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The last patient with Ebola virus disease was identified on June 6 in Ngengobala, a village on the borders of the Congolese rainforest. He was released six days later from the Bikoro treatment center on the shores of Lake Tumba. Since then, no new cases have been reported in Equateur Province, in the north-west of the Democratic Republic of Congo (DRC), where 54 cases have been reported since the beginning of the epidemic on May 8, of which 33 dead and 21 survivors. The authorities declared the end of Ebola on Tuesday, July 24.
This huge country of Central Africa and its partners had prepared "worst case scenario" when this ninth outbreak appeared in two outbreaks identified in areas isolated, difficult to access and without health facilities, before reaching the provincial capital, Mbandaka, 150 km of faulty roads. Ebola was likely to spread to Kinshasa, the megacity of nearly 20 million people, nearly a week or two of navigation on the Congo River. It would have been a disaster. It was not so.
"Lessons Learned from West Africa"
The record of this epidemic, the third longest and most deadly in the DRC, is in stark contrast to that of Guinea before spreading to West Africa, which had resulted in the death of 11,310 people between December 2013 and March 2016. The World Health Organization (WHO) was then strongly criticized for the slowness its reaction to failures on the part of the authorities of the affected countries. This time, in the DRC, the response was immediate and well coordinated.
It took a lot of pedagogy to be able to act effectively
"Lessons learned from In West Africa, centralized coordination and an emergency program have been put in place, says Matshidiso Mœti, Regional Director of WHO. This time, as soon as the epidemic broke out, we mobilized $ 4 million from our reserve fund and quickly dispatched nearly 250 experts on site, the vast majority of whom were from the region. "
they, many Guinean doctors and nurses came to lend a hand, in the front line in this response. Like Alhassane Toure, a 31-year-old Guinean epidemiologist. "Ebola messes up everything," he says. We saw it in Guinea. The virus kills and brings foreigners with syringes and equipment never before seen by local communities. It took a lot of pedagogy to be able to act effectively. "
This time, the Congolese authorities were at the rendezvous and showed an efficiency welcomed by all partners. The DRC, where the virus was first identified in 1976, has acquired some know-how, both in terms of scientific research and epidemiological surveillance. Added to this was the logistical support of the United Nations Mission in the DRC (Monusco), which quickly established airlifts between Kinshasa and Mbandaka for the transport of medical equipment, and provided helicopter services between the capital of the province of Ecuador and the remote villages where most of the cases were concentrated.
"The story is not over"
In this region, neglected by the central government because considered as acquired by the opposition, laboratories created by international organizations quickly flourished in the areas affected by the epidemic. For the first time, the experimental vaccine developed by the US Merck laboratory was administered in a targeted way from May 21, giving priority to people who have been in contact with patients. In all, 3,300 people were vaccinated.
The new vaccine has not only demonstrated its effectiveness against Ebola, it has also changed people's perception of this disease, now considered treatable
For the Congolese Minister of Health, Oly Ilunga, the use of the vaccine will have changed the situation and made it possible to optimize the fight against the epidemic by cutting the chain of transmission more easily. "It was one of the most innovative components of this response," the doctor wrote in a column published in The Guardian. The new vaccine has not only proven to be effective against Ebola, it has also changed people's perception of this disease, now considered treatable. "
Scientifically, no one can really assess the impact of this disease new vaccine, but it is probably the beginning of its systematic use in future epidemics. "This has probably had an impact that scientists will study from the data collected," says Luis Encinas, Ebola expert for Doctors Without Borders. There will be a before and after in terms of response but, if a chapter is closed, the story is not over. "
Gradually, international organizations will withdraw and take with them the sophisticated equipment deployed at beginning of the epidemic. Mbandaka and the province of Ecuador are likely to end up again with untrained health centers. "We did a post-Ebola plan to support the health system by leaving equipment on the ground," says Matshidiso Moti, WHO. We will continue to monitor Ebola and send experts. "The Ministry of Health has validated the implementation of a" strategic plan for consolidation and stabilization "of the health system, stretching from August to October 2018. The Congolese authorities have already declared that they are preparing for a tenth epidemic. In DRC, the post-Ebola fits the possibility of a new crisis.
The epidemic has caused 33 deaths
Between May 8, which corresponds to the beginning of the Ebola epidemic in the Democratic Republic of the Congo Congo, and July 24, its official end, the virus has infected 54 people. Thirty-three died, 21 survived. The great epidemic that hit West Africa between 2013 and 2016 killed 11,310 people.
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