Conflict and insecurity lead to the spread of diseases such as Ebola, warns the head of the WHO | Global development

World Health Organization President calls the world's second-worst Ebola outbreak a "global call" for the growing risk of disease outbreaks from neglected areas of conflict in the international community .

Tedros Adhanom Ghebreyesus said that the international community was spending money only on repression and panic in the headlines. The real problem is the lack of daily funding to prepare to fight serious epidemics before they become regional or international threats, he said.

Before a new call for funding for the response to the Ebola outbreak, he added: "The problem is that [donors] Refrain from paying until there is fear and panic. It must change. We should not fund a lot when we panic, but rather to avoid panic. "

Citing the specter of the Spanish flu, which killed tens of millions of people in the aftermath of the First World War, he added that international health systems in an increasingly globalized world were as powerful as the most important link in the world. low.

In an exclusive interview given to the Guardian in Geneva, Tedros added that, while he believed that the epidemic in the Democratic Republic of Congo could be contained in the short term – with adequate security conditions – the virus would inevitably come back while political instability persisted in the north of the country. Kivu and Iruri, the provinces at the heart of the epidemic.

How serious is the current epidemic?

More than 2,100 people have been infected with Ebola in the Democratic Republic of Congo since last August, making it the second largest epidemic in history. More than 1,412 people died.

The disease has spread at an unprecedented rate. Although it took eight months to reach 1,000 cases, it took only 71 days to double that figure.

What exactly is the Ebola virus and how is it spreading?

Ebola causes fever, body aches and diarrhea and attacks the immune system, causing blood clotting cells to malfunction, so that the victims bleed heavily and die if their immune system can not fight against the blood. ;viral infection. It is transmitted from one person to another by body fluids.

Can it be treated?

Infected patients are isolated and treated by medical teams wearing full protective suits that attempt to strengthen their immune response.

A vaccine, still experimental, has proven very effective in preventing the disease, according to the World Health Organization.

Why does it spread even if there is a vaccine?

The history of conflict in the DRC has led to a suspicion of foreigners: rumors that health workers make money from the crisis – or that the Ebola virus does not exist yet – continue to circulate. The aid agencies have been accused of not solving the problem of distrust of the community.

The decision in December by the government to suspend the vote in the presidential election in areas affected by the Ebola virus fueled the idea that the disease was being used as a political tool.

Repeated attacks on health workers and health facilities have slowed immunization programs. Health workers resorted to police escorts, which exacerbated the feeling of intimidation of the local population.

Tedros also reiterated his resistance to the idea of ​​declaring the ongoing epidemic a public health emergency of international concern (PHEIC). This despite the calls of the British Secretary of International Development, Rory Stewart, during a visit to the city of Butembo, the current epicenter of the epidemic.

"I know we can end this Ebola outbreak," said Tedros, former foreign minister of Ethiopia, who became director general of the United Nations World Health Organization. 2017. "But at the same time, it can come back because all [political and security] the conditions remain the same.

"Some people say we have to declare the epidemic as a [emergency] mobilize resources. It's really wrong. Resources must be available to avoid reporting a PHEIC. Preparation is the solution, not the fight against fires. "

WHO officials also questioned Stewart's claim in the Guardian that more money was needed to pay for ring vaccination. They said that currently, current models of the epidemic were sufficiently supplied, but that this would depend on the long-term evolution of the epidemic.

The outbreak is referred to as "category 3 emergency", the highest level of WHO before a PHEIC statement. Three cases crossed the border briefly in Uganda last month.

Tedros warned, however, that far from contributing to the response to the outbreak, designating her as a PHEIC could actually complicate the response of health teams in the field. It could see closed borders and increase economic hardship for an already highly marginalized and angry population that relies on cross-border trade and has already attacked health teams.

At a meeting of science journalists Friday, before Stewart's intervention, Tedros reiterated his objections.

"PHEIC only shows that there is a very high risk of international spread, which is not the case on the basis of the criteria. But if you take if Ebola is an emergency in the DRC or not, it's – it's actually the highest level of urgency. "

Although outbreaks of the disease in and around the nearby city of Beni were largely controlled last year, the outbreak in Butembo proved extremely complicated, with violent attacks against health officials and treatment centers.

The WHO has been criticized for its response to the DRC epidemic, including whether or not to declare this global health emergency a decision that critics say is critical. could encourage more donor countries to provide funds and other resources.

"I'm not saying that we can not learn from lessons and that there was no shortfall," Tedros told the Guardian, adding that the organization would proceed to an appropriate assessment of the current response.

"But we never had such conditions in other places where we had Ebola."

Tedros cited the DRC government's decision to cancel the vote in national elections in Ebola-affected areas as the epidemic moved to Butembo last fall.

"When we heard about the decision to cancel the elections, we said," Do not do that. It's dangerous, "he said, adding that he personally called on the ministers of the DRC and the African Union to reverse the decision.

"It changed the game, to be honest," he added. "An opportunity was missed and the community was angry and started attacking the stakeholders."

Like other senior health officials involved in the field response, Tedros blamed the resurgence of extremely complex political and security issues.

"Political problems [in DRC] broke the whole system – social, economic and so on. And to be honest, when I talk to the community, it's embarrassing for me because they say, "Ebola only interests you because you do not want it in your own country and you try to protect yourself for that mothers and children die. . Here & # 39;

"The root cause of the problem is the lack of peace, the absence of a political solution. The incidence of Ebola, malaria and cholera is the symptom.

"It's not just about Ebola. What worries me is the lack of understanding on how to make our world safer, "he said, citing the risk of an airborne pandemic.

"We do not invest in the preparation to quickly detect epidemics. We invest after the problem comes knocking on our door when it is too late. So, how can we move from this state of mind? We must be as strong as the weakest link and invest in strengthening the weakest link systems.

"We think that we are very far from the problem, but in a globalized world, even if it only happens in one country, it can be exported – so there is a risk of spreading even when we are spoken. We should support the Congolese but also help ourselves. "