Some unexpectedly good news came out of the long-beleaguered DRC on July 2nd, when the WHO declared an end to the Ebola outbreak that had started just 42 days before. The announcement prompted a global sigh of relief, as the outbreak was the country’s first since the catastrophic West African epidemic that raged in five countries between 2014 and 2016, killing more than 11,000 people.
But it would take a special kind of innocence to assume that the Ebola virus has finally been tamed. In fact, any public health expert worth their salt would agree that the international community is years away from having a functioning emergency response system to deal with intra or inter-continental pandemics. Not to mention that the quickly deteriorating political situation in the DRC raises serious doubts about whether the country will have the capacity to contain the next outbreak.
All things considered, the DRC’s win over Ebola looks more like the exception than the rule. Indeed, the DRC contained last month’s outbreak largely because the virus struck in the remote region of Likati, 1,300 kilometers away from Kinshasa, and infected only a small sample of people. As such, local and national health authorities were able to enact an efficient and coordinated response: the second victim was immediately suspected of Ebola and the local health center rushed a sample to the national lab in Kinshasa. The workers there had the right expertise and connections and ran preliminary testing while also alerting international colleagues.
After the first case was confirmed, the government notified the World Health Organization, which activated their emergency response mechanisms. The successful escalation was also boosted by a new weapon in the WHO’s arsenal: a $41 million contingency fund that the health body set up following the lethargic response to the previous epidemic in West Africa. This fund helped the WHO and other groups rapidly rent helicopters for flying staff, generators, and other supplies into the affected zone.
Lastly, all of this happened in a country that has been battling Ebola for over 40 years and has seen off eight separate outbreaks so far. Which is why the international community should not rest on its laurels, but should instead take urgent action to bolster the readiness of other African countries susceptible to fall pray to the virus. Indeed, Guinea, Liberia and Sierra Leone are still years away from building the capacity to fend off the virus, despite the fact that these three countries accounted for over 90% of Ebola cases during the 2014 outbreak.
Then, the WHO’s foot dragging and political dysfunction in all three countries – two of which, Liberia and Sierra Leone, were still recovering from civil wars – led to the direct death of thousands. If it had not been for charities like Doctors Without Borders (MSF) and private companies, which shouldered the bulk of the initial emergency response, the outcome would have been much worse. MSF led the frontline response and was the first to spot the initial cases in March 2014. Their volunteers were forced to handle the lion’s share of medical treatment, quarantine, and educational efforts as the WHO ignored their calls for help. Meanwhile, the Russian mining company Rusal built and equipped a microbiological research and medical treatment center for patients with infectious diseases in Guinea, as part of a public-private partnership to boost the fight against Ebola and to strengthen the local healthcare system. The project spearheaded by Rusal, among the biggest investors in the country, helped result in a new vaccine that is being delivered to Guinea and will undergo trials later this summer.
It just goes to show that while the private and non-governmental sector quickly mobilized resources, they are no panacea for the international coordination that global health bodies are supposed to offer.
Which brings us to a crucial point: stability is key in the proper management of epidemics. It would be a mistake to ignore the way political and economic agendas shape the way public health science is understood and implemented. If the international community really understood this feedback relation, it would take steps to stabilize the brewing civil war in the DRC.
Indeed, last December, with 16 years in power under his belt, President Joseph Kabila decided to settle in after finishing his constitutionally mandated last term, sparking deadly protests in the capital. Even after signing a subsequent agreement to step down and hold elections before the end of 2017, he has made no sign that he’s ready to do so. Instead, he’s been leading a smear campaign against the main opposition candidate for the presidency, Moise Katumbi, whom he regards as his biggest threat. The former governor of the Katanga province, Katumbi has garnered nationwide support in a country so large and divided that many have openly wondered if it’s even governable.
Unfortunately, Katumbi has been living in exile in Europe since May 2016 and faces the prospect of imprisonment if he returns home, where he has been convicted on a number of trumped-up charges. Meanwhile, as the deadline for the government to call elections approaches, violence between security forces and militia members has been rising. A surge in violence in Kasai province, which comes on top of grinding conflict in the volatile Kivu regions, has caused the deaths of at least 3,300 people and the displacement of more than 1.3 million.
Several weeks ago, the US and EU imposed sanctions on eight government officials and a militia leader implicated in abuses. But they will need to go further, expanding sanctions and working with the DRC’s neighbors to press Kabila to hold credible elections. This wouldn’t just be in the interests of the Congolese people, but is a precondition of laying the foundations of a functioning global health system. The next outbreak is therefore not a question of “if” but “when” – and containing it will depend on preserving political stability in the country. Otherwise, the humanitarian disaster of 2014 will simply repeat itself.