Fatal attacks on Congo clinics risk resurgence of Ebola epidemic

By Fiston Mahamba

GOMA, Democratic Republic of Congo (Reuters) – International organizations warned on Friday of a potential resurgence of Ebola in Congo after deadly militia attacks on health centers forced aid groups to suspend operations and withdraw staff from the epidemic’s last strongholds.

Mai Mai militia fighters killed four people and injured several others at two Ebola centers on Thursday in the worst yet of violence hampering efforts to tame the outbreak in eastern Democratic Republic of Congo (DRC).

The world’s second biggest Ebola epidemic on record has killed over 2,200 people since mid-2018, but new infections slowed in recent months.

“Ebola was retreating and now it is likely to resurge,” World Health Organization (WHO) spokesman Christian Lindmeier told a news briefing in Geneva. WHO has relocated 173 staff while the U.N. children’s agency UNICEF has evacuated 20 staff.

After Thursday’s fatal raids on health centers in Mangina and Byakoto, a screening center was also attacked overnight in the town of Oicha, Congolese health authorities said.

Mai Mai fighters and local residents have attacked health facilities sometimes because they believe Ebola does not exist and in other cases because of resentment that they have not benefited from the influx of donor funding.

The International Federation of the Red Cross (IFRC) halted operations in the towns of Mangina, Beni and Butembo.

“We’ve had to put all Ebola activities on hold in high-risk areas,” said Corrie Butler, spokeswoman for the IFRC in Congo, saying the attacks had been in areas with most Ebola cases.

At least 1,500 Red Cross staff and volunteers are involved in Ebola work in east Congo, she said, most in areas where activities are now suspended due to violence.

The World Food Programme (WFP), another U.N. agency which provides food to those around infected people and at risk of Ebola, said its activities had also been interrupted due to insecurity.

Congolese health authorities said they had evacuated 13 staff and other transfers were underway.

The Alliance for International Medical Action (ALIMA) charity said activities at its treatment centers in Mambasa and Katwa towns were not suspended but it was monitoring the security situation closely.

Thursday’s attacks followed raids on communities by suspected Islamist rebels believed to have killed at least 100 people in the past month, according to U.N. figures.

At least four people also died this week during protests at the perceived failure of the army and U.N. peacekeepers to protect civilians from the Islamist Allied Democratic Forces (ADF)

(Reporting from Fiston Mahamba in Goma, Stephanie Nebehay in Geneva, Anna Pujol-Mazzini in Dakar; Writing by Anna Pujol-Mazzini; Editing by Alessandra Prentice and Andrew Cawthorne)

Ebola death toll in east Congo outbreak climbs above 2,000

FILE PHOTO: A health worker fills a syringe with Ebola vaccine before injecting it to a patient, in Goma, Democratic Republic of Congo, August 5, 2019. REUTERS/Baz Ratner/File Photo

By Djaffar Al Katanty and Aaron Ross

GOMA, Democratic Republic of Congo (Reuters) – The death toll from Democratic Republic of Congo’s year-long Ebola outbreak has climbed above 2,000, government data showed on Friday, as responders battle to overcome community mistrust and widespread security problems.

The death in neighboring Uganda of a 9-year-old girl who had tested positive for the virus after entering the country from Congo underscored the challenge medical teams face containing the disease in border territory with a highly mobile population.

The government team overseeing the response said the number of confirmed and probable cases had also hit a milestone of more than 3,000 in what has become the second-worst epidemic of the virus on record.

Despite the development of an effective vaccine and treatments, health workers have struggled to stop the virus spreading in remote and conflict-hit areas of eastern Congo, where many locals are wary of the response effort.

Nevertheless, the World Health Organization said the latest Uganda case highlighted the border authorities’ skill at detecting and isolating potential sources of transmission.

“This case was picked up at the border,” WHO spokeswoman Fadela Chaib said at a briefing in Geneva. “The people who are at the borders have the expertise.”

This is Congo’s 10th Ebola outbreak, but it is the first in the densely forested hillside provinces of North Kivu and Ituri, where militia-led violence and ethnic killing have undermined security in certain areas for decades.

The WHO declared the epidemic an international health emergency in July – only the fifth outbreak to warrant this status since the system was introduced in 2005.

The authorities have since come up against new fronts in their fight to contain the virus, testing the reach and flexibility of responders.

Health workers confirmed the first cases in South Kivu province on Aug. 16. Soon after, a woman contracted the virus in a remote, militia-controlled territory in North Kivu, hundreds of kilometers away from other known cases.

“The response is being spread too thin chasing new cases at the expense of the longer-term community engagement that is crucial if we’re ever to hope of being Ebola free,” Oxfam’s Congo Director Corinne N’Daw said in a statement.

Despite the virus spreading to new areas, the past week’s transmission rate was little changed from that of the past month and a half, which has seen an average of 77 new cases per week, according to the WHO.

Last week the WHO voiced concern about the widening geographic reach of the disease, but confirmed the virus had not gained a foothold in the major city of Goma, even after four cases were recorded there in July and early August.

Goma, a lakeside city of nearly 2 million people on the Rwandan border, had been on high alert for weeks after a gold miner with a large family infected several people with Ebola before dying himself.

The latest government data showed Ebola deaths reaching 2,006 and cases at 3,004.

“Two thousand deaths means that there is a problem,” said Timothée Buliga, a priest, returning home from his church in Goma. “We need to reach the point where we reject Ebola, say no and eradicate it definitively.”

Only the 2013-2016 Ebola outbreak in West Africa has been deadlier than the current outbreak. More than 11,300 people died then out of the 28,000 who were infected.

(Additional reporting by Tom Miles and Stephanie Nebehey in Geneva; Elias Biryabarema in Kampala; Writing by Alessandra Prentice; Editing by Kirsten Donovan and Hugh Lawson)

Deployment of second Ebola vaccine would not be quick fix, experts warn

FILE PHOTO: Congolese health workers collect data before administering ebola vaccines to civilians at the Himbi Health Centre in Goma, Democratic Republic of Congo, July 17, 2019. REUTERS/Olivia Acland/File Photo

By Fiston Mahamba, Kate Kelland and Aaron Ross

GOMA, Democratic Republic of Congo (Reuters) – The resignation of Congo’s health minister in the midst of the country’s worst Ebola outbreak could clear the way for a second experimental vaccine to be deployed. But the new shot would likely take months to win the trust of frightened locals and show results, health officials say.

Oly Ilunga, who opposed using the vaccine developed by U.S. pharmaceutical giant Johnson & Johnson, resigned as minister on Monday after being bumped off the Ebola response team.

The World Health Organization recommended the two-dose shot to complement a vaccine by U.S. drugmaker Merck, which has proved highly protective but is in relatively short supply.

Proponents, including medical charity Medecins Sans Frontieres (Doctors Without Borders) and the Wellcome Trust, said the new vaccine could be deployed to areas not yet affected by Ebola to create a firewall against the virus, which the WHO declared an international health emergency last week.

But Ilunga said the J&J vaccine had not been proven effective and could confuse people in eastern Democratic Republic of Congo, where wild rumors are hampering the response.

“Congolese have the right to have the gold standard, the best vaccine,” he told Reuters on Thursday, in his first public comments since resigning. “They don’t need to be the subject of experimentation.”

“You can’t have a group of promoters, producers of the vaccine (and) university researchers wanting to introduce the vaccine without contacting the health authorities,” he said, without elaborating further.

Paul Stoffels, J&J’s chief scientific officer, denied there were any efforts to secretly introduce the vaccine and said the company had been in full communication with Congolese authorities.

But skepticism about new medicines can resonate strongly on a continent where some pharmaceutical trials have faced accusations in the past of failing to obtain informed consent and providing sub-par care to participants.

For example, some U.S. government-funded trials of HIV drugs in the 1990s were accused of double standards for giving placebos to women in Africa when effective therapies existed, a practice that is not generally allowed in the United States and other Western nations on ethical grounds. Researchers defended the use of placebos as scientifically necessary.

Jean-Jacques Muyembe, an epidemiologist and Ebola expert named to lead Congo’s response team, dismissed Ilunga’s concerns and said authorities would revisit whether to deploy a second vaccine. However, he downplayed the importance of the decision.

“I don’t think that a vaccine is what’s holding back the response,” he told Reuters, noting that previous Ebola outbreaks had been contained quickly without a vaccine.

“We could use or not use. It won’t change the evolution of the epidemic,” he said.

“NOT ETHICAL”

The nearly year-long outbreak has infected more than 2,500 people and killed more than 1,700, numbers topped only by a 2014-16 outbreak in West Africa that killed more than 11,300. This month, a case was detected in Goma, a city of 2 million on the border with Rwanda, heightening fears about the spread of the hemorrhagic fever.

Efforts to contain it have been undermined by mistrust of health workers and violence by armed militias. Treatment centers have been attacked. Local campaigners say people are scared and confused about the various medicines being used. In addition to the vaccine, four experimental treatments are being given to Ebola patients.

All are still unlicensed, which means they can only be used in clinical trials overseen by Congo’s health ministry. “It is not ethical to test vaccines on people,” said Matina Mwanack, the administrator of an advocacy group in the eastern Congo city of Butembo called Families United Against Ebola.

“(We) have suffered a lot from the lack of needed information about the vaccines and treatments being tested.”

Omar Kavota, who heads a group of religious and political leaders in eastern Congo, said “introducing a second vaccine would amplify rumors”, including over why some patients got one while others received the second.

Muyembe said communicators had been appointed to make the process more transparent.

STOCKPILES

Proponents of a second vaccine argue it can only be tested in a live outbreak since it would be unethical to deliberately infect trial volunteers. They propose deploying it where the disease has not yet spread, while the Merck vaccine continues to be used to protect contacts of suspected cases.

“Both vaccines should work hand in hand,” said Peter Piot, director of the London School of Hygiene and Tropical Medicine and one of the scientists who first discovered the Ebola virus.

Since the West African outbreak, J&J has tested its vaccine on more than 6,000 volunteers in a dozen trials, confirming its safety and ability to generate an immune response.

It requires two injections 56 days apart – another obstacle cited by Ilunga – in an area where fighting causes frequent displacement but should last longer.

“The goal is to give a long-term safe profile for people who may never be exposed to Ebola,” said J&J’s Stoffels, adding that 1.5 million doses were available.

Josie Golding, head of epidemics at the Wellcome Trust, said “we could run out of Merck vaccines” if the outbreak extends into a second year. Health authorities have already begun using smaller doses to ration supplies.

Congo’s health ministry disputes there is a shortage of the Merck vaccine. The company said it expects to produce about 900,000 doses over the next six to 18 months, in addition to 440,000 doses that have already been donated or are available.

The ministry has also considered potential vaccines developed by China’s CanSino Biologics and the Russian research institutes Rospotrebnadzor and Gamaleya, but those discussions are less advanced.

(Mahamba reported from Goma, Kelland from London and Ross from Dakar; Additional reporting by Stanis Bujakera in Kinshasa and Manas Mishra in New York; Editing by Tim Cocks, Alexandra Zavis and Giles Elgood)

WHO sounds Ebola alarm as risks intensify

A Congolese health worker administers ebola vaccine to a child at the Himbi Health Centre in Goma, Democratic Republic of Congo, July 17, 2019. REUTERS/Olivia Acland

By Tom Miles

GENEVA (Reuters) – The World Health Organization on Wednesday declared Congo’s Ebola outbreak an international health emergency, sounding a rarely used global alarm after the virus threatened to spread to a major city and into neighboring countries.

Despite a highly effective vaccine and a swift international response after it was declared 11 months ago, the outbreak has proved tenacious in an unstable region beset by violence, becoming Congo’s worst ever, with almost 1,700 dead.

A vast campaign of vigilance and vaccination, with almost 75 million screenings, has kept the highly infectious virus almost entirely confined to two provinces in northeastern Congo. The emergency committee of international health experts that advises WHO had thrice declined to declare an emergency.

But this month a pastor died after traveling to Goma, a city of 2 million and a gateway to other countries in the region. On Wednesday, the WHO reported a fisherwoman had died in Congo after four vomiting incidents at a market in Uganda, where 590 people may be sought for vaccination.

“The committee is concerned that a year into the outbreak, there are worrying signs of possible extension of the epidemic,” the committee’s report said.

The committee had been under pressure from many experts who felt the scale of the outbreak and the risks meant it had to be given the emergency status – only the fifth such disease outbreak since the WHO introduced such designations in 2005.

“It shows no sign of coming under control,” said Peter Piot, a member of the team that discovered Ebola and is now director of the London School of Hygiene & Tropical Medicine.

“I hope that today’s decision serves as a wake-up call to drive high-level political action, improved coordination, and greater funding to support DRC in their efforts to stop this devastating epidemic,” he said.

NO BORDER CLOSURES

The previous international emergencies, under a system introduced after the 2004 Asian SARS epidemic, were the 2013-2016 West African Ebola epidemic that killed over 11,300 people, the 2009 flu pandemic, polio in 2014 and the Zika virus that caused a spate of birth defects across Latin America.

The WHO committee’s chairman, Robert Steffen, tempered the outbreak’s designation as an emergency by saying it remained a regional, rather than a global threat, and stressed that no country should react to Ebola by closing borders or restricting trade.

The WHO has warned that the nearby countries of Rwanda, South Sudan, Burundi and Uganda are the most at risk, while Central African Republic, Angola, Tanzania, Republic of Congo and Zambia are in a second tier.

Earlier this week the WHO said hundreds of millions of dollars were needed immediately to prevent the outbreak billowing out of control and costing far more lives and money.

But WHO chief Tedros Adhanom Ghebreyesus, who convened the emergency committee after viewing the Goma case as a “potential gamechanger”, said the designation as an international emergency was not meant to suggest that some countries had been withholding funds and would now unlock them.

One priority was to accelerate the production of the vaccine, which is in short supply. It is produced by Merck and still unlicensed, which means it can only be used in a clinical trial overseen by Congo’s health ministry.

WHO has already begun using smaller doses to ration supplies and the committee recommended taking “all measures to increase supplies”, including contracting supply to other manufacturers and transferring Merck’s technology.

(Reporting by Tom Miles, Kate Kelland and Nairobi newsroom; Editing by Gareth Jones, John Stonestreet and Dan Grebler)

Ebola is real, Congo president tells skeptical population

FILE PHOTO: A health worker wearing Ebola protection gear, walks before entering the Biosecure Emergency Care Unit (CUBE) at the ALIMA (The Alliance for International Medical Action) Ebola treatment centre in Beni, in the Democratic Republic of Congo, March 30, 2019. Picture taken March 30, 2019.REUTERS/Baz Ratner/File Photo

GOMA, Democratic Republic of Congo (Reuters) – Congolese President Felix Tshisekedi on Tuesday implored people in areas hit by the nation’s worst-ever Ebola outbreak to accept the disease is real and trust health workers.

Mistrust of first responders and widespread misinformation propagated by some community leaders has led many in affected areas of eastern Democratic Republic of Congo to refuse vaccinations. Instead, they turn to traditional healers, whose clinics have contributed to the hemorrhagic fever’s spread.

“It is not an imaginary disease,” Tshisekedi said after arriving in the city of Beni on his first tour of eastern Congo since being inaugurated in January.

“If we follow the instructions, in two or three months Ebola will be finished,” he optimistically told a crowd after having his temperature taken and washing his hands, as required of all incoming passengers to Beni airport.

Congo has suffered 10 outbreaks of Ebola, which causes severe vomiting, diarrhea and bleeding, since the virus was discovered there in 1976. The current one has seen 1,264 confirmed and probable cases and 814 deaths since it was declared last August.

It is surpassed only by the 2013-2016 outbreak in West Africa, in which more than 28,000 cases were reported and more than 11,000 people died.

Following a series of attacks on treatment centers by unidentified assailants in February and March, the current outbreak is now spreading at its fastest rate yet.

More than 100 cases were confirmed last week.

Tshisekedi, who won a disputed election last December to succeed Joseph Kabila, also called on Tuesday for the disarmament of dozens of militia that operate in the east and whose presence has complicated the Ebola response.

“The time of armed groups is over,” he said. “The new government is reaching out to these children of the country to surrender arms through disarmament programmes.”

(Reporting by Fiston Mahamba and Stanis Bujakera; Writing by Giulia Paravicini; Editing by Aaron Ross and Andrew Cawthorne)

Ebola spread concentrated in Congo, not a wider emergency: WHO

FILE PHOTO: Health workers carry a newly admitted confirmed Ebola patient into a treatment centre in Butembo in the eastern Democratic Republic of Congo, March 28, 2019. REUTERS/Baz Ratner

By Stephanie Nebehay and Kate Kelland

GENEVA/LONDON (Reuters) – An outbreak of Ebola in the Democratic Republic of Congo (DRC) that has killed more than 700 people and is continuing to spread does not constitute an international emergency, the World Health Organization said on Friday.

Declaring the epidemic a “public health emergency of international concern” would have signaled that greater resources and international coordination are needed.

The WHO’s independent Emergency Committee, which analyzed the latest data, said the disease was entrenched in several epicenters in the northeast and was being transmitted in health care settings.

It had not spread across borders to Uganda, Rwanda or South Sudan, but neighboring countries should shore up their preparedness, the experts said.

“It was an almost unanimous vote that this would not constitute a PHEIC (public health emergency of international concern) because we are moderately optimistic that this outbreak can be brought into control – not immediately, but still within a foreseeable time,” panel chairman Professor Robert Steffen told a news conference.

Dozens of new cases reported this week have been mainly in the epicenters of Butembe, Katwe and Vuhovi, said Mike Ryan, head of the WHO’s health emergencies program.

“It’s quite a focused amplification of disease in a very specific geographic area,” Ryan said.

“But the disease there has risen because of lack of access to that community, we’ve fallen behind in starting vaccination rings,” he said, referring to attacks on health centers by armed groups in February that cut-off hotspot areas.

“Vaccine is proving to be a highly effective way of stopping this virus but if we can’t vaccinate people we cannot protect them,” he added, noting that nearly 100,000 people have been vaccinated.

Experts have declared four emergencies in the past decade: the H1N1 virus that caused an influenza pandemic (2009), a major Ebola outbreak in West Africa (2014), polio (2014) and Zika virus (2016).

Some experts expressed concern that the Emergency Committee was too narrowly interpreting WHO guidelines.

“This is a deeply concerning event, due to the pathogen itself, the total number of cases, the increase in cases just this week, and the difficulty of coordinating the response due to conflict – that needs to receive the appropriate level of attention,” health experts Rebecca Katz and Alexandra Phelan of Georgetown University in Washington D.C. said in a statement.

The Ebola outbreak – by far the biggest Congo has seen, and the world’s second largest in history – was declared by national authorities in August. It is concentrated in Congo’s North Kivu and Ituri provinces.

It has already infected at least 1,206 people, of whom 764 have died – giving a death rate of 63 percent.

They include 20 new cases reported by the health ministry on Thursday, another one-day record after 18 on Wednesday. Two workers at the Butembo airport tested positive, it said.

(Reporting by Stephanie Nebehay and Kate Kelland Additional reporting by Aaron Ross in Dakar; Editing by Hugh Lawson and Frances Kerry)

Congo fire destroys thousands of voting machines for presidential election

A motorcyclist rides near smoke billowing from fire at the independent national electoral commission's (CENI) warehouse in Kinshasa, Democratic Republic of Congo December 13, 2018. REUTERS/Olivia Acland

By Giulia Paravicini

KINSHASA (Reuters) – A fire overnight at a warehouse in Congo’s capital destroyed thousands of voting machines and ballot boxes that were due to be used in the country’s long-delayed Dec. 23 presidential election, authorities said on Thursday.

Democratic Republic of Congo’s national electoral commission (CENI) said in a statement the blaze had destroyed 8,000 of 10,368 voting machines due to be used in the capital Kinshasa, but said the election would go ahead as scheduled.

CENI did not say who it believed to be responsible for the fire – which broke out about 2 a.m. (0100 GMT) in the Gombe riverside area of Kinshasa that is also home to President Joseph Kabila’s residence – but the ruling coalition and leading opposition candidates immediately traded accusations of blame.

Kabila’s Common Front for Congo (FCC), which is backing former interior minister Emmanuel Ramazani Shadary in the presidential race, accused opposition candidate Martin Fayulu of inciting violence earlier this month.

“Over the course of this electoral campaign, (Fayulu) called on his supporters and sympathizers to destroy electoral materials,” the FCC said in a statement.

Fayulu rejected the charge and suggested that state security forces might have been behind the blaze.

“The fire erupted in a building guarded by the Republican Guard,” Fayulu told Reuters. “You understand today that the Kabila people do not want to organize elections.”

Felix Tshisekedi, the other leading opposition candidate, also suggested on local radio that the government was responsible. “How is it that what should be the best protected place in the republic at this time can burn so easily?” he said.

Barnabe Kikaya Bin Karubi, a Kabila adviser, said police guarding the warehouse had been arrested and that forensic police had launched an investigation.

Kabila, in power since his father’s assassination in 2001, is due to step down because of constitutional term limits. The vote has already been delayed by two years due to what authorities said were logistical challenges but the opposition said stemmed from Kabila’s reluctance to relinquish power.

This month’s highly anticipated vote could mark Congo’s first peaceful transition of power after decades marked by authoritarian rule, coups d’etat and civil wars in which around five million people are estimated to have died.

ELECTION DATE MAINTAINED

CENI president Corneille Nangaa told a news conference the destroyed equipment represented the materials for 19 of 24 voting districts in Kinshasa.

“Without minimizing the gravity of this damaging situation for the electoral process, CENI is working to pursue the process in conformity with its calendar,” Nangaa said.

Kikaya said voting machines from elsewhere in Congo would be recalled for use in Kinshasa, which is home to more than 15 percent of the Congolese population.

The introduction of the untested tablet-like voting machines for the election has been widely opposed by opposition candidates competing against Shadary.

They say the machines are more vulnerable to vote-rigging than paper and ink and could be compromised by the unreliability of Congos power supply.

The delay in the elections has coincided with a breakdown in security across much of the vast mineral-rich country. Militants fight over land and resources in the east near the border with Uganda and Rwanda.

Campaigning over the past three weeks has been mostly peaceful, though deadly clashes erupted between police and opposition supporters this week in the southeast.

(Additional reporting by Stanis Bujakera and Aaron Ross; Writing by David Lewis; Editing by Aaron Ross and Gareth Jones)

Ebola outbreak in east Congo now world’s second biggest

FILE PHOTO: A medical worker wears a protective suit as he prepares to administer Ebola patient care at The Alliance for International Medical Action (ALIMA) treatment center in Beni, North Kivu province of the Democratic Republic of Congo September 6, 2018. REUTERS/Fiston Mahamba/File Photo

KINSHASA (Reuters) – The Ebola outbreak in eastern Congo is now the second biggest in history, with 426 confirmed and probable cases, the health ministry said late on Thursday.

The epidemic in a volatile part of Democratic Republic of Congo is now only surpassed by the 2013-2016 outbreak in West Africa, where more than 28,000 cases where confirmed, and is bigger than an outbreak in 2000 in Uganda involving 425 cases.

Ebola is believed to have killed 245 people in North Kivu and Ituri provinces where attacks by armed groups and community resistance to health officials have hampered the response.

Congo has suffered 10 Ebola outbreaks since the virus was discovered there in 1976. It spreads through contact with bodily fluids and causes hemorrhagic fever with severe vomiting, diarrhea and bleeding, and in many flare-ups, more than half of cases are fatal.

“This tragic milestone clearly demonstrates the complexity and severity of the outbreak,” Michelle Gayer, Senior Director of Emergency Health at the International Rescue Committee said in a statement. “The dynamics of conflict (mean) … a protracted outbreak is … likely, and the end is not in sight.”

(Reporting by Giulia Paravicini; Editing by Tim Cocks and Andrew Heavens)

Current Ebola outbreak is worst in Congo’s history: ministry

FILE PHOTO - Workers fix an Ebola awareness poster in Tchomia, Democratic Republic of Congo, to raise awareness about Ebola in the local community, on October 9, 2018. Picture taken October 9, 2018. WHO/Aboulaye Cisse/Handout via REUTERS

KINSHASA (Reuters) – The current Ebola outbreak in the Democratic Republic of Congo is the most severe in the country’s history with 319 confirmed and probable cases, the health ministry said late on Friday.

The hemorrhagic fever is believed to have killed 198 people in North Kivu and Ituri provinces, where attacks by armed groups and community resistance to health officials have complicated the response.

FILE PHOTO: A Congolese health worker prepares to administer Ebola vaccine, outside the house of a victim who died from Ebola in the village of Mangina in North Kivu province of the Democratic Republic of Congo, August 18, 2018. REUTERS/Olivia Acland/File Photo

FILE PHOTO: A Congolese health worker prepares to administer Ebola vaccine, outside the house of a victim who died from Ebola in the village of Mangina in North Kivu province of the Democratic Republic of Congo, August 18, 2018. REUTERS/Olivia Acland/File Photo

Congo has suffered 10 Ebola outbreaks since the virus was discovered near the eponymous Ebola River in 1976.

“The current epidemic is the worst in the history of DRC,” Jessica Ilunga, a spokeswoman for the ministry told Reuters.

With over 300 cases the epidemic also ranks as third worst in the history of the continent, following the 2013-2016 outbreak in West Africa where over 28,000 cases were confirmed and an outbreak in Uganda in 2000 involving 425 cases.

World Health Organization Director-General Tedros Adhanom Ghebreyesus said on Thursday that security represented the primary challenge in the current epidemic, followed by community mistrust.

“When there is an attack, the operation actually freezes. So we hold the operation. And when the operation stops, the virus gets advantage and it affects us in two ways,” he told reporters in Kinshasa.

“And one is catching up on the backload. Because when operations are stopped, there is always a backload of vaccinations or contact tracing. And the other, the second problem, is that more cases are generated because we can’t vaccinate them,” he said.

The confirmation of new cases has accelerated in the last month and an emergency committee of World Health Organization experts said in October that the outbreak was likely to worsen significantly unless the response was stepped up.

(Reporting by Giulia Paravicini; Additional reporting by Fiston Mahamba; Editing by Alessandra Prentice and Hugh Lawson)

Ebola fight has new science but faces old hurdles in restive Congo

A doctor cares for a patient inside an isolate cube at The Alliance for International Medical Action (ALIMA) treatment center in Beni, North Kivu province of the Democratic Republic of Congo September 6, 2018. REUTERS/Fiston Mahamba

By Fiston Mahamba

BENI, Democratic Republic of Congo (Reuters) – When Esperance Nzavaki heard she was cured of Ebola after three weeks of cutting-edge care at a medical center in eastern Democratic Republic of Congo, she raised her arms to the sky with joy and praised the Lord.

Her recovery is testament to the effectiveness of a new treatment, which isolates patients in futuristic cube-shaped mobile units with transparent walls and gloved access, so health workers no longer need to don cumbersome protective gear.

“I started to feel sick, with a fever and pain all over my body. I thought it was typhoid. I took medicine but it didn’t work,” Nzavaki told Reuters in Beni, a city of several hundred thousand, where officials are racing to contain the virus.

“Then an ambulance came and brought me to hospital for Ebola treatment. Now I praise God I’m healed.”

The fight against Ebola has advanced more in recent years than in any since it was discovered near the Congo River in 1976. When the worst outbreak killed 11,300 people in West Africa in 2013-2016, there was no vaccine and treatment amounted to little more than keeping patients comfortable and hydrated.

Now there’s an experimental vaccine manufactured by Merck which already this year helped quash an earlier outbreak of this strain of the virus on the other side of the country in under three months. And there are the cube treatment centers, pioneered by the Senegalese medical charity, ALIMA.

“With this system … where there are not people donning masks, the patients feel reassured and perceive that there is life here,” said Claude Mahoudeau, the coordinator of ALIMA’s treatment center in Beni.

In addition, three experimental treatments have been rolled out for the first time, offering patients additional reason to hope that their diagnosis is not a death sentence.

Yet even the smartest science can do little about the marauding rebel groups and widespread fear and mistrust that could yet scupper efforts to contain Congo’s tenth outbreak of the deadly haemorrhagic fever.

The latest outbreak is so far believed to have killed 90 people since July and infected another 40.

The stakes are high, not just for health reasons. Ebola could complicate Congo’s first democratic change of power, the holding of a Dec. 23 election to replace President Joseph Kabila that is already two years late.

FILE PHOTO: Congolese officials and the World Health Organization officials wear protective suits as they participate in a training against the Ebola virus near the town of Beni in North Kivu province of the Democratic Republic of Congo, August 11, 2018. REUTERS/Samuel Mambo

FILE PHOTO: Congolese officials and the World Health Organization officials wear protective suits as they participate in a training against the Ebola virus near the town of Beni in North Kivu province of the Democratic Republic of Congo, August 11, 2018. REUTERS/Samuel Mambo

REBELLION, FEAR, MISTRUST

The affected North Kivu and Ituri provinces have been a tinder box of armed rebellion and ethnic killing since two civil wars in the late 1990s. Some areas near the epicenter require armed escorts to reach because of insecurity. Two South African peacekeepers there were wounded in a rebel ambush last week.

And last week, authorities confirmed the first death from Ebola in the major trading hub of Butembo, a city of almost a million near the border with Uganda, dampening hopes that the virus was being brought under control.

Insecurity aside, the biggest challenges the government faces could be panic and downright denial, as they were during the catastrophic West Africa outbreak.

“Ebola does not exist in Beni,” resident Tresor Malala said, shaking his head. “For a long time, people got sick with fever, diarrhea, vomiting and they healed. Now someone gets a fever, they get sent to the Ebola treatment center and then they die.”

Taxi driver Mosaste Kala was equally skeptical: “The only people dying are the ones going to the … treatment center.”

Tackling these perceptions will be crucial if authorities are to halt the epidemic.

At a news conference on Saturday, Health Minister Oly Ilunga Kalenga admitted that “community resistance is the first challenge to the response to the epidemic”.

In the district of Ndindi, in Beni, Ebola is spreading due to the community’s reluctance to cooperate with health workers, the ministry says. Some locals have hidden sick relatives or refused to be vaccinated.

The problem, says school teacher Alain Mulonda, many of whose pupils were being kept at home by anxious parents, is that locals have little understanding of Ebola.

“If the population of Beni continues to show this distrust,” he said, “this disease will consume the whole town.”

(Additional reporting by Amedee Mwarabu in Kinshasa and Aaron Ross in Dakar; Writing by Alessandra Prentice; Editing by Tim Cocks, David Evans and Peter Graff)