Ebola 'reality check' urged after deadly epidemic declared an ‘international emergency’

EBOLA response teams must expand the use of vaccinations in their fight against the epidemic in the Democratic Republic of Congo, the head of the medical charity Doctors Without Borders (MSF) said on Thursday. In an interview with AFP, MSF’s international president, Joanne Liu, also said DR Congo health officials needed a “reality check” in their response to the worsening outbreak. Her comments came a day after the WHO declared Ebola a “public health emergency of international concern,” after the killer virus threatened to spread to the major city of Goma and jump into neighbouring Rwanda.

Doctors fighting the outbreak have so far used a so-called ring-vaccination strategy, whereby they focus on protecting a small circle of people who have been in contact with Ebola patients. 

That is a “great, cost-effective way of doing things when you have real contact tracing of people, but we are not in that scenario,” Mrs Liu warned. “We are not able to follow up everybody.” 

Mrs Liu was referring to the constant struggle to trace contacts in the eastern provinces of North Kivu and Ituri, two Ebola hotspots marred by violence and with poor transport links. 

Instead of this targeted vaccination strategy, “we should have a geographic approach, meaning that if someone is infected coming from a village, we would not only vaccinate the contacts and the contacts of contacts, we would vaccinate the whole village,” she said. 

The latest Ebola figures released by the health ministry on Thursday said that some 1,698 people have died since the outbreak was declared last August. The current epidemic is the second-deadliest on record, after the 2013-2016 West African outbreak that killed 11,300 and infected scores more.

Ebola is highly contagious and spreads through close contact with the bodily fluids of an infected person. It causes hemorrhagic fever, severe vomiting, diarrhoea and bleeding and is often fatal.  

But despite a highly effective vaccine and swift response, efforts to end the DR Congo epidemic have been hampered by violent rebel groups and fierce community mistrust. 

The WHO also admitted on Wednesday a “shortage of supply” of the rVSV-ZEBOV vaccine despite “commendable efforts” by manufacturer Merck to double supplies by 2020. 

Mrs Liu, for her part, regretted the fact there had been “a lot of opacity” regarding available stocks of the vaccine, which is being used for the first time and has proven highly effective. 

“What is the supply the world has right now? We are told it is between 250,000 to 500,000 doses. So great, if we have that, but then where are they? When will they be available?” she asked. 

“We need much more transparency and clarity about the status of vaccine supply today.” 

The WHO has urged health teams to use a second, less tested vaccine by the healthcare firm Johnson & Johnson, saying it could be given to those facing a lower risk of infection. 

But DR Congo’s health ministry has refused to use the J&J vaccine, saying that introducing a new product amid a climate of deepening community mistrust would be problematic. 

Mrs Liu stressed she understood that introducing a new vaccine was “complex,” but that “we need to deploy everything we’ve got” until the disease is brought under control. 

Earlier this week the WHO said that hundreds of millions of dollars were needed immediately to prevent the outbreak from spiralling out of control. 

Authorities have struggled to contain the virus partly because health workers and Ebola clinics have been repeatedly and brutally attacked in eastern Congo, the epicentre of the outbreak.