Rate of Ebola cases dropping but violence, mistrust impede progress warn experts
The rate of weekly Ebola cases in Democratic Republic of Congo is declining but the picture on the ground remains dismal as a “criminal element,” armed rebels and community distrust prevent aid groups from bringing the second worst-ever epidemic under control.
That’s the view of global and U.S. health officials working to rein in the DRC outbreak that began last summer and has resulted than 920 cases and more than 580 deaths.
The World Health Organization says it hopes to declare an end to the epidemic within six months, though a host of challenges are canceling out progress.
Robert Redfield, director of the Centers for Disease Control and Prevention, says close to half of Ebola patients are dead by the time health responders find out about their infections, making it difficult to track the disease. Criminals are trying to extort money from people working at treatment centers, and rebel groups are actively fighting government factions.
Topping it off, a contentious election and deep-seated distrust of authority in the country has resulted in resistance to aid workers and repeated attacks on treatment centers.
“It doesn’t trust its own government it’s been in conflict for over 20, 25 years and it sure doesn’t trust outsiders,” said Dr. Redfield, who visited the hot zone last weekend and testified Thursday before the Senate Appropriations Committee.
World Health Organization Director-General Tedros Adhanom Ghebreyesus who toured the affected zone with Dr. Redfield aired similar concerns but highlighted positive metrics, too, including a number of towns that have eliminated infections. He said responders are seeing an average of 25 new cases per week, compared to 50 new cases per week in January.
“It’s contracting,” he said.
About 87,000 people have received a trial vaccine against Ebola, and about 400 people have been treated with pioneering therapeutic that may be able to cure people of the virus.
“We’re happy that people are surviving,” Mr. Ghebreyesus said.
Ebola is a serious often-fatal disease that is transmitted to people from wild animals and spreads from human to human through the bodily fluids of people who exhibit symptoms.
Despite WHO’s optimism, Doctors Without Borders this week said the disease is hard to track at its epicenter in Katwa in Butembo, with 43 percent of new patients in the last three weeks having no known links to other cases.
“We have a striking contradiction: on the one hand a rapid and large outbreak response with new medical tools such as vaccines and treatments that show promising outcomes when people come early and on the other hand, people with Ebola are dying in their communities, and do not trust the Ebola response enough to come forward,” said Dr. Joanne Liu, the organization’s international president.
Mr. Ghebreyesus said there was an attack on an Ebola treatment center in Butembo ahead of his visit last weekend.
Armed men shot at the center, killing a police officer and wounding three workers.
“They left bullet holes in the windows of the center, but they did not dampen the spirits of the health workers who work there,” said Mr. Ghebreyesus, noting the center was back open within five hours.
Dr. Redfield said CDC personnel are supporting the response in the DRC capital of Kinshasa and Geneva, Switzerland where WHO is headquartered but do not have a physical presence in the hot zone because of security concerns.
Senate appropriators said they were pleased that President Trump’s fiscal 2020 budget calls for $100 million to support the CDC’s global health security activities an increase of $50 million over enacted levels in 2019.
As it stands, the virus has been contained within DRC, with little fear of a U.S. outbreak or elsewhere in the globe.
Sen. Patty Murray, Washington Democrat, fired a warning shot, however, saying the administration cannot take its foot off the pedal or enact cuts in other parts of its health budget.
She said investments under President Obama helped global responders defeat the worst-ever Ebola epidemic, which killed more than 11,000 in West Africa from 2013 to 2016.
“We have to remember the dangers of falling back on ‘America first’ rhetoric,” Ms. Murray said. “We cannot do this on the cheap. And we can’t pretend diseases are stopped by borders or walls or bans.”