On Friday, officials from the United Nations health sector commended the advancements made in addressing the Ebola outbreak, which raised international alarm six months ago. However, they warned that the virus is infiltrating more remote and hazardous regions of Congo.
With confirmed cases exceeding 11,100, this outbreak ranks as the second most severe in Ebola history and has spread across eastern, central, and western Africa. The Africa Centres for Disease Control and Prevention (Africa CDC) reports that over 5,400 individuals have lost their lives to the disease so far.
Initially identified by health authorities in mid-May, this outbreak is associated with the uncommon Bundibugyo strain of the virus, for which there are currently no approved vaccines or treatments.
Chikwe Ihekweazu, the head of the World Health Organization’s Health Emergencies Programme, stated, “We observe some positive developments,” noting a decrease in cases in previous hotspots like Bunia, located in eastern Democratic Republic of Congo.
“Nonetheless, we are now witnessing cases appearing in more rural and challenging-to-reach locations.”
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He noted that children represent over one third of the fatalities, while transmission persists with approximately 500 new cases reported each week.
According to him, “The most significant obstacle to the response at this moment is the escalating insecurity,” referring to WHO data that indicates there have been 80 assaults on health facilities and personnel to date.
“Violence limits our ability to assist those in need. It disrupts monitoring efforts, impedes treatment, and forces individuals to relocate, thus hindering their access to care,” Ihekweazu explained.
A recent attack by a rebel group in North Kivu resulted in the deaths of 66 civilians, including three health workers. Additionally, three medical facilities were looted and set ablaze, and over 1,000 individuals being monitored for exposure were lost to follow-up due to the violence. Three confirmed Ebola patients are also currently unaccounted for.
Congolese civilians carry their belongings as they flee following an attack by Islamic State-linked militants, who burned homes, a health post and other buildings, in Cantine-Aloya, Democratic Republic of Congo, on Nov. 6. (Gradel Muyisa Mumbere/Reuters)
Dr. Marie Belizaire, an emergency director at WHO, emphasized the need for an immediate cessation of hostilities and violence during a briefing.
Belizaire warned that the ongoing violence jeopardizes the progress achieved over the past six months.
“Health workers and humanitarian teams must be able to access affected communities safely, and patients should be able to seek care without fear,” she stated.
Surveillance remains a hurdle
Since the outbreak was officially announced on May 15, Ebola has expanded into eight provinces.
The Africa CDC indicates that there have been some advancements. The capacity for laboratory testing and the number of patient beds have seen considerable growth. Initially, only two labs were operational, but now there are 30 testing labs functioning across the affected health zones.
Dr. Wessam Mankoula, a medical epidemiologist with the Africa CDC, noted, “At the start of this response, we could only conduct testing for a handful of cases — we now have the capacity for over 4,300 samples per day.”
Currently, there are 2,000 beds available for patient admission, and more than 3,000 individuals have recovered from Ebola.
However, Mankoula pointed out that simply having more beds and testing capabilities will not be sufficient to control the outbreak.
Dr. Toussaint Selemani, head of medical activities at the Ebola Treatment Center of the Kitatumba Reference Hospital, speaks with his medical colleagues in Butembo in October. (Gradel Muyisa Mumbere/Reuters)
“Surveillance is a significant obstacle — identifying all potential contacts,” he stated. “This is crucial for the success of this response.”
Only 11 percent of new cases are traced from contact lists, and nearly two-thirds of fatalities continue to happen outside of healthcare facilities.
Limited access to funding leads to ‘dysfunctions’
During a briefing, the Africa CDC reported that, according to their tracking, $3 billion USD has been pledged to assist with the crisis, but only 45 percent has been released.
According to the French medical charity Doctors Without Borders, aid is not reaching the most affected populations, highlighting issues such as untrained and unpaid personnel, ambulances lacking fuel, and a shortage of surveillance teams and supplies to manage suspected cases safely.
“Despite the substantial sums allocated for the response, many frontline responders are left attempting to manage the outbreak with inadequate resources,” remarked Dr. Javid Abdelmoneim, the international president of Doctors Without Borders, on Thursday.
“Our teams often find themselves at a loss for words due to the dysfunctions they encounter in many regions. Six months into the response, this situation is utterly unacceptable.”
Doctors Without Borders urged the Congolese government and United Nations agencies, including the World Health Organization, to ensure that the resources mobilized translate into effective support at the ground level.