UN hails progress in Ebola response, cites insecurity as biggest challenge

United Nations health officials on Friday hailed progress in the Ebola response six months after the ​outbreak first prompted global concerns, but cautioned that ‌the disease continues to spread to more remote and dangerous parts of Congo.

With the number of confirmed cases now surpassing 11,100, ​the outbreak is the second-worst for Ebola on record and ​has spread to parts of east, central and ⁠west Africa. More than 5,400 people have died so far, according to the Africa Centres for Disease Control and Prevention (Africa CDC). 

Flagged by health authorities in mid-May, the ​outbreak is driven by the rare Bundibugyo species of the ​virus, for which there are no approved treatments or vaccines. 

“We do see encouraging signs,” said Chikwe Ihekweazu, head of the World Health ​Organization’s Health Emergencies Programme, citing falling cases in ​former hotspots like Bunia in eastern Democratic Republic of Congo.

“But what we ‌have ⁠seen now is the emergence of cases in more rural and more difficult-to-reach areas.”

He added that children account for more than one third of deaths while transmission continues with up to 500 cases reported every week.

“The biggest challenge the response faces right now is the rising insecurity,” he said, ​citing WHO data ​showing 80 ⁠attacks on health sites and workers so far. 

“Violence restricts our access to people in need of help. It disrupts surveillance, it disrupts treatment and forces people to move, disrupting their access to care,” said Ihekweazu.

An attack last week by a rebel armed group in North Kivu killed 66 civilians including three health workers. Three health facilities were also looted and burned and more than 1,000 contacts that were being monitored were lost to followup after the violence. Three patients confirmed to have Ebola are also unaccounted for.

Congolese civilians carry their belongings as they flee following an attack by Islamic State-linked militants, who burned homes, a health post and other buildings, in Cantine-Aloya, Democratic Republic of Congo, on Nov. 6. (Gradel Muyisa Mumbere/Reuters)

“We need an urgent halt in hostilities and violence,” said Dr. Marie Belizaire, an emergency director with the WHO during a briefing. 

Belizaire says the ongoing violence puts any progress made over the past six months at risk. 

“Health workers and humanitarian teams need to be able to reach affected communities safely and patients will be able to seek care without fear,” she said. 

Surveillance still a challenge

Since the outbreak was declared on May 15, Ebola has spread across eight provinces. 

Africa CDC says there has been some progress. Laboratory testing capacity and patient beds have significantly scaled up. Initially there were only two labs available and now 30 testing labs are up and running across the affected health zones. 

“At the beginning of this response, we were only able to do testing for dozens of cases — with the capacity now for more than 4,300 samples per day,” said Dr. Wessam Mankoula, a medical epidemiologist with the Africa CDC.

There are also 2,000 beds for patient admission and more than 3,000 people have recovered from Ebola. 

However, in a briefing, Mankoula said having more beds and testing will not control the outbreak.

Dr. Toussaint Selemani, head of medical activities at the Ebola Treatment Center of the Kitatumba Reference Hospital, talks to his medical colleagues in Butembo in October. (Gradel Muyisa Mumbere/Reuters)

“Surveillance is a big challenge — identifying all possible contacts,” he said. “This is very critical to the success of this response.”

Only 11 per cent of new cases are coming from contact lists and nearly two thirds of deaths are still occurring outside of health centres. 

Low access to funds contributing to ‘dysfunctions’

In a briefing, Africa CDC says according to its tracking, $3 billion US has been pledged to help with the crisis but only 45 per cent has been disbursed. 

Help is not reaching those who need it most, according to French medical charity Doctors Without Borders, pointing ​to untrained and unpaid staff, ambulances without fuel and a lack of ​surveillance teams and supplies to safely manage suspected cases.

“Despite the vast amounts of money provided for the response, many front-line responders are left trying to contain the outbreak with empty hands and empty pockets,” Dr. Javid Abdelmoneim, ​international president for Doctors Without Borders, said on Thursday.

“Our teams are often left speechless by the dysfunctions they witness in many ⁠areas. Six months into the ⁠response, this situation is simply unacceptable.”

Doctors Without Borders called on the Congolese ‌government and UN agencies, which include the World Health Organization, to ensure the resources that have been mobilized translate into support on the ground.