May 14, 2018; The Conversation
Nineteen people have died recently from the Ebola virus in the Democratic Republic of the Congo, where a ninth Ebola outbreak has struck. Responses from the World Health Organization (WHO) and the Congo’s own health system have improved somewhat since the 2014 epidemic in which they proved devastatingly ineffective. However, US support this time is notably lacking.
The weaknesses that were revealed in 2014 included slow response times and poor communication, especially with affected communities. Connor Bamford, a virologist at the University of Glasgow, said “blame has been placed on the slow response of the international community, the fragility of the region’s health services, and the failure of public health campaigns to reach all people.” Since then, several organizational shifts have improved the outlook for future outbreaks.
For one thing, the WHO worked to develop better rapid response systems. WHO shouldered a lot of the blame in 2014 after over 11,000 people died. Nevashan Govender from the National Institute for Communicable Diseases said this time, the necessary teams are already prepared. He told Candice Bailey of The Conversation,
[WHO] has set up an incident management system where staff and resources are dedicated to coordinate a response to the outbreak. [They will also] deploy epidemiologists, logisticians, clinicians, infection prevention and control experts, risk communications experts and vaccination support teams….The team will also engage with communities to explain the risk of the virus and the necessary precautions that need to be followed to reduce the chances of it spreading.
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Crucially, the Congo’s own health systems have begun to improve. USAID reports that after being gutted by economic collapse and conflict, “The country has made measurable progress in recent years, due to improved leadership, coordination and investments in priority health issues by the government of DRC (GDRC) and international partners.” They are supported by the new Africa Centres for Disease Control and Prevention, which was formed in 2017.
However, all of these efforts will suffer from US unpreparedness in the near future. NPQ has noted how the US has reduced its support in other areas of global health. Now, according to Lena Sun at the Washington Post, officials said the CDC “is dramatically downsizing its epidemic prevention activities in 39 out of 49 countries because money is running out.” The DRC is not among the ten countries still deemed “priority countries,” so its funding will run out in September 2019.
US under-preparedness extends beyond just the money. Julia Belluz at Vox reports, “Health experts have long said the US is underprepared for a pandemic. But right now the situation looks more precarious…the top White House official who would lead a pandemic response is gone. The health security team [he] was leading has also been dismantled.”
Sun adds that “a coalition of global health organizations representing more than 200 groups and companies sent a letter to U.S. Health and Human Services Secretary Alex Azar…[saying] ‘Not only will CDC be forced to narrow its countries of operations, but the U.S. also stands to lose vital information about epidemic threats garnered on the ground through trusted relationships, real-time surveillance, and research.’”
WHO, the Congolese Ministry, and the African CDC have bolstered their efforts, but there’s no guarantee they are fully prepared to cope with a large epidemic like the one that ended only two years ago. WHO notes that the DRC’s reforms “are still being implemented.” Shortsighted policy on behalf of the US may leave vulnerable populations without the resources they need.—Erin Rubin