Why the Ebola outbreak in DRC has spun out of control

Saturday, December 1, 2018
By Paul Martin

The WHO’s top emergency responder explains why the outbreak is now the second largest in history.

By Julia Belluz
Dec 1, 2018

GENEVA — An Ebola epidemic that experts are calling “exceptionally dangerous” is unfolding in the Democratic Republic of Congo.

So far, there have been more than 420 cases and 240 deaths, which makes it the largest outbreak of Ebola since the 2014-2016 West Africa outbreak, which killed 11,000. It’s also the second-largest Ebola outbreak on record.

Humans have tangled with the Ebola virus for centuries with deadly results. But until five months ago, Ebola had never emerged in an active war zone.

On August 1, the World Health Organization declared an Ebola outbreak in the Democratic Republic of the Congo. The virus had started spreading in cities in North Kivu, an unstable province in the Central African country, where fighting among multiple rebel and militia groups has repeatedly interrupted the painstaking work of health workers who came to respond to the outbreak.

Even though Ebola responders have never had so many tools at their disposal to fight the virus — experimental vaccines and treatments that have shown promise — the incidence of the disease has more than doubled since September. Even worse, many of the newly diagnosed cases cannot be linked to other known cases. That means there are still people spreading the disease whom health officials have not yet identified.

Due to the ongoing conflict in the region, the US government has decided it’s too dangerous to allow its top Ebola experts to work at the outbreak’s epicenter. The US has maintained this stance despite outcry from public health officials who say the US isn’t doing enough to help.

To unpack how the outbreak got so bad, and what the WHO needs right now, I sat down with Peter Salama, the head of the new Health Emergencies Program at the WHO. His team was created in 2016 as a direct response to the WHO’s fumbling of the West Africa Ebola outbreak. This year alone, he’s helped the organization respond to 50 health emergencies in 47 countries.

But the Ebola outbreak in DRC is something different, Salama said. Sitting in his office in Geneva, in front of a map of DRC — which he keeps in front of him “to remind me I need to keep focused on this on a minute basis” — he walked me through the extraordinary complexity of trying to quash an Ebola outbreak in a war zone and why the WHO could use the world’s best Ebola minds right now. Our conversation has been edited for length and clarity.

The Ebola response could use US experts

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