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Ebola fighters need to expand the use of vaccination in their campaign against the deadly epidemic in DR Congo, said Thursday at the head of Doctors Without Borders (MSF).
Joanne Liu, international president of the medical charitable badociation known as French acronym MSF, told AFP that health officials needed a "reality check" in their response to the epidemic.
A day after the World Health Organization declared that Ebola was a "public health emergency of international concern" – a designation reserved for the most serious epidemics – Liu called for a wider vaccination.
Until now, doctors have used a so-called ring vaccination strategy, which aims to protect a circle of people who have been in contact with patients with Ebola.
It's a "great, cost-effective way to do things when you're looking for contacts, but we're not in this scenario," Liu said in an interview.
"We are not able to follow everyone," she said.
Liu spoke of the difficulties in finding contacts in the provinces of North Kivu and Ituri, in the east of the DRC, plagued by chronic insecurity and poor transport conditions.
Instead of a targeted vaccination approach, "we should take a geographical approach, which means that if an infected person came from (a) a village, we would not just vaccinate contacts and contacts of contacts, we would vaccinate the whole village, "she said. I said.
– "Opacity" & # 39; –
New figures released Thursday by the Ministry of Health indicate that 1,698 people have died since the declaration of the outbreak last August 1.
When the WHO launched the emergency appeal on Wednesday, she acknowledged the "lack of rVSV – ZEBOV vaccine supply" despite "commendable efforts" from the Merck manufacturer to double its supplies by 2020.
According to Mr. Liu, "there has been a lot of opacity" with regard to the available stocks of vaccine, which is being used for the first time and has proven to be effective.
"What is the world's offer right now?" she asked.
"We are told that there are between 250,000 and 500,000 doses.It's great, if we have some, but where are they? When will they be available? We need a lot more of transparency and clarity on the status of vaccine supply today. "
The WHO has called for the use of a second, less elaborate vaccine, manufactured by health care company Johnson & Johnson, suggesting administering it to people at risk. lesser infection.
The DRC Ministry of Health has rejected the J & J vaccine, citing problems introducing a new product into communities where the mistrust of Ebola workers is high.
Ms. Liu said that she appreciated the fact that building trust around a new vaccine was "complex", but that "we need to deploy everything we have" until the next day. Epidemic is under control.
The Merck vaccine has been widely deployed, but is still not registered from a regulatory point of view. The J & J vaccine, meanwhile, is in the experimental stage.
– Spacemen & # 39; –
The MSF chief also stressed that improving the response will require the creation of an environment in which people will feel comfortable asking for care.
According to her, Ebola patients are "deprived of their rights" when they are removed from their homes to be cared for by "people dressed in a spacesuit", with over 50% chance to die far from their family.
"Could we think of a decentralized approach to treating patients, and not placing them somewhere with only men-ships away from their loved ones?" she says.
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