World Health Assembly 2019: Failures persist in DRC Ebola outbreak responses, leaders say

Science Speaks is in Geneva this week covering the 72nd session of the World Health Assembly, May 20-28. GENEVA - While international agencies identify violence and community mistrust as the main reasons the Ebola outbreak in the Democratic Republic of the Congo remains uncontrolled, here DRC Minister of Health Dr. Oly Ilunga Kalenga identified gaps in communication, data and planning as additional weaknesses preventing effective responses. “We need to emerge from silos,” he said, “All actors who participate in the response need to continually stay in touch and communicate.” Better data that helps identify “danger areas where there’s greater risk of the virus spreading” would allow responders to get ahead of the outbreak, Dr. Kalenga said, and optimize the use of resources. The third weakness in the response rests on implementation, Dr. Kalenga said. “There are many recommendations from the international community but those need to be translated into action plans,” he said. Operational plans and preparedness activities at the national level are strong, World Health Organization regional director for Africa, Dr. Matshidiso Moeti, said, citing "gaps at sub-national levels which we are addressing now.” Nine neighboring countries are ready to respond if the virus spreads across the DRC border, Dr. Moeti said, adding that all countries have strengthened their laboratory capacity and will be able to confirm cases with GeneXpert rapid molecular diagnostic technology. More than 8,000 frontline health workers in neighboring countries have been vaccinated in these countries, and more than 4,500 health workers have been trained to detect and manage cases, she said. Emergency operational centers are now operational in almost all neighboring countries, she added. These accelerated efforts have helped detect outbreaks of other infectious diseases, including the spread of yellow fever in South Sudan, Dr. Moeti said. Still, a gap of $28 million dollars for preparedness in in the region persists, she said. Additional funding is needed to strengthen community engagement, particularly for following up with people who have been given an Ebola vaccine and further vaccinating their contacts, Dr. Kalenga said. Ongoing violence has complicated the response, he said, adding, “We all need to draw a clear distinction between community engagement and violence,” he said. “There is no correlation between the two.” “This is a dangerous narrative that is based on the assumption that communities are intrinsically violent,” Dr. Kalenga said. “This cannot be accepted.” Rabita Aziz is senior global health policy specialist at the Infectious Diseases Society of America, which produces this blog.