In late August 2014, Tom Frieden, then director of the Centers for Disease Control and Prevention, traveled to West Africa to assess the raging Ebola crisis.

In the five months before Friedens visit, Ebola had spread from a village in Guinea, across borders and into cities in Liberia and Sierra Leone. Mdecins Sans Frontires, the first international responder on the scene, had run out of staff to treat the rising numbers of sick people and had deemed the outbreak out of control back in June.

But when Frieden arrived in West Africa, the World Health Organization, the United Nations agency charged with coordinating the global response to disease outbreaks, had only just declared Ebola to be an international public health emergency. Although WHO had announced a $100 million Ebola action plan the week prior to that declaration, many major donors were still sitting on the sidelines.

Frieden returned to the United States desperate to find more help. On Aug. 30, one day before a scheduled call with President Barack Obama , he emailed his point person for one of the key organizations in global public health. That person wasnt at a U.N. affiliate or any other public agency he was Chris Elias, president of the global development program at the Bill and Melinda Gates Foundation.

We do not have a specific strategy or budget for emerging infections, but these are extraordinary times and Id be willing to make the case internally if it makes sense, Elias wrote back hours later.

Situation is incredibly dire, Frieden replied very late that night. I should brief you, Bill, and others next week. All of Africa is at risk. Support now is worth many times what support in a few weeks would be worth. Literally every day counts.

Frieden emailed again on Sept. 1. I think Bill should hear directly and soon, he wrote. The situation is catastrophic.