The World Health Organization warned Friday that it may not be possible to contain Ebola to the two affected provinces in eastern Congo if violent attacks on health teams continue.
The ominous statement comes amid escalating violence nine months after the outbreak began, crippling efforts to identify suspected cases in the community and vaccinate those most at risk. Earlier this week, Mai-Mai militia fighters attacked the town of Butembo at the epicenter of the crisis.
Friday’s update also noted that a burial team had been “violently attacked” after they interred an Ebola victim in the town of Katwa. The corpses of victims are highly contagious, requiring special precautions to ensure the disease is not transmitted at funerals. Nearly five days of Ebola response activities were halted in Butembo and surrounding areas recently because of the insecurity, WHO said.
“The ongoing violent attacks sow fear, perpetuate mistrust, and further compound the multitude of challenges already faced by frontline health care workers,” it said. “Without commitment from all groups to cease these attacks, it is unlikely that this (Ebola) outbreak can remain successfully contained in North Kivu and Ituri provinces.”
The outbreak, which has killed 1,069 people, marks the first time that Ebola has struck inside a conflict zone. Eastern Congo has suffered decades of violence perpetrated by warring rebel groups and militias awash in arms.
The affected area, though, is also close to Congo’s borders with Uganda and Rwanda, and health officials in both countries have been preparing in case someone sick with Ebola should bring the disease across international borders.
WHO and others have previously said that the risk of that happening was low. The difficulties in accessing some of the hardest hit areas in Congo, though, means that health workers are struggling to isolate the sick, and track down and isolate their caregivers and family members.
About half of those dying remained in their homes instead of seeking treatment at Ebola health centers, giving the virus an opportunity to spread to those in physical contact with victims.
Amid the rising number of cases, WHO said Friday that an advisory group was now recommending that those at high risk of contracting Ebola be given a vaccine dose of 0.5mL of vaccine instead of 1mL. The group is proposing that the vaccine be given more widely, including to those living in communities where there have been recent Ebola cases.
In addition to the risks posed by militias there also has been widespread community mistrust in eastern Congo, a byproduct of years of conflict and grievances with the government. WHO said it was aiming to have the majority vaccine teams comprised of local health workers by the end of the month in an effort to reduce tensions. (VOA)
The vaccine alliance GAVI announced Thursday it would invest $178 million to create a global stockpile of about 500,000 Ebola vaccines, a decision that health officials say could help prevent future outbreaks from spiraling out of control.
The public-private partnership includes the World Health Organization, UNICEF, the Bill & Melinda Gates Foundation and the World Bank, among others. The funding announcement was made after a meeting of GAVI’s board. GAVI said the investment, which it called an estimate, will be provided between now and 2025.
Since the current outbreak in eastern Congo was identified last August, health officials have immunized more than 255,000 people with a recently licensed vaccine made by Merck. To date there have been nearly 3,200 confirmed Ebola cases, including more than 2,200 deaths, in what has become the second deadliest Ebola outbreak in history.
Dr. Ngozi Okonjo-Iweala, chair of Gavi’s board, called the creation of the Ebola vaccine stockpile a “historic milestone in humanity’s fight against this horrific disease.” GAVI said “a coordinating mechanism” to decide how and when vaccines will be used will be established with partner organizations.
There are similar stockpiles for vaccines against yellow fever, meningitis and cholera. Those limited shots are doled out to developing countries by WHO, UNICEF, the Red Cross and Doctors Without Borders after receiving technical advice from others.
The Ebola vaccine stockpile will be available to all countries, but only developing countries will be able to get vaccines for free in addition to support for the logistical costs of mounting vaccination campaigns.
Jason Nickerson, a humanitarian affairs adviser at Doctors Without Borders, said the new stockpile would change how officials respond to future Ebola outbreaks.
“Knowing how many doses of the vaccine exist in the world, and then being able to get a supply of them to high-risk countries in a very quick way, gives us another tool to respond to these outbreaks,” he said.
Earlier this year, the medical charity publicly called for an independent committee to oversee Ebola vaccination efforts in Congo, saying WHO sometimes used arbitrary criteria to determine who would get immunized. It said the fact that Ebola was continuing to spread despite the large number of people vaccinated was a damning assessment of the response.
Containing this outbreak has been complicated by violence and misunderstandings in a part of Congo that had never reported an Ebola case before.
Last week, response activities were suspended after attacks killed four Ebola responders, including a member of a vaccination team. Multiple rebel groups operate in eastern Congo and the region has been described as a war zone.
WHO has warned continued attacks on health workers and Ebola clinics could undermine attempts to curb Ebola and prompt a resurgence of the disease. (VOA)