The response to the Congo’s fast-spreading Ebola epidemic has been hampered by a severe lack of funding and pervasive misinformation, according to people on the front lines, with the outbreak on track to become the worse in history, reports The Washington Post.
At least 5 700 people have been infected since the first case was identified on 15 May, of whom at least 2 700 have died. That means the outbreak is already bigger than the one that lasted from 2018 to 2022, which killed 2 200 people, and is spreading faster in its initial months than the West Africa epidemic that began in 2014 and caused more than 11 000 deaths.
At the same point in that outbreak – about 100 days after the first case had been reported – there were only 759 recorded cases, according to the CDC, less than 15% of what has been recorded so far in the DRC’s outbreak.
Interviews with more than a dozen doctors, relief workers and patients operating in Ituri and North Kivu, the provinces at the heart of the outbreak, suggest that the confirmed figures are likely to represent only a fraction of the total current toll.
“The situation looks bad, and it is worsening,” said Alice Ribes, the Congo-based Ebola lead for the International Rescue Committee, a humanitarian group. “It’s spreading very, very fast.”
In Bunia, a city at the centre of the heartbreak, there is a frightening dual reality: while the virus is quietly spreading, Ribes said, “life is continuing as if nothing is happening”.
“You have massive crowds,” she said. “Massive weddings, big parties. Churches that are completely full.”
But most people on the front lines of the response believe that the current figures are under-estimated, she said.
“It’s a rapid fire,” said Grace Wairima, the senior Africa media and communications manager for Mercy Corps, an aid group.
Wairima noted that many people with confirmed Ebola diagnoses do not appear on contact lists for others already in treatment. “The virus has moved through so many cracks,” she said.
Medical personnel and aid organisations say their ability to respond has been hampered by sweeping cuts in aid to the DRC and the World Health Organisation by the United States and other Western nations.
Especially in the early days of the outbreak, aid groups and medical personnel said, they lacked the staff, surveillance systems and emergency supplies to quickly detect infections or contain the virus as it surged.
The US Agency for International Development, or USAID, in particular, had operated in the Congo for decades and worked in previous Ebola outbreaks – this is the 17th – to co-ordinate with the local Ministry of Health and aid organisations on the international response.
In a statement last week, the State Department said it had announced more than $512m in direct assistance to combat the ongoing outbreak, supported 8.6m health screenings across affected and at-risk countries, reached more than 1m people with risk communication messaging, supported more than 180 health facilities in affected areas, contributed to the direct operation of 12 special facilities in the DRC, and procured and distributed nearly 300 metric tons of supplies, among other efforts.
The WHO has said that the outbreak, caused by the rare Bundibugyo virus, for which there is no vaccine or approved treatment, probably started as early as February, months before a global emergency was declared.
WHO Director General Tedros Adhanom Ghebreyesus said the disease was moving with “unprecedented speed”.
“We must be frank: the epidemic is far from being under control,” he said. “It had a big head start, and we are still playing catch-up.”
Tedros added that what concerns him most is “where people are dying: at home, in their communities, outside treatment centres, and outside known contact lists. …”
“Every death like that points to a chain of transmission we have not yet found.”
Maurice Kakule, the lead doctor on Ebola cases at the General Reference Hospital in Oicha in North Kivu, said that one of the biggest difference between this outbreak and the two previous ones on which he worked is the level of surveillance.
Because many international organisations are stretched too thin to do surveillance this time around, some health workers at his hospital have taken it upon themselves to identify and track new cases, he added.
But misinformation is so intense that many people who suspect they have Ebola choose to die at home instead of going to the hospital, where they fear medical interventions. The true toll, he and other local medical personnel said, could be two to three times higher than official statistics.
See more from MedicalBrief archives:
Ebola outbreak the deadliest ever – WHO
Mammoth struggle to contain rapidly-spreading Ebola cases in DRC