Amid other challenges, Burundi begins front-line, health worker Ebola vaccinations at border

DRC neighbor boosts preparedness for spread of virus while grappling with increasing malaria cases, continued cholera outbreak

Burundi's health ministry Tuesday launched a campaign to vaccinate  health workers and others on the front line of a Democratic Republic of Congo border crossing Tuesday, the most recent in a series of steps preparing for the eventuality that the more than year-long DRC Ebola epidemic will enter the neighboring nation. The effort, which will use the rVSV-ZEBOV vaccine being administered to health workers and patient contacts in the DRC, and to health workers in neighboring Uganda, Rwanda and South Sudan border areas, is being supported by the GAVI the Vaccine Alliance and by the World Health Organization, which also is supporting health worker training, community outreach, and public health education efforts.

Like the other near neighbors of the DRC most at risk from the ongoing epidemic, Burundi already is confronting public health challenges on multiple fronts. A steep increase in malaria cases across the country has culminated so far in more than 5 million illnesses leading to 1,855 deaths, more than 2.5 million of those cases, with 582 deaths, since the first week of June. At the same time a continuing outbreak of cholera across two provinces continues to demand resources, stretching capacities "faced with constraints of human logistical and financial resources needed to mount a robust response," according to this week's Africa Region report on outbreaks and other emergencies. The report cites "a dire need for the national authorities, local, and international partners to galvanize the requisite resources in order to reinforce and sustain control interventions." Uganda, the first DRC neighbor to confront the spread of the current Ebola outbreak across its border, last week confirmed a case of Crimean-Congo hemorrhagic fever, a tick borne disease also spread from human to human by exposure to bodily fluids, with a fatality rate as high as 50 percent. Uganda also continues to confront outbreaks of cholera, measles and Rift Valley Fever as well as the humanitarian crisis stemming in part from the displacement of hundreds of thousands of people from continuing violent conflict in the DRC, as well as from local conflicts. South Sudan, also grappling with outbreaks of measles as well as hepatitis E caused by unsafe drinking water, does so amid continuing tensions caused by population displacement and flooding that has so far forced the movement of more than 3,000 households. Rwanda which shares a border that has been described as "porous" with the DRC densely populated city of Goma, where two Ebola cases so far have been confirmed, is facing a continued spread of measles first reported in June amid low rates of vaccination against that disease. This is the latest following a week that saw a White House order to freeze funding for foreign aid. The order has since been lifted, while reports indicate the administration continues to consider cancel the unspent money, including for foreign assistance, a process known as rescission. That proposal was last made by the White House in May 2018, coinciding with the confirmation then of the DRC's 9th outbreak of Ebola. That proposal was subsequently rejected by Congress.