By P.J. Heller

Efforts to battle the second worst outbreak of Ebola in the Democratic Republic of the Congo were being hampered at year’s end by a deterioration in the security situation, leading the head of the World Health Organization to warn that recent gains in fighting the deadly virus could be lost.

“We have reached a critical point in the Ebola response,” said Dr. Tedros Adhanom Ghebreyesus, director-general at WHO. “After an intensification of field activities, we were seeing hopeful signs in many areas, including a recent decrease in cases in Beni.

“These gains could be lost if we suffer a period of prolonged insecurity, resulting in increased transmission. That would be a tragedy for the local population, who have already suffered too much,” he said.

Raphael Mbuyi, acting country director for Oxfam, sounded an even more ominous tone in describing the situation, where pre-election violence forced the nonprofit, as well as WHO teams, to suspend their work in the Ebola ravaged areas of Beni and Butembo in eastern DRC.

“This is an extremely worrying situation, as every time the Ebola response has been suspended before, we’ve seen a big spike in the number of new cases,” Mbuyi said. “This could mean Ebola spreading to even more people and potentially other countries in the region, putting many more lives at risk.”

WHO reported that since the latest Ebola outbreak was declared on Aug. 1, more than 350 people have died out of nearly 600 people infected. Some 20 percent of the cases were reported in the last month.

So far, more than 50,000 Congolese have been vaccinated with an experimental drug designed to protect them from the virus, according to
the Ministry of Health. Ebola is a deadly disease spread through direct
contact with body fluids of people infected with it. It is also spread by
touching things that have been contaminated with these fluids. It first
appeared in 1976 near the Ebola River in what is now the DRC.

Officials worry that recent national elections, that took place on Dec. 30, will result in more people being infected due to traveling to polling places and coming into contact with others. There was also concern about people who had traveled during the holidays, not only within DRC but to Uganda, Rwanda and South Sudan, which border Congo areas with Ebola outbreaks.

“As the risk of national and regional spread is very high, it is important for neighboring provinces and countries to enhance surveillance and preparedness activities.” WHO said. “The International Health Regulations Emergency Committee has advised that failing to intensify these preparedness and surveillance activities would lead to worsening conditions and further spread.”

The DRC elections, which have been delayed for years, have prompted dozens of local militia groups to step up their attacks, forcing health workers to suspend their work tracking cases and isolating people with Ebola. Protestors allegedly broke into an isolation center for Ebola patients in Beni, prompting two dozen of them to flee; 17 had already tested negative for Ebola and seven others had yet to be tested.

The pre-election violence prompted Ebola experts from the Centers for Disease Control and Prevention to be pulled out of the outbreak zones in northeastern Congo. They initially went to Kinshasa, the capital, about 1,000 miles away. Staff with the U.S. Agency for International Development were also there.

On Dec. 14, the U.S. State Department ordered all non-emergency personnel and their families to leave the DRC, ahead of the elections, which had been scheduled for Dec. 23 but were pushed back one week due to the ongoing violence and a reported delay in deploying voting materials.

“The U.S. Embassy’s ability to provide emergency services to U.S. citizens in the DRC is severely limited, particularly outside of Kinshasa,” the State Department said. “Elections are scheduled to take place on Dec. 23 and could trigger large-scale demonstrations which could further limit the services of consular staff even in Kinshasa.”

Health officials, meantime, are hoping to resume their battle against the disease in the new year. There have, however, been varying statements about the road ahead.

Robert Redfield, director of the Centers for Disease Control and Prevention, suggested in November that public health experts needed to consider the possibility that the Ebola outbreak in DRC could not be brought under control and instead would become entrenched.

WHO’s Ghebreyesus said that the priority was to end the outbreak. “We hope to return to full operations as soon as possible while remaining committed to ensuring the safety of all staff deployed. We cannot afford to take a step back at this critical point in the response,” he said.

He said teams in Beni and Butembo were doing everything possible to continue responding despite the challenging security environment.