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An outbreak of Ebola in a conflict-torn region in the Democratic Republic of Congo is uncontrollable and could become as serious as the epidemic that devastated three countries in West Africa between 2013 and 2013 and 2016, have warned experts and heads of help.
The new cases reported in the past month have increased at a record pace since the beginning of the epidemic last year, as aid agencies struggle to put public health action in areas that have suffered decades of neglect and conflict, with incredibly fragile health systems and regular epidemics of deadly violence involving armed groups.
"I am very worried – as worried as possible," said Jeremy Farrar, chairman of the Wellcome Trust, who called for a ceasefire to allow health teams to reach the sick and protect other members of the community. community.
"Whether or not it reaches the sheer magnitude of West Africa, none of us know, but that figure is huge in comparison to any other epidemic in the world. History of Ebola and it continues to grow. It's remarkable that it has not spread geographically anymore, but the numbers are scary and the fact that they're going up is terrifying. "
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A six-to-nine-month ceasefire negotiated by the UN, the Red Cross or similar organizations is essential to stop the spread, he said. "There has been violence in West Africa, in Freetown and Monrovia, but on a different scale and from multiple sources."
More than 1,600 people have been infected with Ebola in the North Kivu region of the DRC and more than 1,000 have died to date, including a large majority of women and children. At least 10 months after the start of the epidemic, their numbers are increasing steadily and the mortality rate is higher than in previous epidemics, at about 67%.
Back from a visit to his teams in the region, David Miliband, chairman of the International Rescue Committee, called for a "reset" of the response. "The situation is far more dangerous than the statistics of 1,000 deaths, itself the second-largest in history, suggest – and the suspension of essential services may create a lethal point of inflection the trajectory of the disease, "he said. "The danger is that the number of cases will become uncontrollable despite a proven vaccine and treatment."
The IRC teams, which burned three triage units in the health centers, warned that the situation in North Kivu was increasingly volatile and made progress in the fight against the disease impossible. Last week, fighters from the Mai-Mai armed rebel group attacked a treatment center in Butembo, one of the cities at the center of the crisis. This week, two patients were killed during an assault on a treatment center in Katwa, the second such incident in the city this month.
The Director General of WHO, Dr. Tedros Adhanom Ghebreyesus, also expressed his deep concern. In March, Dr. Tedros said that the Ebola outbreak was contracting and would be over in six months. After a visit in late April to the Regional Director for Africa, Dr. Matshidiso Moeti, he expressed deep concern about the situation. "The number of cases is increasing because of violent acts that delay us every time," he said.
The two men traveled to Butembo, where Dr. Richard Mouzoko, a WHO epidemiologist, was killed by armed men while he and his colleagues were working on the Ebola response.
"We are entering a phase where we will need major changes in the response," said Dr. Tedros. "WHO and its partners can not meet these challenges if the international community does not intervene to fill the large funding gap." Only half of the funds requested have been received, which could lead WHO and its partners to cancel certain activities when they are most needed.
Those on the front line in North Kivu fear that no end is in sight. Whitney Elmer, national director of Mercy Corps, one of the humanitarian NGOs working to prevent the spread, said that there had been "a drastic change in the security situation," which is why resulted in a sharp increase in the number of cases.
Elmer said that there had been about 400 cases in the last month – the highest figure since the beginning of the epidemic – and that the number of new cases was increasing at a much higher rate than the one observed before.
More than 1,600 cases of Ebola have been confirmed in the DRC during the nine months following the start of the epidemic.
"We are very worried," she said, adding that the epidemic could spread to neighboring Rwanda or Uganda.
Front-line workers say that there has not been enough community involvement and that the involvement of armed police, especially the cancellation of elections in the region, provoked hostility and suspicion. "The overall strategy was to do everything in our power to act as quickly as possible," said Elmer. She added that it was vital that local people and organizations be involved in decision-making.
Médecins Sans Frontières, whose volunteer doctors have been at the forefront of all Ebola outbreaks, have agreed that not involving communities has been a disaster.
"We are very worried and the signs around the outbreak response are not good at the moment," said Kate White, one of her emergency officers.
New cases must be detected by routine surveillance and contact testing of people who become ill. "But what we're seeing right now is that the majority of confirmed cases are due to deaths in the community. This is a very disturbing sign, "she said. "This means that communities are not conscious or actively participating in the response. People are dying in their communities and they have the ability to spread the virus to as many people as possible. "
She added that the agencies needed to ensure that local people are actively working against Ebola. "Everything else is a dressing solution."
The WHO recently announced an extension of vaccination guidelines and the introduction of a second vaccine to try to protect the population. Experimental drugs were also administered to 700 people, although no one yet knows how successful they were. But unless it is possible to reach affected communities with vaccines and drugs, new technologies are useless.
"The tragedy is that we have the technical means to stop Ebola, but until all parties stop the attacks, it will be very difficult to end this epidemic," said Dr. Tedros. tweeted Friday.
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