The government is to send new funding and expert personnel to the Democratic Republic of Congo (DRC) amid fears the rapidly escalating Ebola crisis there is spiralling out of control and could spread into neighbouring countries.
The International Development Secretary Rory Stewart will tell the Commons on Monday that the crisis in DRC is at a “tipping point” and call on others to follow Britain’s lead and pledge further expertise and support.
“I am deeply concerned by the ongoing Ebola outbreak which is spiralling dangerously out of control,” Mr Stewart is expected to tell MPs.
“It's clear to me that urgent action is needed to stop this deadly disease from spreading any further – with the consequent inevitable loss of thousands more lives.
“I believe we are at a critical tipping point, and that we need to respond with the kind of urgency and ambition which reflects that.
“Today I am announcing new funding to help tackle the crisis. I can also confirm I will be putting more UK experts into crucial roles in the response. I am also calling on allies to follow the UK’s example.”
The warning comes amid growing concern from health experts that, if not contained, the highly contagious hemorrhagic fever could spread internationally.
Despite the success of a widespread vaccination campaign, violence and mistrust threaten a perfect storm and case numbers are rising fast.
Just two weeks ago the grim milestone of 1,000 deaths was surpassed, while roughly 20 per cent of the 1,739 cases reported since the outbreak began in August were recorded in the last 21 days.
Ebola response teams have also been attacked and killed in the last few months and clinics burned. Between January and the end of April there were 119 deliberate attacks on the Ebola response – health workers were wounded or killed in of these 85 incidents.
“The challenge in the DRC is that there is widespread deep-seated distrust of outsiders, with people led to believe that Ebola is not real – or, worse, that it is sent deliberately to undermine their communities,” said Mr Stewart.
“This is therefore much more than a public health emergency. With armed groups operating in the worst hit areas, aid workers are having to risk their own lives just to treat Ebola patients and vaccinate those at risk of the disease.”
On Friday last week, the International Federation of the Red Cross (IFRC) warned it may have to “dramatically” scale back operations in DRC because of underfunding.
The organisation has led work to safely bury victims of the virus - a cornerstone of the fight to stop Ebola spreading – but said it only had enough money to continue operations for another fortnight.
Speaking at a press conference in Geneva – where he was accompanied by a volunteer in an Ebola protection suit – Emanuele Capobianco, director of health and care at IFRC, said the world needs to urgently step up the response.
“Ebola is a disease of death,” he said. “The response faces a double jeopardy right now, there is a problem with security and a problem of critical underfunding... The financial situation for many of the humanitarian organisations is quite dire.”
“Having safe and dignified burials performed by people in suits such as this one are absolutely critical to contain the outbreak and avoid the spreading of the disease,” Dr Capobianco added. “This is an activity that is extremely risky, extremely complex and also expensive.”
During the West Africa epidemic in 2014-2016, funerals were a major source of Ebola transmission – causing almost 80 per cent of infections in Sierra Leone. A study later found that as many as 10,500 cases were prevented by efforts to safely bury the highly contagious bodies of Ebola victims.
But a single safe burial costs roughly $500. The IFRC said this covers protective gear for a 12-person team as well as body bags and coffins. Since August the organisation has conducted more than 5,000 burials of confirmed and suspected Ebola victims.
Dr Capobianco said that the crisis was reaching a “tipping point” and additional funds were urgently required. “The containment of the epidemic depends on [safe burials],” he said.
The stark warning follows a series of tense statements from leading figures, including Rory Stewart and David Miliband, calling for the Ebola strategy to be “reset.”
Violence, in particular, is a huge concern. Every time there is a security incident, essential response activities are suspended for an indefinite period, giving time and space for the virus to further spread.
North Kivu and Ituri, the regions at the epicentre of the outbreak, have been at the centre of conflict for more than two decades and over 100 armed groups are in operation in the area.
But protecting response teams is a balancing act – increasing armed protection can further alienate an already suspicious community.
“The view among our own staff is that there is a lack of trust in the local community and that’s fuelling the insecurity that exists,” David Miliband, now president of US NGO International Rescue Committee, told The Telegraph last week.
“We don’t have armed guards in our facilities because our experience is that’s not the way to engender the support or acceptance or trust of the community.”
A quarter of people in the region believe the Ebola virus does not actually exist and a third think it was fabricated for financial gain. While efforts to build trust have been ramped up in recent weeks, critics say mistrust has been fuelled by a sudden influx of money and resources to an area which was largely ignored for decades.
Others have said that the World Health Organization is not equipped to deal with security challenges and community resistance.
“That’s not their mandate, and they’re never going to have that capacity,” Ron Klain, a former US Ebola response coordinator, told a pandemic and biosecurity forum last Tuesday.
As the risk that the outbreak will cross international borders remains significant, Ebola will be high on the agenda at the World Health Assembly in Geneva this week.
“It will not possible to end this outbreak if there is no trust built between the response and the affected people,” Trish Newport, representative for Médecins Sans Frontières' Ebola response in DRC, told The Telegraph.
“We have to listen to the needs of communities, give them choices when it comes to managing their health, and involve them in every aspect of the Ebola response,” she added.
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