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According to figures from World Health Organization
the Ebola epidemic in the Democratic Republic of Congo is the second largest in history. Since 1965,
was declared . it is suspected or confirmed that 426 people were infected with the deadly haemorrhagic virus, which killed at least 242 .
"It's a tragedy because it should be able to be completely avoided, but that's not the case. J. Stephen Morrison told HuffPost. The director of the Global Health Policy Center, a program of the think-tank Center for Strategic and International Studies, pointed out that although this epidemic is still minimal compared to that which began in 2014 in West Africa, it killed more than 11,300 people and infected 28,600 – it's very dangerous.
The Ebola crisis became a battle on many fronts . The epidemic is in a war zone where violence and demonstrations often interrupt efforts to control the disease. the resistance of the community has increased slightly, often entrusted to international actors, whose foreign status sometimes gives rise to fear and mistrust, particularly in the new outbreaks of the Butembo epidemic and Katwa. The period leading up to the parliamentary elections of December 23 should be marked by further unrest and political instability. And now, there is a threat of terrorism directed against the US embbady in Kinshasa, which could limit an already limited flow of US actors in the DRC, according to the US Control Center and disease prevention.
The number of cases continues to climb, health workers continue to constitute close to one-tenth cases, and infants and children continue to be infected at alarming rates.
WHO Assistant Director General for Emergency Preparedness Mike Ryan pointed out that, although the international organization knows that its strategy will work, there is no "quick fix" To extinguish the epidemic if not to elaborate an answer.
"We are almost always at the origin of the virus," he said. "The virus is spreading to the next place before we have a total chance to stop the transmission."
Morrison and other world health experts are particularly disturbed by the fact that the epidemic in northeastern DRC has grown into important new tools – an experimental but very effective vaccine and new treatments – currently in the arsenal of global health. More than 30,000 people have been vaccinated to stop the spread of the disease – an answer that could only be deployed at the end of the epidemic in West Africa in 2016 – and yet, the epidemic in the DRC continues to develop.
Reach this point where we have all the tools to stop this epidemic, but this effort fails, and we have to wonder why, "said Morrison.
With the growing number of cases, experts worry about the possibility that [19659005] Dr. Robert Redfield, head of the CDC, mentioned earlier this month: Ebola could becoming "endemic" for the first time in history – meaning he would not be defeated and would continue to live
"The human toll is getting heavier and the risk of spreading in Uganda is increasing, and on its current course, the epidemic is only getting worse, "Ron Klain, the" tsar "of Ebola in the Obama Administration, told HuffPost. "This is the paradigm of the coming epidemic that poses a truly frightening problem, where it is not only difficult to control medical problems, but security, diplomatic and geopolitical problems."
A Cascade of Problems
According to Ryan of the WHO, the situation at the epicenter of the city of Beni seems to be moving in the right direction. current violence is a constant concern – doubling the number of cases in October – and two new hotspots are in Katwa and Butembo.
An increase in the number of cases in Butembo, a large community of people. a million inhabitants limited infrastructure located less than 30 miles from Beni, increases the risk of creeping urban spread .Minarians Without Borders plans to open another Ebola treatment unit in the region, declaring that this one is almost saturated, according to Ryan.
Community resistance remains a major problem as the epidemic infiltrates into new areas, such as Katwa. Last weekend, local residents recovered the highly contagious body of an Ebola victim in a health center Katwa instead of allowing his staff to have him. to bury safely, HuffPost Nora Love of the International Rescue Committee told HuffPost. As Love, the field coordinator for emergencies at IRC in Beni, pointed out, as the epidemic spreads, new communities need to become familiar with the risks of spreading the Ebola virus while learning to trust the teams. coming in.
trend in recent weeks in Katwa and Butembo: a number of people who have been in contact with known patients with Ebola have refused vaccination or follow-up and were found a few days later in institutions health or died at home after probably spreading the
"Many were known as contacts but had gone out of follow-up because they did not want to be found," Ryan said. "It's a disturbing trend because it means to some extent that the disease is underground."
And that does not mean anything about the growing fear of elections scheduled for December 23rd. The elections of President Joseph Kabila's successor, which have been delayed for two years, are already charged with mistrust of the community. And the northeastern region where the epidemic is occurring is already very hostile to the national government, Morrison said, because of the lack of security of the past 20 years. So no one really knows how the country will react to the election results – no matter how it goes.
MSF expert Ebola on behalf of Dr. Michel Van Herp, who was on the ground in October, said mbadive crowds, population movements and political violence that the election could create would only make the epidemic more difficult to control.
For Klain all these complicating factors mean that this epidemic is far from over. 19659002] "As long as the situation worsens, not better, the end is really not in sight."
A shameful American response on the ground ]
The United States was criticized during this epidemic as " leading from behind ", in the words of Klain . While the US has poured huge sums of money and expertise into the response, CDC and USAID stakeholders are not allowed to go to the field at the epicenter of the United States. Epidemic because of fears for their safety. " Hangover from Benghazi ." This takes away some of the world's leading experts from the threat of fires related to violence in Beni, but also from the epidemic zone of Benghazi. 39; Ebola.
Fighting around Beni This prompted the withdrawal in August of part of the CDC forces in Kinshasa, the capital of the country, mainly at the instigation of the Allied Democratic Forces insurgent group. ADF terrorized the region for decades – killing US peacekeepers and DRC military forces, and targeting civilians during machete attacks and kidnappings. # 39; children. A report published two weeks ago by the Congo Research Group, based at the Center for International Cooperation of the University of New York, evoked links between the group and a financier Islamic State, Waleed Ahmed Zein
The US Embbady in Kinshasa is closed to the public since Monday after issuing an alert about the terrorist threat "[ ]] credible and specific "over the weekend. . CDC spokesman Benjamin Haynes told HuffPost that in light of the state department's threat and direction, it was difficult to determine whether the new US intervention staff would be able to travel to the DRC until February 1 at the earliest, which means that the US reaction in the country might not
While Ryan, of the WHO, pointed out that He was grateful for the huge US funding and CDC staff for the growing efforts in Geneva and the DRC's borders in neighboring countries This lack of field badistance is a waste .
"It would obviously be a big development if we could have more CDC resources on the ground, but it's not for lack of effort or courage on the part of the CDC," said Ryan. "Everyone must take into account the security badessments of their own countries."
Thursday, in the Journal of the American Medical Association more than two dozen global health officials called for a rise of the CDC workers not only in Kinshasa, but also to the epicenter of the epidemic . They are part of a growing group of experts calling for the return of the CDC on the ground, saying that without the expertise and considerable resources of the agency, this epidemic would continue to grow.
A Question of International Leadership
Klain's concerns about the US government's abdication of its leadership role echo many other global health experts who say that without an increase in the true international will, this outbreak would continue to infect and develop.
Morrison was a little more direct, claiming that the United States, the United Kingdom, Germany, France and other world leaders had no desire to mobilize the resources necessary to truly intervene .
"There is a certain level of silence about this. , "he said." I just think we are at a particular moment between inner populism, rampant nationalism, the Brexit and EU crises, and America first that has altered security calculations.
Thomas Inglesby, director of the Johns Hopkins Center for Health Security, stated in an article published Wednesday in the New England Journal of Medicine that the WHO needed to declare a public health emergency out of reach The WHO chose not to call a USPI for this epidemic earlier last month .
"The WHO, the DRC, other governments, including the United States, and NGOs need to find ways to step up their efforts beyond what has already been done to date, "said Inglesby HuffPost. "If the effort is not intensified, the epidemic will probably get worse."
Or, as the authors of the JAMA article put it: "It is in the national interest of the United States to control epidemics before they degenerate into crisis. The cost of fighting this epidemic is much lower than if mbad mobilization was needed because of the international spread of the virus.
In this debate, WHO and voluntary non-governmental organizations are still working in the field. Many people were deployed several times during the year, as WHO and NGO staff, along with the DRC Ministry of Health, had been battling the Ebola virus in DRC for the past month. April, when the Ecuador epidemic was declared. This epidemic ended just days before the announcement.
"Everyone has been working for a long time, everyone is tired, everyone is stressed and now it's time to double," Ryan said. "We must not simply maintain our efforts, but we must increase our efforts in the face of fatigue and insecurity."
The worst-case scenario in the dreaded case
World experts fear a worse scenario in which ADF or Mai Mai, another rebel group, would attack or kidnap Ebola health workers (kidnappings of NGO workers) and clergy in the area have been in place for years.) This would trigger a complete withdrawal of the international intervention team, fearing that Morrison would be "close enough" to produce – and would be "catastrophic."
"Propagation has been slowed down and controlled to a point by international mobilizations, but it does not work in terms of stopping and bending the curve," he said. he explained. "It slows down the If you remove these links, there will be precipitation and acceleration. "
Ryan also mentioned the serious possibility.
" We simply hope that the security system does not deteriorate further, which could trigger a necessary withdrawal from the ground, and nobody wants it. Because at this point, if we have to withdraw important resources from the field, this virus becomes uncontrollable. "
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