The Ebola outbreak that emerged in August 2018 in the Democratic Republic of the Congo (DRC) has been causing growing concern among the international community. Contamination has been expanding rapidly in the country and the virus even crossed the Congolese border with the confirmation of new deaths in Uganda earlier this month. This alarming situation is questioning the response of international organisations and calling for new emergency approaches.
Although many international health actors have taken action to restrain transmission, multiple factors have been affecting their efforts. Political instability and violence in DRC pose a major threat as they considerably jeopardize the security of health workers and narrow the space in which they can operate. Moreover, the strong distrust and suspicion that is associated with global health organisations and foreign treatments generates fear among the Congolese population.
The first Ebola Outbreak in West Africa in 2014 involved many challenges and highlighted the need for new approaches in outbreak responses. On 13 May 2019, the London School of Hygiene & Tropical Medicine and the Global Health Centre organised a panel discussion to explore how former responses to the Ebola West African outbreak can be relevant for the current crisis in DRC. Based on a three-year study, the invited experts presented various pathways that could better support the work of international responders in fragile environments.
Susannah Mayhew, professor at LSHTM and principal investigator of the Ebola Gbalo Research Project, illustrated various lessons learnt from the Sierra Leone crisis and detailed how they could help health agencies to rethink their response in DRC. She explained that simple actions such as bringing healing centres closer to communities have the potential to reduce suspicion. Esther Mokuwa, researcher at Njala University, insisted on the role of families, culture and local knowledge and how they should be included in the response to limit disease dissemination. According to the findings of the study conducted by the Ebola Gbalo Research Group, community trust can be facilitated if international workers engage with multiple country leaders. It is therefore crucial for health actors to collaborate with traditional authorities, community healers, local and religious leaders and other figures of influence. These groups play an important role as they legitimate the work of Ebola responders and reassure the population.
Emanuele Capobianco, Director of Health and Care at International Federation of Red Cross and Red Crescent Societies, called for stronger alliances with local healers and partners. He also urged agencies to integrate their Ebola response to larger global health responses rather than isolating it.
The security of the staff represents another urgent challenge which prevents WHO and other NGO partners to stop the spread of Ebola. Michael Ryan, Executive Director of the Health Emergencies Programme at WHO, addressed the complex political context in DRC. He explained that interventions could not be carried out safely as health workers have been repeatedly aggressed by armed groups. He also stressed the financial gaps related to emergency situations: "NGOs have lost capacities as donors do not pay for preparedness to emergencies. We need long-term donor commitment and a systemic investment to be able to prepare for upcoming crises".
The discussion held at the Maison de la Paix demonstrated that many lessons from the 2014 Ebola outbreak can be used to improve the DRC response. The issues that international actors are currently facing can be partly addresses by establishing a closer cooperation with local partners and strengthening collaboration with governments in order to secure safe bases for health workers.