“It wasn’t easy,” said Matshidiso Moeti, the World Health Organization’s Africa director. “At times, it felt like mission impossible.”
Ebola is a hemorrhagic fever endemic in animal populations that reside in Africa’s tropical forests and is passed from person to person through contact with bodily fluids. Congo has had 11 outbreaks since the virus was first identified in humans in 1976. A new outbreak began on June 1 in the country’s northwest and has resulted in 15 deaths as of Thursday. The worst outbreak of the virus swept through Guinea, Sierra Leone and Liberia between 2014 and 2016, killing more than 11,000.
North Kivu and Ituri proved to be an exceptionally challenging theater for the contact tracing and community outreach required during an Ebola outbreak. Armed groups have killed hundreds of locals in numerous regional conflicts since the outbreak began, and health workers often came under fire while doing their work.
Front-line nurses were routinely evacuated from particularly volatile areas, leaving the response on pause and the virus more free to spread. One deadly stretch late last November saw four people involved in the response killed in attacks by unknown assailants. Overall 11 were killed and 86 injured, according to the WHO.
The broader humanitarian situation has worsened as well. The number of people in need of aid in the two Ebola-affected provinces has grown more than 250 percent since the start of the outbreak, from 1.2 to 4.3 million people, according to the International Rescue Committee, which has worked closely with the Ebola response. Eastern Congo has not seen a large number of coronavirus cases, but Congo at large has not escaped the new pandemic.
“Initial research indicates that covid-19, which continues to spread with nearly 6,000 cases [across the country], could compound these devastating consequences for the most vulnerable populations,” said Borry Jatta, the organization’s Ebola response director.
Eteni Longondo, Congo’s health minister, said in a news conference on Thursday that tackling the coronavirus would require “the same strategy in the struggle, the same methodology in the struggle” against Ebola.
Despite the hurdles, a well-financed global response was able to make use of several experimental vaccines and treatments, which were credited with helping slow the virus’s spread while a cure remains elusive. Different strains of the virus exist, and different outbreaks have had mortality rates ranging from 25 to 90 percent.
More than 300,000 people were vaccinated with Ervebo, a vaccine made by the American pharmaceutical giant Merck, which became the world’s first fully licensed Ebola vaccine late last year.
A second vaccine, made by Johnson & Johnson, also an American company, was used as part of a clinical trial. Another clinical trial tested four experimental treatments, and two were found to improve survival.
While the response succeeded in containing the virus to two Congolese provinces, it was regularly criticized by locals for being involved in the region’s rampant corruption as well as paying unpopular security forces for protection, evidence of which was uncovered by journalists. The WHO, which led the response, has refused to comment on how much money it paid to the United Nations’ peacekeeping force, Congolese army, or other local armed groups.
Aid workers involved with the response regularly voiced frustration at the reliance on security forces and corrupt local business executives who they and locals say had vested interests in prolonging the outbreak for financial gain, and who sometimes used their positions of power to commit violent crimes.
“For the humanitarian and public health sectors this is not a moment of victory but of reflection,” said a senior response official who spent most of the outbreak in the worst-affected areas and asked to remain anonymous to speak freely about allegations aired by locals. “There are very serious allegations of systemic corruption, fraud and sexual exploitation and abuse. We owe it to the people of Congo and taxpayers that funded this response to have these charges investigated and for those responsible to be held to account for their actions. We must learn the lessons of this response and do better next time.”