Ada Igonoh was the physician who pronounced 40-year-old Patrick Sawyer dead. Four days after he was admitted to First C­onsultants Medical Centre, a hospital in Lagos, Nigeria, she found him collapsed and unresponsive in his private bathroom. That day, no one was allowed near the door until World Health Organization (WHO) officials removed the body. On the day he died, July 24, 2014, an evaluated blood sample confirmed everyone’s worst fears. Ebola Virus Disease (EVD) had arrived in the largest city on the African continent.

At that time, Ebola infections had dispersed for eight months across countries of the Mano River countries—Liberia, Sierra Leone and Guinea—where the Ebola outbreak began in December 2013. None of these countries’ heads of state had yet declared a medical crisis. Neither had the WHO. Yet, the death of a visitor traveling from Liberia led Nigerian officials to immediately declare a national state of emergency. They began managing a potentially catastrophic situation, one that would catch by surprise those at the forefront of infectious disease management.

In Nigeria, there is a critical mass of scientific, medical and public health expertize—founded on decades of experience managing medical crises, natural disasters and the health-related fallouts of economic breakdown driven by policies of international financial institutions. Bypassing a highly underfunded health care system and a global racial divide when it comes to accessing medical treatment, Nigerian personnel set up an emergency response unlike any other in the past. Their efforts resulted in one of the highest survival rates in the history of Ebola outbreaks.