Due to the worsening Ebola outbreak, many Congolese are avoiding vaccines developed by Canada.

After the worst week of new infections in one of the deadliest Ebola epidemics in history, there is growing concern that the Ebola vaccine developed Canada continues to distrust many of the most vulnerable people in the crisis area.

More than 100 new cases of Ebola have been detected during the past week in the Democratic Republic of Congo, by far the largest number of weekly cases since the beginning of the epidemic last year. In total, more than 1,250 people have been infected and more than 800 have died so far, making it the second most serious Ebola epidemic in history.

New evidence shows that the Ebola vaccine, developed by the Winnipeg Microbiology Laboratory, has been remarkably effective in preventing the virus. According to data published by the World Health Organization, about 100,000 doses of vaccine were administered during the last outbreak and the protection rate reached 97.5% among those who took it.

But a "big part" of Ebola infections is among those who refuse to be vaccinated and nearly 10% of those who may be exposed to the virus refuse to be vaccinated, according to Michael Ryan, Executive Director of the Health Emergencies Program from WHO.

"Some health workers have even refused to be vaccinated," said Dr. Ryan at a press conference Friday in Geneva. "We need to make communities understand that this vaccine is very effective."

There is growing concern that health workers and government officials have been unable to dispel suspicion and fear among Ebola-spreading communities in North Kivu and Ituri, in eastern Congo.

Due to distrust of the medical system and the government, many people refuse to seek treatment when they fall ill and many die without treatment, which can spread the virus further. In the past week, about 40% of new cases detected were among people who died in their communities before the virus was detected.

This mistrust is due in large part to a long history of neglect, poverty, armed conflict and trauma in the region, which has lasted for several decades. More than 20 armed groups are active in both provinces. Much of the region was excluded from the Congolese elections in December because of the Ebola outbreak, which heightened the sense of alienation and resentment. Five Ebola treatment centers in the region were attacked and damaged and many health workers were assaulted. Police and soldiers have been deployed to protect health workers or to force people to comply with sanitary measures, which has created more mistrust and pushed some people to hide when they fall ill.

A survey in the region, published in the Lancet medical journal, found that almost half of those polled believed that the Ebola virus did not exist or was invented to destabilize the region or make money. People with these beliefs were much less likely to seek Ebola treatment. And about a third of those surveyed did not want to take the Ebola vaccine.

"More than eight months after the beginning of the epidemic, the situation is alarming," said Doctors Without Borders (Doctors Without Borders). "It is clear that the epidemic is not under control."

MSF calls for urgent changes. The Ebola response should be integrated with local health centers, allowing people to choose health care in their own communities instead of forcing them to go to a formal Ebola treatment center, MSF said.

The International Federation of the Red Cross, which has 700 volunteers working in the Ebola zone, warned of the growing number of deaths from Ebola among those who do not seek care. "It's a very painful development," said Emanuele Capobianco, director of health and care at the Red Cross Federation.

"The bottom line is that the Ebola virus is spreading faster now and many people are no longer seeking care. It is clear that some vulnerable communities do not trust Ebola responders. "

Oxfam, another humanitarian group active in Congo, said local communities should be treated as "equal partners" in the Ebola response. "The relationship with them is currently broken and needs to be corrected if we want to stop the spread of the Ebola virus," said Tamba Emmanuel Danmbi-saa, Oxfam program manager in Congo.

"Too often, health workers and local clinics have been sidelined and the response to Ebola has created a parallel system that has not gained the trust of the local population."

The current epidemic of Ebola in Congo has been surpassed only by another epidemic in its history: that which plagued Africa from the West of 2014 to 2016 and which killed more 11,300 people.

The arrival of large shipments of Ebola vaccine in Congo was expected to bring a major improvement over the outbreak in West Africa. But mistrust has always been a problem. In 2015, in West Guinea, in West African country, the Globe and Mail went to neighborhoods where some people feared the vaccine would deliberately transmit the virus. Even government officials refused to take the vaccine.

On Friday, the World Health Organization rejected the possibility of declaring the Ebola outbreak an international health emergency, even though the outbreak is close to Uganda's borders, of Rwanda and South Sudan. Several health experts immediately criticized the decision, saying that the legal criteria for a global emergency had already been met and that the epidemic presented a risk of international spread.