USAID chief: Key to containing Ebola is transparency

NAIROBI — The humanitarian response to Ebola in the Democratic Republic of the Congo has failed to contain the virus. In order to effectively “reset” these efforts, responders need to increase the transparency of their operations, said U.S. Agency for International Development Administrator Mark Green during a meeting with reporters in Nairobi on Tuesday.

Green is wrapping up a nine-day trip to five African nations, including a visit to the North Kivu province of DRC, where he met with health care workers responding to the crisis, community and local leaders, and representatives from NGOs.

The current Ebola outbreak has accelerated since it began in May 2018, with the first cross-border cases reported last week in Uganda. There have been over 2,100 cases during this outbreak and over 1,400 deaths so far, according to the World Health Organization.

A key challenge for those working to contain the spread of the virus is that the affected communities have little trust in the government and the foreign workers responding to the crisis, said Green. This means that people aren’t working with health teams to report cases early, for example.

“We have to undo some of the damage and distrust that has been built up over the years,” Green said.

Research from John Hopkins University found that a lack of understanding of the disease and a lack of trust in institutions to put in place a control strategy could be a reason the virus has spread more rapidly in recent months than it did at the beginning of the outbreak.

“You have people who are impoverished, who have lost faith in institutions, who see outsiders coming in — in some cases, they see them as being more concerned about the virus than they are about them,” Green said.

In order to change this, the humanitarian sector needs to communicate more transparently with communities, he said. This includes clear messaging on how people are tested and treated. It also includes publicly accessible information on the processes organizations are using to hire workers, regular reporting on how resources have been spent, as well as progress reports on containment.

“We need to turn it into a community-based response,” he said. “There is no reason for information to be withheld from the community at all.”

One example that Green gave in increasing transparency is the use of clear tarps at Ebola treatment centers, which allow communities to see the conditions in which family members are receiving treatment.

“Those kinds of steps, which may be small from a technical standpoint, are extraordinarily important, from a community standpoint,” he said.

While Ebola is endemic in DRC, the escalation of this particular crisis is largely due to the difficulty of responding to an outbreak in an area with a heavy presence of armed militia.

But Green cautioned that any response to security concerns should not further exacerbate this distrust.

“We need to see an effective approach to security concerns in the region. This needs to be done without militarizing the response, which will only further alienate the local community," he said.

Last week, WHO declined to declare the outbreak a public health emergency of international concern, saying a formal declaration could harm DRC’s economy because of potential restrictions on travel, trade, and border closures.

“Even though the WHO has not declared a public health emergency, it is very clear to me that this is a development emergency,” he said. “A deadly virus has struck a region of Africa that was already besieged over the years by a number of failures — failures in development, failure of democracy, and a failure of governance. This is a combustible, deadly mix.”