WHO calls for return to basics to fight DRC Ebola crisis

UNITED NATIONS — The ongoing Ebola response in the Democratic Republic of the Congo requires a review of the basics to prevent the crisis from escalating, World Health Organization and U.N. experts said on Thursday at a press briefing in New York.

“This is the most difficult environment where an Ebola response has ever been attempted. The environment is difficult because of the high density of population. It is difficult because it is a conflict zone ... It is an area of opposition that has felt marginalized, with a high level of distrust of authorities,” said David Gressly, U.N. emergency Ebola response coordinator, speaking from DRC.

New technologies and vaccines have been helpful in containing the health crisis, which broke one year ago and has since escalated to more than 2,600 confirmed cases and 1,800 deaths, according to WHO’s latest estimates. About 700 of those diagnosed with Ebola are children.

Interruptions over the past year, such as political demonstrations and strikes over nonpayment of salaries, have caused WHO to temporarily pause its work in the volatile North Kivu and Ituri provinces, Gressly said. In December, protesters in the eastern city of Beni attacked an Ebola triage center. 

“You often lose weeks for one or two days of interruptions. We cannot afford to continue with those interruptions. There are still too many gaps in the response, geographically,” Gressly said, explaining that the virus has most recently spread from the cities of Beni and Butembo to Goma.

But improved core response techniques, such as proper surveillance and monitoring systems, are still needed to boost vaccination rates and treat all infected people, Gressly explained. Timely delivery of funding and a coordinated effort, beyond the work of WHO, are also key, Gressly said, noting that “this is no longer a WHO-led effort. All of the agencies that have something to contribute have come together.”

“The basics are still important and the basics include good surveillance, good contact identification from an Ebola patient, tracking those same individuals to see if they develop the symptoms, and if they do, testing in isolation to see if they are, in fact, positive,” Gressly said.

“That is the way you break this epidemic, and if you can apply it strictly, we can bring this to an end quickly. We need to review where those weaknesses are, as well. We have many challenges ahead and it is not going to be easy,” Gressly continued.

Aid organizations have also called for a reset on the response, with more emphasis on coordination, dialogue, and community engagement.

There is a 95% acceptance rate of the Ebola vaccine among impacted communities, said Margaret Harris, a spokesperson for WHO’s Ebola response work. WHO is aiming to ensure that every at-risk person is vaccinated. But the stigma of the deadly disease, as well as trust of WHO and other responders, have complicated community engagement, she said.

About two-thirds of people who have contracted Ebola in DRC have died, Harris and Gressly said.

“It is not so much the people we know of — they want to be vaccinated. It is the people we do not know of,” Harris said.

“Without access to communities, all the public health tools we have are useless. If we have one person who does not trust and decides they need to hide their illness because they are frightened of us … if that person hides … the epidemic continues,” Harris continued.

Update, August 2, 2019: This story has been updated to clarify that David Gressly is U.N. emergency Ebola response coordinator and that two-thirds of people who have contracted Ebola in DRC have died.