing ongoing construction activity a Parchin military base, a suspected nuclear site. It also revealed that Tehran had only implemented three out of five measures to be more transparent under a deal with the IAEA. Iran denies that it wants or is working on nuclear arms.

A plane chartered by coalition forces in Afghanistan, and carrying about 100 Americans, had to land in Iran today after filing the wrong flight plan. The Washington Post first reported the incident. Iranian air traffic control reportedly asked the plane to return to Bagram Air Base in Afghanistan, but it didn’t have enough fuel. A senior State Department official said the issue has been resolved and the plane is scheduled to resume its flight.

There was new information released today on one of the deadliest friendly-fire episodes of the war in Afghanistan. An investigation by the U.S. military into the June episode found communication errors led to the deaths of five American soldiers and one Afghan. The incident happened in Zabul province when a B-1 bomber crew failed to check their information properly before launching two laser-guided bombs which hit the soldiers.

The Pentagon confirmed the death of the leader of the African terror group Al-Shabab today. Ahmed Abdi Godane was killed in a U.S. airstrike on Monday in Somalia. In a statement, the Defense Department said it was a major symbolic and operational loss for the terrorist organization.

Flash floods and landslides sparked by torrential monsoon rains have killed at least 116 people in Eastern Pakistan and Kashmir. Swollen rivers today swept away buildings and bridges and left many trapped on their own rooftops. Soldiers and emergency workers used boats and helicopters to ferry the stranded to safety. The flooding was forecast to intensify this weekend.

A third American aid worker infected with the Ebola virus in Liberia is now in stable condition in Nebraska. Dr. Rick Sacra arrived at a hospital in Omaha early this morning with a police escort. He had been evacuated from West Africa. The 51-year-old delivered babies at a Liberia hospital, and it’s still unclear how he contracted the virus. The head of the Nebraska Center’s Infectious Diseases Division said the patient is in a specially equipped bio-containment unit.

DR. MARK RUPP, Infectious Diseases Division Chief, Nebraska Medical Center:  We’re doing our basic checks on him right now with getting some of our baseline laboratories, making sure that his fluid status is equilibrated, that his electrolytes are in control. We know that he is seriously ill with a virus that has a fairly high mortality rate associated with it.

Like I said, we will continue to care for him with very aggressive, supportive care, and we’re looking into alternatives for some of our experimental therapeutics right now.

JUDY WOODRUFF: Two other American health workers who contracted the virus in Liberia were treated and cured at Emory University in Atlanta.

Also today, the World Health Organization reported the death toll in West Africa from the Ebola outbreak passed the 2,000 mark. Half of those deaths were in Liberia.

Job growth slowed in August, as U.S. employers hired fewer workers than analysts had expected. But stocks on Wall Street seemed undeterred by the news. The Dow Jones industrial average gained more than 67 points to close at 17,137; the Nasdaq rose 20 points to close above 4,582; and the S&P 500 added 10 points to finish at 2,007. For the week, the Dow, the Nasdaq, and the S&P all rose a fraction of a percent.

And in a special piece of good news, the California blue whale has bounced back from near extinction. A study done at the University of Washington found that they have recovered to number about 2,200 in the Pacific Ocean. That’s about 97 percent of historic 19th century levels. But the largest animals on earth are still vulnerable to being stuck by large ships.

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A banner explains Ebola prevention measures and symptoms of the disease in Dolo’s Town, east of Monrovia, Liberia. Photo by Dominique Faget/AFP/Getty Images.

Despite world health agencies’ best efforts to clamp down on ever-increasing Ebola outbreaks, people in West Africa who are in the center of the virus’ path are finding it hard to get accurate information and proper medical care, United Nations officials who recently visited the region said Wednesday.

Dr. Margaret Chan, director-general of the U.N.’s World Health Organization, said in a conference call that there are an estimated 3,500 confirmed Ebola cases mostly in Guinea, Liberia and Sierra Leone. More than 40 percent of new cases occurred in the past 21 days.

“The outbreaks are racing ahead of the control efforts,” she said.

On Aug. 28, the World Health Organization released an updated Ebola strategy aimed at stopping the spread of the disease in the affected countries in six to nine months. The agency also is reviewing the most promising experimental therapies and vaccines later this week to add to the response plan, said Chan.

The bulk of Ebola infections occur when family members take care of each other, said Dr. Keiji Fukuda, assistant director-general for health security at WHO. There aren’t enough beds in treatment clinics, so the sick stay at home, he said. “Ill people have nowhere to go.”

Several thousand more workers are needed to care for patients in the hard-hit nations, along with additional vehicles to transport the sick and dead. “Bodies are not removed quickly enough” by health authorities, he said. “It is really upsetting” to the residents.

Chan said the World Health Organization is trying to recruit medical teams from other countries, but hasn’t found very many. “Without them, it is very difficult to mount a response in keeping with the situation,” she said.

Airlines are cancelling flights to the Ebola-stricken nations to protect against the spread of the disease, but it complicates getting the health care workers to the region, she added.

Meanwhile, quarantined communities are going hungry because not enough people are bringing them food, said Fukuda. They also crave more information about the devastating disease. Many know it’s unsafe to touch people who have died from Ebola or are sick, but they don’t know what to do beyond that, he said.

The United Nations is working with its partner organizations in the field, including Doctors Without Borders and the International Committee of the Red Cross, to spread information about the causes and symptoms of Ebola, and encourage people to get treated early to increase their likelihood of survival, said Chan.

“There is a lot of misunderstanding, rumor and denial in communities that Ebola isn’t real and is something being given to them from the outside,” she said.

The United Nations also is working with the heads of the affected African governments to forge a coordinated response, but stigmatization of the disease and those who have it is making it difficult to implement, Chan said.

At least $600 million will be needed to help the governments get the situation under control, including paying for vehicles, medical supplies and salaries of health care workers, said Dr. David Nabarro, senior U.N. system coordinator for Ebola disease.

“We are not in a position where we can afford to lose a day, because this outbreak is currently moving ahead of efforts to control it,” he said.

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“NewsHour” correspondent Fred de Sam Lazaro reports as part of his Agents for Change series. A version of Fred’s story aired on the PBS program “Religion & Ethics Newsweekly.”

And a warning:  This piece contains some disturbing images.

FRED DE SAM LAZARO: For the Bowen family, this was a huge day.

MAN: She got the international baccalaureate diploma, and then she got the biliteracy medal, as opposed to bilingual. It’s like she can read and write and talk.

FRED DE SAM LAZARO: That 18-year-old Maya Bowen can talk, let alone graduate with honors, seems both natural and unlikely, given her early childhood in a distant orphanage. Richard and Jenny Bowen adopted her when she was two.

Jenny Bowen, Half the Sky Foundation: No one had ever talked to her and, you know, language develops when people talk to you. That’s how you learn to speak, so she had no language at all.

WOMAN: OK. Daddy is going to take pictures of you.

FRED DE SAM LAZARO: Jenny Bowen recently published a book called “Wish You Happy Forever,” chronicling how Maya and later Anya came to be part of the family. The California couple were already in their 50s, with grown children, but they were moved by reports of child neglect on a vast scale in China.

WOMAN: Here, we found toddlers tied to bamboo seats, with their legs splayed over makeshift potties.

FRED DE SAM LAZARO: This 1995 film, shot undercover, called “The Dying Rooms” showed orphanages filled with girls, abandoned in a country that had begun restricting families to one child in a culture that traditionally favored boy children.

JENNY BOWEN: We thought the thing we could do was save one life. So that’s what we did. We went to China to save a life.

FRED DE SAM LAZARO: But she found it impossible to ignore the conditions Maya would escape, but where millions of others still languished — in the custody of indifferent or untrained workers, invisible in a nation focused on industrializing its way out of Third World poverty.

Sixteen years later, Jenny Bowen heads a group called the Half the Sky Foundation that’s helping transform the way orphans are cared for across China, with the blessings of and often in partnership with the government.

The name derives from a Chinese proverb that says women hold up half the sky. The group has so far trained 12,000 teachers and nannies in 27 provinces. We visited in the northeastern city of Shenyang.

JENNY BOWEN: All these children are abandoned. Many of them are abandoned because they have what are called special needs.

Before Half the Sky, children are tied to their chairs. They were lying in bed. You could see the tragedy. You walk into a room, and you were just confronted with the tragedy. Here, it’s invisible. These children are going on with their lives. They’re being treated like their lives matter. And they know it. They know they’re loved, and so they thrive.

FRED DE SAM LAZARO: She says children need a sense of being part of a family, in whatever shape family takes.

JENNY BOWEN: It doesn’t mean that they have to be back with their birth families or permanently adopted or anything. They just need to have the love that a family gives naturally to a child, and, to me, it was like a no-brainer.

FRED DE SAM LAZARO: It was not a no-brainer to get her ideas across in an opaque state-run welfare system. What’s more, the publicity about orphanage conditions was deeply insulting to a government highly sensitive about China’s image.

Zhang Zhirong works for Half the Sky’s China offices.

ZHANG ZHIRONG, Half the Sky Foundation: China always want to tell the world she is the best, everything perfect. We are serving the people. We are helping the people. That’s China politically. But, as you know, China is such a big country. At that time, it was difficult to let people, especially foreigners, to come in to see some of the problems, to see some of the dark side.

FRED DE SAM LAZARO: Zhang was a key early ally, an English professor and official interpreter well-versed in the culture and politics of the bureaucracy. She was convinced of Bowen’s sincerity.

ZHANG ZHIRONG: I really feel she had the heart. She wanted to help. No other intentions.

FRED DE SAM LAZARO: Did it help that she had Chinese daughters as well?

ZHANG ZHIRONG: That’s also — we would tell — she always says, “I’m half-Chinese. My daughters are all Chinese.”

JENNY BOWEN: I know that resonated. Certainly, the international criticism let them know that something had to be done. I probably was the least threatening of the options out there.

FRED DE SAM LAZARO: Bowen began by seeking guidance from child development experts. She raised funds in Hollywood, where she was a screenwriter and filmmaker, and from American couples who’d adopted Chinese daughters. She organized volunteer trips to train caregivers and spruce up the environment in which orphans spent their days.

Children who once sat impassively are now in busy preschools. Walls that had generic cartoon images now display the children’s own artwork and pictures.

JENNY BOWEN: Children in institutions, in traditional institutions, they move in packs. They all eat at the same time, they all sleep at the same time, they all pee at the same time, and they don’t separate themselves from each other.

So we use a lot of mirrors, we use things like this, where they can identify themselves and their friends, and it’s a way for them to start knowing who they are, and that’s the beginning of developing intellectual curiosity and opinions.

I can tell you already have opinions, right?

FRED DE SAM LAZARO: Teacher Lin Lin says Half the Sky’s approach, called responsive care, is tailored to children’s individual learning interests — a far cry from the previous rote learning.

LIN LIN, Schoolteacher, Half the Sky Foundation (through interpreter):  Kids were asked to recite a lot of things, old poems and literature, which they did not understand, they weren’t interested in. Now we’re doing things that are interesting to them. Gradually, you build a trust with these children, and they begin to consider you as part of their family.

FRED DE SAM LAZARO: That’s a key goal: to make such caregivers part of the child’s understanding of family. But Half the Sky is also building so-called family villages, a more traditional setting.

Couples, most with grown children, like Liu Peng Ying and her husband, Chen Yung Chang (ph), are given housing and a small stipend to raise their young orphaned charges. It’s an easy sell in a country where large families used to be the tradition.

LIU PENG YING, China (through interpreter): These are like my own children, like my grandchildren. My husband likes children even more than I do. That’s why we decided to apply for this program.

FRED DE SAM LAZARO: In today’s wealthier, more urbanized China, Bowen says fewer healthy female babies are abandoned. About three quarters of a million children are in state custody.

They are more likely to be from impoverished rural areas and more likely to have congenital or medical conditions their families cannot afford to treat.

JENNY BOWEN: So, in this room, we find children who have pretty severe special needs.

FRED DE SAM LAZARO: For them, Half the Sky runs a care center in Beijing, with corporate foundation and government support. It provides care for children as they await or recover from surgery or as, in the sad case of 4-year-old Pin Pin, chemotherapy

JENNY BOWEN: She has cancer in both of her eyes?

WOMAN: Yes, and eight times chemo.

JENNY BOWEN: Eight times chemo.

FRED DE SAM LAZARO: For the weeks or months Pin Pin will spend here, a teacher will help her adjust to the loss of her sight.

JENNY BOWEN: You need to have a teacher, because you have a lot of things you have to learn. We don’t just worry about your eyes. We have to worry about your brain, huh?  Yes.

MAN: Maya Bowen!

(CHEERING AND APPLAUSE)

FRED DE SAM LAZARO: Maya Bowen plans to become an elementary teacher. She and Anya, a high school junior, have gone from being thankful to impressed.

MAYA BOWEN: I did a paper and we could — at school, and it was a research paper, and we could do it on anything, so I chose my mom, because I thought that would be an easy topic. But then, when I started researching and learning everything she did, I was like, wow, like, this goes way farther than I thought. She has, like, a much bigger influence than I ever thought.

FRED DE SAM LAZARO: Jenny Bowen is now 68 and CEO of a now $7 million-a-year enterprise that she hopes to expand beyond China to neighboring countries in Asia. She has no plans to retire.

JUDY WOODRUFF: Fred’s reporting is a partnership with the Under-Told Stories Project at Saint Mary’s University of Minnesota.

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And, Dr. Frieden, there was a level of urgency and concern put forward today that I don’t think we have heard from you and other officials so far. Have we entered a new and frightening phase in all this?

DR. THOMAS FRIEDEN, Director, Centers for Disease Control and Prevention: Well, unfortunately, the situation is bad.

It’s worse than I and others had feared. The number of cases is increasing rapidly. The human tragedy is heartbreaking. And we anticipate that, in the next few weeks, we’re going to see significant further increases in cases and in the places where it’s spreading.

So, this is definitely an epidemic and really the world’s first epidemic of Ebola, meaning spreading widely. And it’s spiraling out of control.

What’s really important to understand is that we know how to under — we know how to control it. And there is this window of opportunity that’s closing, but it’s not too late. We have to act now. Urgency couldn’t be higher. Speed is of the essence.

JEFFREY BROWN: Well, tell us — you use this kind of language, the window of opportunity is closing, the challenge is so great. You said today the epidemic is so overwhelming that it now requires an overwhelming response.

What specifically did you see on your trip and are you getting from responses from health officials around the world that is so alarming now?

DR. THOMAS FRIEDEN: Well, I will tell you an example.

Doctors Without Borders, MSF, is doing phenomenal work. They’re working an extraordinarily difficult situation and trying to really do whatever they can to help patients and stop the outbreak, but they’re overwhelmed by the number of patients. So they’re opening new hospital beds as fast as they can, but only safety — they have a terrific track record of safety for the people working in the Ebola treatment units.

But in order to do that, they can’t open them as fast as the patients are requesting hospitalization. What that means is that patients are not being hospitalized, and they are spreading Ebola in communities, including in urban communities, where it can spread quite widely.

JEFFREY BROWN: Well, so you said today and you just said to us again that, in essence, we know how to contain Ebola, but then why the lack of success?  What are the greatest impediments and what do you most need right now?

DR. THOMAS FRIEDEN: It’s fundamentally about speed and scale. Every day we delay in getting the proven treatments and prevention out there, it spreads more widely and we have more of it.

One of the encouraging things I did see was people throughout the region willing to help, willing to really work to make a difference. Ninety percent of the staff at the Doctors Without Borders hospitals are local staff who have been rigorously trained and are working hard to stop the outbreak and care for patients, but the challenges really are enormous, and the urgency is so great.

The sooner we increase beds, the sooner we make burials safer, the sooner we help health care workers be safer from infections, we are going to be better off in terms of beginning to turn this outbreak around. Time is lives here.

JEFFREY BROWN: One of the things you said today really jumped out at me. You were talking about as the world isolates itself from these countries, it is having an adverse effect.

It’s harmful to the countries and it’s ultimately harmful to the rest of the world, including us, and you said, like it or not, we are connected. So explain that. Should we not be isolating those countries?

DR. THOMAS FRIEDEN: The fact is, people are going to move around the world, and the only way to really protect ourselves from this is to stop it at the source.

It’s not dissimilar to the dynamic that’s happened within these countries. Frankly, against the advice of many, some of the countries enforced quarantines in some areas. And the — as Dr. Liu from MSF said earlier on your program, that’s really counterproductive, because it drives patients underground, it increases hostility. And it’s not a way to help.

What we need to do is to get services to patients, to families, get people into care and isolation quicker, so they stop spreading disease and so they have a better chance of survival, because early treatment does improve survival.

JEFFREY BROWN: But given the interconnectedness that you’re talking to, what about the potential for a spread in the U.S.?  And given this new alarm of how quickly this is spreading, what do you tell people tonight who are afraid here in this country?

DR. THOMAS FRIEDEN: Well, given the large increase in cases that we’re seeing and think we’re likely see in the coming weeks, I would be surprised if we didn’t see other cases in other parts of Africa.

For the U.S., it’s certainly possible we will get someone here who develops symptoms of Ebola and may have Ebola. That’s a possibility. That’s why we have asked doctors working in emergency departments and elsewhere to be on the lookout for people who have been in an area with Ebola in the past three weeks, and, if they have fever or other symptoms consistent with Ebola, to isolate and test them.

That’s also why we have worked with about 10 states from around the country to have tests for Ebola up and available, so that they can be tested in a regional approach, so we’re prepared in this country.

Ebola doesn’t spread through casual contact. It doesn’t spread through the air naturally. The way it spreads is by physical contact with a sick person or their body fluids or someone who’s died from Ebola with their body fluids.

And standard infection control in hospitals has prevented spread of five cases of hemorrhagic fevers that have been in the U.S. in the past decade.

JEFFREY BROWN: I just want to ask you in our last minute about one other frightening scenario that you raised today, which was the possibility that Ebola might become easier to spread through genetic mutation.

You said you didn’t see signs of it yet, but it’s — the possibility is not zero, I think is the way you put it. Explain that, because that would be a quite frightening new step.

DR. THOMAS FRIEDEN: Well, the genetic material of the virus has been quite stable for 40 years. So we don’t think of this as a virus that changes much.

But the longer it spreads and the more people it spreads to, the more what’s called selective pressure that might favor strands that do spread more easily. And that’s a concern. It’s something we will be tracking for.

But the bottom line here is, we have to surge our response and act now. By bringing down the number of cases, we will protect ourselves, we will protect West Africa, we will reduce the humanitarian crisis, insecurity that’s there, and we will make it less likely that there are patients traveling to other parts of the world, and less likely that we could get that kind of a mutation.

JEFFREY BROWN: All right, Dr. Thomas Frieden of the CDC, thank you so much.

DR. THOMAS FRIEDEN: Thank you.

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