Opinion: DRC needs urgent long-term Ebola plan

The Democratic Republic of Congo is struggling to cope with its 10th outbreak of Ebola since 1976. As Rwanda closes its border with DRC following the second Ebola death in densely-populated Goma, there are no quick fixes. A long-term plan to cope with the disease must be found.

Since last August, a deadly Ebola outbreak has raged through the Ituri and North Kivu provinces of the Democratic Republic of Congo (DRC), claiming over 1,700 lives. Having decimated Liberia, Guinea and Sierra Leone between 2014 and 2016, killing over 11,300 people and sparking global panic and billions in losses, the return of the highly contagious virus is dismaying but sadly unsurprising.

The latest epidemic is the 10th outbreak the country has faced since 1976, where it thrives off desperately poor communities beset by extreme poverty, absent central authority and armed conflict. The current outbreak appears to be more serious still. In a bid to mobilise resources, the World Health Organisation announced in July that the current outbreak constitutes a Public Health Emergency of International Concern.

In response, the World Bank announced that it is mobilising up to $300m in grants and credits to scale up a global response. The institution already supports health clinics, treatment centres and healthcare workers. More support is expected to be delivered following talks between the DRC government and a consortium of global partners.

While critical to saving lives, emergency support of this kind can only offer short-term respite. The roots of the DRC’s ill-preparedness lie much deeper. Large parts of the affected provinces are beyond the effective control of a weak central government and lack both security and health systems. By October 2018, over 51% of the DRC’s violent events and protests in that year had taken place in North Kivu, a disproportionately high number. The crisis response in the province has been impeded by the activity of armed groups, and residents’ lack of trust in the government has put humanitarian aid workers in danger and made it difficult to implement public health measures, according to a note by researcher Hilary Matfess.

The long-term work of rebuilding that trust, providing security against armed groups and boosting the legitimacy of the state cannot wait until after this crisis. Yet the political response by the government to this pressing task is lacking. Health minister Oly Ilunga resigned in July, condemning a decision by President Félix Tshisekedi to replace him as the head of the Ebola response team and refusing to support an experimental vaccine. Infighting appears to have trumped cooperation. 

Effective response

Policymakers should learn from neighbouring Rwanda, which is leading the way with an effective and united response. The country has a detailed National Preparedness Plan in place, and is training health workers in early detection and response, educating communities about Ebola, vaccinating health workers in high-risk areas, equipping health facilities, and conducting simulation exercises to maintain a high level of readiness, according to the WHO. There have been no cases of Ebola in Rwanda to date, despite high levels of traffic and movement of people between the two countries.

There are no quick fixes, but the DRC and its international partners must formulate a similar long-term plan to boost capacity, taking into account the country’s unique security problems.  Absent this, an 11th outbreak is surely not far away.