The whereabouts of almost 300 people who tested positive for the Ebola virus in the Democratic Republic of Congo (DRC) are currently unknown, according to information from the main public health authority on the African continent. The situation represents a gigantic challenge for efforts to contain the disease in the region.
The crisis is worsened by a scenario of conflict and humanitarian instability. More than 1 million individuals are living in camps, areas that are often inaccessible to health professionals, making it difficult to track and treat cases, said Dr. Jean Kaseya, director general of the Africa Centers for Disease Control and Prevention (Africa CDC) last week.
Context of the humanitarian crisis prevents tracking of infected people
Political instability and armed conflicts in the Democratic Republic of the Congo have a direct and devastating impact on the health response. The areas where camps for internally displaced people are located are insurmountable barriers for medical teams, preventing contact tracing and full understanding of the dynamics of the outbreak.
The lack of access not only hides the real number of infected people, but also increases the risk of uncontrolled spread of the virus. The difficulty of reaching these vulnerable communities means that authorities are fighting the epidemic “blindly”, without the necessary visibility to protect the populations and stop the spread of the disease.
Alarming WHO projections and risk of regional expansion
Projections from the World Health Organization (WHO) regional office for Africa, published in the journal The Lancet Infectious Diseases, indicate a worrying scenario. Models predict about 8,210 cases and 1,420 deaths by mid-September if current conditions persist.
Even more alarming is the estimate that the outbreak has a 70% probability of spreading to neighboring South Sudan in the coming weeks, adding a regional dimension to the health crisis. To date, 1,118 cases and 291 deaths have been confirmed in the DRC, in addition to 20 cases and two deaths in the neighboring country, Uganda, demonstrating the movement of the virus.
Current outbreak surpasses initial phase of the 2014-2016 epidemic
This outbreak, caused by the Bundibugyo strain of the virus, is the largest ever recorded in the first five weeks since its declaration, even surpassing the initial rate of the devastating epidemic in West Africa between 2014 and 2016. In that period, after five weeks, 239 cases and 160 deaths were recorded.
The data comparison highlights the severity and speed with which the disease is spreading in the current scenario. With 1,118 cases and 291 deaths in just five weeks, the DRC is facing a worrying acceleration, highlighting the urgency of a more robust and coordinated response.
Intense community transmission and hospital capacity at risk
Africa CDC Director Dr. Jean Kaseya warned that 30% of new cases are identified among known contacts of individuals confirmed with Ebola. This data highlights “huge community transmission”, indicating that the virus is circulating widely in communities.
Disease treatment centers operate with 95% bed occupancy, a warning sign that the peak of the epidemic has not yet been reached. Congolese authorities announced that anyone who has transited through the affected provinces must wait 21 days before resuming their travels, a measure to try to control the movement of the virus.
Financial challenges compromise containment and humanitarian response
The response to the Ebola outbreak in Congo faces a severe shortage of financial resources. To combat the epidemic, the Africa CDC and WHO estimated the need for US$518 million in health spending. However, when considering additional humanitarian needs, the total amount for an effective response jumps to US$1.4 billion, a figure that is far from being achieved.
To date, only 13% of the US$910 million that has been pledged by governments and international organizations to address the crisis has actually been made available. This funding gap is one of the main obstacles to expanding access to conflict areas, tracking the missing, and implementing large-scale containment measures. Lack of funds prevents the hiring of more than 20,000 community health workers, who would be crucial to bolstering contact tracing and education about the disease.
Amid these challenges, hope lies in scientific advances. The first clinical trial of drugs to treat the Bundibugyo virus is expected to begin in the DRC next week, followed a week later by a clinical trial of an antiviral aimed at preventing exposed people from developing the disease. These tests are vital to offering new tools to combat the epidemic.