WHO warns against potential Ebola spread in DR Congo and beyond

Ebola is spreading in a western province in the Democratic Republic of the Congo (DRC), raising fears that the disease could reach neighbouring Republic of Congo and even the capital, Kinshasa, the World Health Organization (WHO) said on Friday. 

The outbreak in Equateur Province emerged in early June and has now spread into another of its 17 health zones, bringing the total number of affected zones to 12. So far, there have been 113 cases and 48 deaths.

“The most recently affected area, Bomongo, is the second affected health zone that borders the Republic of Congo, which heightens the chances of this outbreak to spread into another country”, said WHO Spokesperson, Fadéla Chaib, underlining the need for cross-border collaboration and coordination.

The risk of the disease spreading as far as Kinshasa is also a very real concern for the UN agency. One of the affected areas, Mbandaka, is connected to the capital by a busy river route used by thousands every week.

Logistical challenges, community resistance
This is the second Ebola outbreak in Equateur Province and the 11th overall in the DRC, which recently defeated the disease in its volatile eastern region after a two-year battle.

This latest western outbreak first surfaced in the city of Mbandaka, home to more than one million people, and subsequently spread to 11 health zones, with active transmission currently occurring in eight.

The health zones all border each other and cover a large and remote area often only accessible by helicopter or boat.

Managing response logistics in Equateur is difficult as communities are very scattered. Many are in deeply forested areas and reaching them requires travelling long distances.

In some areas, community resistance is also a challenge, Ms. Chaib added.

"We learned over years of working on Ebola in DRC how important it is to engage and mobilize communities. WHO is working with UNICEF in engaging religious, youth and community leaders to raise awareness about Ebola," she said.

Health workers on strike
The situation has been further complicated by a health worker strike that has affected key response activities for nearly four weeks.

Locally based Ebola responders have been protesting against low salaries as well as non-payment since the start of the outbreak.

Although some activities have resumed, many are still on hold, making it difficult to get an accurate picture of how the epidemic is evolving and which areas need the most attention.

Response ‘grossly underfunded’
WHO and partners have been on the ground since the early days of the outbreak.

More than 90 experts are in Equateur, and additional staff have recently been deployed from the capital, including experts in epidemiology, vaccination, community engagement, infection prevention and control, laboratory and treatment.

Nearly one million travellers have been screened, which helped identify some 72 suspected Ebola cases, thus reducing further spread.

However, the UN agency warned that response is “grossly underfunded”. WHO has provided some $2.3 million in support so far, and has urged donors to back a $40 million plan by the Congolese government.

This latest Ebola outbreak is unfolding amidst the COVID-19 pandemic. As of Friday, there were more than 10,300 cases and 260 deaths across the vast African nation.

While there are several similarities in addressing the two diseases, such as the need to identify and test contacts, isolate cases, and promote effective prevention measures, Ms. Chaib stressed that without extra funding, it will be even harder to defeat Ebola

Distrust of public institutions, health inequities could push more countries into conflict, UN political affairs chief warns.

Rosemary DiCarlo, Under-Secretary-General for Political and Peace building Affairs, said the breakdown in public trust, while a problem before the pandemic, now has the potential to drive instability in settings where people perceive authorities have not addressed COVID-19 effectively or have not been transparent about its impact.

The pandemic could derail fragile peace processes and conflict prevention initiatives, as travel restrictions force efforts to move online.

In response, the UN has adapted its operations to better support its missions, she explained. The Departments of Political and Peace building Affairs, Peace Operations and Operational Support, have joined forces to strengthen risk management systems and protect personnel.

Council leadership essential

At the same time, “Leadership from the Council - and the support of Member States with leverage - are essential if we are to change the calculations of conflict parties, open the space for dialogue, and end these wars,” she insisted.

The same holds true for preventing other situations from reversing gains. “The better the global response to the pandemic, the better our prospects for the prevention, management and resolution of conflicts around the world.”

‘Significant’ impact on peacekeeping

Jean-Pierre Lacroix, Under-Secretary-General for Peace Operations, said countries where peacekeepers are deployed, suffer from weak health and governance structures, and a lack of the resources required to combat the pandemic.

In these environments, he said the effects of COVID-19 can undermine governance and local institutions and prompt a return to inter-communal conflict.

The combined effects also negatively impact mandate implementation.

“Helping to prevent and contain the spread of the virus where peacekeeping operations are deployed is, therefore, not only a moral imperative, but also a political priority as well as an operational requirement”, he assured.

To this end, he said a number of measures have been put in place to prevent and contain the spread among field personnel. Missions too have maintained political engagement and community outreach through virtual platforms, and undertaken public diplomacy initiatives to urge political unity, respect for human rights and in response to inter-ethnic incidents.

“The COVID-19 pandemic has undoubtedly had a significant impact on the conduct of our peacekeeping operations”, he said, citing the Juba peace talks on Sudan, whose parallel negotiating tracks were moved online and eventually resulted in a peace agreement between transitional authorities and participating armed groups.

Vaccine campaigns hit
Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Mark Lowcock said the full extent of COVID-19 in fragile countries is unknown, as testing levels are low, and in some places, people are reluctant to seek help if they fall sick.

“What is now sure - beyond reasonable doubt - is that the indirect consequences of the pandemic in the most fragile countries are dwarfing the impact of the virus itself”, he said.

Chief among them is the economic impact, as the global contraction has weakened commodity prices, forced declines in remittances and disrupted trade. Lock downs themselves are making it harder for people to make enough money to survive said relief chief Lowcock.

Beyond the economy, the biggest indirect effect is on public services, especially health and education. “Any reduction in the availability of very basic health services makes a big difference in these countries”, he said.

Vaccination campaigns have been hampered in 45 countries already facing humanitarian or refugee crises, placing 80 million children under age one at risk of vaccine-preventable diseases. More than half a billion children in fragile contexts have been affected by school closures.

‘Woeful’ political, economic action, enabling warfare
Indeed, the pandemic has been more damaging than the financial crisis – yet the response has been far from exceptional. “It barely justifies the description of tepid,” he lamented. Low-income and fragile countries simply do not have the resources, capacity or market access needed to adopt the stimulus measures taken by more wealthy nations.

“Woefully inadequate economic and political action will lead to greater instability and conflicts in the coming years”, he cautioned. And more crises will simply end up on the Council’s agenda.