Dr Matshidiso Moeti, WHO Regional Director for Africa
Today marks 6 months since the 10th outbreak of Ebola was declared in the Democratic Republic of the Congo. Before I say anything else, I want to recognize and thank our WHO and partner colleagues in the field for their courage, commitment and professionalism. They make us all proud. I also want to acknowledge the steadfast leadership of the Democratic Republic of Congo Ministry of Health and other colleagues. No country would wish to face this deadly pathogen, and their spirit of cooperation is what allows us all to face the virus together.
As we look back on these 6 months, we can clearly see the strategies that have been successful at controlling the outbreak in some of the affected areas such as Mangina, Béni, Komanda and Oicha, though we continue to face flare-ups in some of these areas and outbreaks in others.
What has worked is public health measures such as training health workers on infection prevention and control in health centres; closer engagement with communities--particularly women’s and religious groups; other public health measures such as case investigation, and contact tracing, alongside the use of newer tools. So far 70,000 people have agreed and received the investigational vaccine, and 350 patients have been treated with therapeutic drugs, available for the first time at this scale.
In each town or area, the outbreak has slightly different drivers. The outbreaks in Butembo and Katwa health zones are partly being driven by transmission in private and public health centres, with about a fifth of patients reporting contact with a health care facility before their onset of illness. The rest are being infected within communities.
We therefore tailor our actions accordingly both in the health facilities and at community level.
Let me provide some examples:
- In order to strengthen infection prevention and control practices, we prioritize facilities according to risk, we train health workers and monitor their progress, and provide incentives to encourage best practices. We’re also working with the highest risk health facilities in as yet non-affected health zones in North Kivu and surrounding provinces, and countries.
- In addition, we work with health facilities to ensure they and the communities report all deaths, allowing teams to conduct safe and dignified burials.
- WHO, the Red Cross, UNICEF, and other partners work together to collect and analyze community feedback, to ensure our actions are tailored appropriately and address community concerns and needs.
- Underpinning this all, the UN peacekeeping force provides us the security umbrella under which we can function.
These are the approaches that work. But let us step back to consider the context. The Ebola outbreak is happening in a country that is also responding to outbreaks of polio, cholera, measles, and monkeypox and the health needs related to the ongoing humanitarian crisis in other provinces. This is putting a lot of pressure on the health system in general.
In Béni, one of the Ebola affected areas, we had to respond to a malaria outbreak at the same time as the Ebola response. This required additional teams working hand-and-hand with our Ebola response teams. The malaria Mass Drug Administration campaign reaching 300,000 people in Béni, and helped to alleviate pressure on the health system.
Ultimately, this outbreak has put into even sharper focus the weaknesses in the health system, and reinforced, once again, our ultimate message: stronger health systems are the only way to rapidly detect, respond and eventually end outbreaks.
By using proven public health measures and newer tools at hand, under the government’s leadership and working collaboratively across agencies, WHO is committed to addressing these challenges and ending the outbreak.