New Ebola infections in the DR Congo

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by Hans Dembowski

It looks as though Ebola lessons have been learned

In mid-May, international media reported a new outbreak of Ebola in the Democratic Republic of the Congo. Most worrisome, a city of about 1 million people is affected. The good news is that this crisis, so far, does not seem to be spinning out of control. There are several reasons.

When Ebola haunted the West African countries of Guinea, Liberia and Sierra Leone in the years 2014 to 2016, some 28,000 people were infected, of whom about 40 % died. It became evident that the response of international agencies, and in particular the World Health Organization (WHO), had been too slow. The disease should have been contained early on, but it was allowed to spread.

This time things are different. The Economist, for example, praises the WHO for having deployed experts to Mbandaka, the city on the shores of the Congo River where Ebola was recently reported. The London-based magazine also points out that authorities in neighbouring cities are paying attention.

It helps that Ebola outbreaks have happened in the DRC before. The country’s governance system is chaotic and its health-care system is overburdened. Nonetheless, it has some experience of dealing with Ebola. The disease actually carries the name of a river, close to which it was first diagnosed in the mid 1970s. Jean-Jacques Muyembe, a doctor who was involved in the research back then told the BBC: “I am confident because I think we have very good experience of this disease, and we’ll stop this outbreak as soon as possible.” 

Previous outbreaks occurred in rural areas, where the disease is easier to contain. There is reason to worry that it may spread fast in densely-populated Mbandaka. On the up-side, however, a new vaccine is likely to help to limit the damage. The WHO is cooperating with DRC authorities, UNICEF, Doctors without Borders (MSF) and Gavi, the global vaccine alliance on administering it.

They are taking the unusual approach of not trying to immunise the population in general, but only targeting people who have been in touch with patients. This “ring” strategy makes sense for several reasons:

  • It obviously is important to contain the disease.
  • The vaccine is innovative, and its supply is limited. So far, some 7000 doses have been made available.
  • The vaccine’s clinical testing has not been concluded, so side-effects are not well understood. Nonetheless, the use of this innovative medication is ethically correct because its risks are sure to be smaller than those of an Ebola infection, which all too often proves deadly.

It is too early to say that things will go well in the DRC. The outbreak could still spin out of control and kill masses of people. But in contrast to the West African epidemic a few years ago, national and international actors have been responding fast and decisively. Advanced technology is probably helping too. It seems that some lessons have been learned.

Unfortunately, it must be added not all globally relevant institutions have learned the lessons. The New York Times opines: “The Trump White House (…) appears to be uniquely amnesiac. On the same day that officials in the Democratic Republic of Congo reported the new Ebola cases, the administration sought to rescind $ 252 million in Ebola response funds left over from the earlier epidemic. (…) The National Security Council dissolved its biosecurity directorate, a small team focused exclusively on global health security threats and led by a director often referred to as the Ebola czar.”

 

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