Congolese health workers clean their clothes at a health centre in Goma, Democratic Republic of Congo, on July 18 2019. Picture: REUTERS/DJAFFER SABITI
Congolese health workers clean their clothes at a health centre in Goma, Democratic Republic of Congo, on July 18 2019. Picture: REUTERS/DJAFFER SABITI

Melbourne — The Ebola emergency in the Democratic Republic of Congo (DRC) will require about three times more money than currently provided, the UN agency leading the public-health response says.

The World Health Organisation (WHO) estimates $324m is needed to fund its response and preparedness in the Africa region over the next six months. Additional funds will be required to support other functions outside the WHO’s remit to help stop transmission of the deadly hemorrhagic virus, the Geneva-based agency said on Tuesday.

The money sought is on top of the $114m contributed since August and will largely support the massive expansion of dozens of teams administering protective vaccines to vulnerable Congolese communities, undertaking disease surveillance and reporting, and bolstering capacity at treatment centers, said WHO spokeswoman Margaret Harris.

“This may seem like a lot of money to invest in this, but it’s going to cost the world a lot more if we don’t get this under control,” said Michael Osterholm, director of the Centre for Infectious Disease Research and Policy at the University of Minnesota.

“We have a gas-can with an Ebola match hitting it. If this gets into large metropolitan areas, it’s going to be like a gas-tanker with an Ebola match hitting it,” said Osterholm, who finished a yearlong term in May as a science envoy for health security on behalf of the US state department.

$53bn legacy

The economic and social burden of a 2014-16 outbreak in three west African countries that sickened more than 28,600 people, killing some 11,325, cost an estimated $53.2bn, a study in October found. In the current outbreak, 2,498 people are confirmed to have been infected with Ebola, causing 1,737 deaths, since it began in Congo, Sub-Saharan Africa’s biggest country, in May 2018.

Cases doubled from April to June 2019, according to humanitarian group Medecins Sans Frontieres, with about 75 to 100 infections occurring weekly.

The WHO has 650 to 700 people working during daylight hours in the conflict-riven region, where armoured vehicles, armed police escorts, bullet-proof vests, and helmets have been needed to protect the security and personal safety of staff, Harris said, ratcheting up the cost and complexity of the Ebola response.

At least 25 vaccination teams comprising about 14 people each have been critical to curbing the virus’s spread, with about 93% of those offered the shot willing to be immunized, Harris said from Goma, the eastern Congolese city where an infected priest travelled in mid-July before dying en route to a clinic for treatment.

“Without the vaccine, I think we would have seen numbers worse than west Africa,” she said.

Costs of the Ebola response have also been heightened by the need to deploy anthropologists, communications specialists and psycho-social workers to engage closely with communities to win trust in the health services being offered, Harris said.

Non-believers

“The biggest challenge is a community that either doesn’t believe or doesn’t wish to believe that Ebola is a real and present threat,” she said. “It’s a community that has so many other threats that are seen as more serious.”

Rampant poverty and insecurity, particularly in the eastern regions where Ebola is spreading, have contributed to Congo ranking 176th out of 189 countries and territories on the UN’s human development index, a measure of a population’s prospects for a long and healthy life, access to knowledge, and a decent standard of living.

Harris, who trained as a medical doctor, worked on the response during the West African outbreak mostly in Sierra Leone, where she did not observe the same levels of violence, mistrust in the health system or erroneous belief that Ebola is “a narrative by authorities for the advantage of authorities”, she said.

“It’s considerably more challenging here. In West Africa, one of the issues was a weak health system. Here we have a broken health system and a health system that people don’t trust.”

The WHO’s fourth strategic response plan for the Ebola outbreak is slated to be released by the end of July. The biggest individual donors to the previous three plans were the UK’s department for international development, the World Bank, vaccine alliance Gavi, and the World Bank’s pandemic emergency financing facility, according to the WHO.

“Money is necessary, but it’s not sufficient,” the University of Minnesota’s Osterholm said. “We have to also figure out socially, economically and culturally how we’re going to deal with this in that security situation.”

Bloomberg