Health authorities in the Democratic Republic of Congo (DRC) and the Africa Centres for Disease Control and Prevention (Africa CDC) have bitterly complained over their inability to track down new cases of Ebola, which has spread into the Republic of Uganda. An estimated 1,635 Ebola cases have been confirmed, and 127 people have died from the dangerous infectious disease in the DRC.
The Ebola outbreak is increasingly impacting on the social interaction and people-to-people movements, as skepticism toward the disease appears to accelerate among the population, cross-border movements are being controlled daily. Alarm was sounded last week as the virus moved into new areas of the DRC. In some instances, patients routinely escape, and limited contact tracing undermines containment efforts. Contact tracing coverage has plummeted to 56.5 percent, a sharp decline from the 95% target, Health Ministry officials said.
“We remain committed to supporting affected countries until transmission is stopped. We call on partners and donors to urgently mobilize resources to strengthen the response and save lives,” Jean Kaseya, director general of the Africa Centres for Disease Control and Prevention, said on Sunday.
Shortage of Medical Kits
The World Health Organization (WHO) reported that the three major laboratories, in South and North Kivu, have run out of Ebola testing kits, as infections continue to rise daily. Teams are working through a large backlog of samples from suspected Ebola patients, many of which were collected several weeks ago, to confirm or rule out the presence of the deadly virus.
In a situation report released earlier this week, the global health agency said the labs in major cities, including Bukavu and Goma, were awaiting the arrival of reagents—substances required to run the tests—to resume work on the backlog of samples.
“Running out of Ebola testing reagents during an active outbreak is a serious setback,” Dr. Krutika Kuppalli, associate professor in the division of infectious diseases at the University of Texas Southwestern and former WHO officer, told The Telegraph.
“Diagnostics are the foundation of outbreak control; if cases cannot be rapidly confirmed, this may lead to delays in isolation, treatment, and contact tracing, which can allow transmission to continue unchecked,” said Dr. Kuppalli.
The Race for Vaccines
Vaccine candidates are racing to fill the gap. The Coalition for Epidemic Preparedness Innovations (CEPI)—a multinational nonprofit organization that finances vaccine development for emerging infectious diseases—has so far prioritized several vaccine candidates for development.
Two are Ervebo-like prototypes aimed at recognizing Bundibugyo’s specific blend of glycoproteins, a platform that showed experimental potential years ago. In 2013, an early version of the vaccine protected 100 percent of monkeys infected with Bundibugyo. However, because most Ebola outbreaks didn’t involve this species, the vaccine didn’t get the investment needed to become licensed. That’s an outcome CEPI aims to remedy with its latest investment.
The International AIDS Vaccine Initiative and Public Health Vaccines are developing the vaccines which, like Ervebo, also rely on the vesicular stomatitis virus. The World Health Organization (WHO) called this technology the most promising of the candidates.
VSV-based vaccines are front-runners because the weakened version of the virus used to produce them is so good at replicating itself inside humans—including the small chunk of whatever germ it’s been hybridized with—without causing harm. As a result, a single dose typically leads to a strong immune response.
Another candidate, called ChAdOx1, operates using a similar concept: a virus shows the immune system part of a pathogen to generate a protective response. However, it uses an adenovirus that causes colds in chimpanzees—and is also harmless to humans—that University of Oxford scientists modified to keep it from replicating.
There’s also a vaccine candidate based on Moderna’s mRNA science, which was also used to produce the company’s COVID-19 vaccines. This vaccine employs tiny fat bubbles to deliver genetic instructions to cells on how to produce a small part of the Bundibugyo virus. The immune system generates a protective response, and the mRNA degrades quickly without causing lasting changes to cells’ genetic codes.
U.S.-Backed Kenya’s Quarantine Centre
Health Cabinet Secretary Aden Duale has, consistently, defended the establishment of U.S.-backed health centres in Kenya. The U.S. says it will quarantine citizens exposed to the virus but not showing symptoms in a facility it is building in Kenya and will not bring them home if they develop symptoms, instead sending them to a third country.
The CDC imposed temporary travel bans last month on people who have been in the DRC, Uganda, or South Sudan, including green card holders, who are typically exempt from such bans. It is also screening Americans traveling from those countries at three U.S. airports. The strategy marks a sharp break from past practice as President Donald Trump’s administration seeks to keep all cases out of U.S. territory.
There are 13 U.S. treatment centers in a government-funded hospital network for severe infectious diseases ready to handle Ebola patients. Public health experts have, however, called on the government to bring any sick Americans home for treatment, and local protests at the Kenya site have led to at least two deaths. A Kenyan court has ordered a halt to the construction.
WHO Appeals for International Community Support
In a rapid and comprehensive response to the World Health Organization’s appeal to marshal resources for support of Ebola prevention, the United States has provided an additional $38 million. The additional funds brought the total amount committed by the U.S. to more than $200 million in direct funding, the State Department said in an official statement.
CDC model scenarios show that without strong public health interventions, the outbreak of the Bundibugyo strain of Ebola in the DRC could become as large as, or even larger than, the 2014-2016 West Africa outbreak, the agency said.
In modeled scenarios where the isolation of patients is limited, the outbreak could become one of the largest ever documented, said Jason Asher, director of the CDC’s Center for Forecasting and Outbreak Analytics.
From Addis Ababa, the Africa Centres for Disease Control and Prevention (Africa CDC) also said it had received a renewed commitment of €11.5 million from the European Union Commission (EU) to support a stronger preparedness and coordinated response to the Ebola outbreak. Dr. Jean Kaseya, Director General, Africa CDC, described the partnership with the European Union as respectful and without any conditionality, a type of partnership the continent needs.
The package is aimed at reinforcing the EU Commission’s support through the Africa CDC’s emergency response to the Ebola crisis within the long-standing and comprehensive AU-EU health partnership. This demonstrates the central role of the Africa CDC in coordinating the continental response to health emergencies, as well as the EU’s action as the world’s largest humanitarian contributor.
This includes €6.5 million to strengthen the Africa Pathogen Genomics Initiative to help equip frontline teams, train healthcare workers, and improve surveillance through diagnostics and an in-kind contribution of €5 million worth of testing equipment, including rapid diagnostic devices and lab test kits, to be deployed quickly where they are needed most. The EU’s partnership with Africa CDC spanning technical expertise, capacity-building, and policy dialogue continues to play a key role in building resilient health systems.
Ebola epidemic at G7 summit
Amid the horror of the Ebola epidemic, world leaders gathered at the G7 summit in France were urged to find the “political will” to push through the final part of the Pandemic Agreement on Monday. In a joint letter, Brazil’s President Luiz Lula da Silva and World Health Organization (WHO) chief Dr. Tedros Adhanom Ghebreyesus urged leaders gathered on the shores of Lake Geneva to get the “benefits sharing” annex of the deal signed with a “sense of urgency.”
The Pandemic Agreement, which seeks to ensure the world is better prepared for the next global outbreak, was agreed upon last year, but a vital element of it was deferred because of arguments over its wording. It is unclear, and perhaps unlikely, that a truly global agreement on benefits sharing can be reached.
Nevertheless, an agreement between the remaining 192 member states of the WHO is possible and would represent a major step forward. “Every month this annex stays unfinished is a month the world is less ready than it could be, and people are less safe than they deserve to be,” say Mr. Lula da Silva and Dr. Tedros. “Finalizing this agreement, through a shared commitment to one another, is our collective promise to protect humanity.”
The epidemic, caused by the rare Bundibugyo strain of the virus, for which there is no approved vaccine or specific treatment, was declared on May 15. It has since spread across Ituri, North Kivu, and South Kivu, regions marked by insecurity, displacement, and cross-border movement.
The Democratic Republic of the Congo (DRC), also known as the DR Congo, is situated in the central African region. With a population of around 124 million people, it shares borders with the Republic of Congo and Angola to the south Atlantic Ocean and the Central African Republic and South Sudan to the north, and also with Uganda, Rwanda, Burundi, and Tanzania (across Lake Tanganyika) to the east and Zambia and Angola to the south.
