Ebola outbreak demands more urgent attention - Financial Times

The World Health Organization has for a third time declined to declare the Ebola outbreak in the Democratic Republic of Congo, which in the past week worryingly crept over the border into Uganda, a public health emergency — for technical reasons that may be correct. Such a declaration could have triggered unhelpful actions, such as suspension of flights to Congo or the closure of borders with neighbouring countries. Making the impoverished central African country a pariah would probably not help anyone. 

If it is right not to panic, it would be equally wrong to be complacent. Make no mistake. What is happening in lawless eastern Congo — a region where poverty, violence and neglect are rife — is exceptionally dangerous. A tragedy in itself, it could yet ripple out much further afield. 

This outbreak of Ebola, a disease that resides harmlessly in bats but becomes deadly in humans, is already the second-worst in history. Only the west African epidemic of 2014, which killed more than 11,000 people in Guinea, Liberia and Sierra Leone, claimed more lives. In Congo, some 1,400 people have died since August, two-thirds of the roughly 2,000 who contracted the disease. Three cases have been confirmed in Uganda, though there are tentative signs that health authorities in that country are bringing things under control. 

For the moment the greatest concern lies in eastern Congo. There, about half of those who have died had no contact with doctors. That is worrying. The way Ebola is normally brought under control is by tracing those who have come into contact with patients. Thanks to a new vaccine, produced by US pharmaceutical company Merck, such people can now be vaccinated, as can those who have come into contact with them. That creates a “ring” to prevent the disease from spreading into the wider population. 

That strategy falls apart, however, if patients are dying before they get to a clinic. By that time they could have infected many others. That is what is happening in eastern Congo, a region riddled with dozens of militias who have filled a vacuum left by a dysfunctional state. Kinshasa, the capital, is more than 1,000 miles away from North Kivu and Ituri, the affected provinces where health workers have been attacked and even killed. Many people are suspicious of outsiders and fearful of quarantine centres from which at least half do not come out alive. After years of abuse, some even believe that Ebola is just another plot to keep them down, a theory that gained traction when presidential elections were cancelled in the area last year because of the epidemic. 

Three things are needed now to bring the crisis under control. The first is money. The World Health Organization has requested $98m to fight the epidemic. Shockingly, despite all the suffering and signs of escalation, it has received only $44m. Second, plentiful supplies of vaccines are needed. A shortage of the Merck vaccine has led health authorities to halve the dose to eke out supplies. Thankfully, Merck has agreed to make more. Another, slightly different, vaccine made by Johnson & Johnson should also be rapidly employed.

The third requirement is the hardest of all. Eastern Congo needs peace. Everything possible should be done to organise some sort of truce with militias. Troops often make things worse, but if more are needed that too should be considered.

The root cause of the violence is the poverty that stalks much of Congo. If something cannot be done to tackle that, then even if this epidemic is brought under control, sooner or later Ebola will be back. 

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