With the death toll from the world’s worst measles outbreak in the Democratic Republic of the Congo (DRC) now exceeding 6000, the World Health Organization (WHO) appealed to donors on Tuesday for $US 40 million more in funding to stop the advance of the disease – which has killed nearly three times as many people as the Ebola outbreak raging for more than a year.

Meanwhile, Ebola, which had almost been squashed in late November, continued its resurgence, with some 29 cases reported over the last two weeks of December, according to the latest WHO disease news outbreak report. The surge in cases, which had dropped to less than ten a week, occurred in the wake of widespread civil unrest as well as targeted attacks on health workers by militias in the eastern DRC in late November and early December.

The violence interrupted community-based work to contain the epidemic in a few remaining hotspots, restricting the access of health workers to affected communities for the referral of Ebola patients to treatment centres, vaccination of contacts, and safe burials for Ebola victims.

As for measles, lack of funding remains a key barrier to curbing the outbreak, WHO said, calling on donors to step up to the bat with more contributions to measles vaccine efforts in the DRC.

Despite ramped up immunization campaigns in 2019, routine measles vaccination coverage remains low in some areas of the countries, due to weak health systems as well as the ongoing civil unrest. As evidence of that, some 25% of the reported measles cases are occurring in children over the age of five, who are the most vulnerable, said WHO.

Officials said that while $US27.6 million has been mobilized, another US$ 40 million is required for a six-month plan to extend the vaccination to children in the vulnerable age categories of six to 14 years. The plan would also reinforce elements of the outbreak response beyond vaccination, including improving treatment, health education, community engagement, health system strengthening, epidemiological surveillance and response coordination.

“We are doing our utmost to bring this epidemic under control. Yet to be truly successful we must ensure that no child faces the unnecessary risk of death from a disease that is easily preventable by a vaccine. We urge our donor partners to urgently step up their assistance,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.

In 2019, around 310 000 suspected measles cases were reported. In the same year, the DRC Ministry of Health together with WHO, Gavi, the Vaccine Alliance, The European Union’s Humanitarian Aid department and other aid agencies vaccinated more than 18 million children under 5 years of age across the country.  But that has not been enough.

“We recognize the Government’s engagement in the efforts to end the outbreak and we are grateful for the generosity of our donors. But we still need to do more,” said Dr Amédée Prosper Djiguimdé, Officer in charge of WHO’s DRC office. “Thousands of Congolese families need our help to lift the burden of this prolonged epidemic from their backs. We cannot achieve this without adequate finances.”

The measles outbreak in DRC is part of a broader worldwide epidemic – which has hit poor countries where weak health systems are unable to reach vulnerable populations with immunizations, as well as more affluent countries where pockets of “vaccine resistance” exist in some communities. For a country to be safe from measles, 95% of the population must be immune, WHO says. Yet global vaccination rates have remained stagnant for the last ten years – hovering at around 10% below the recommended threshold for the first dose and 25% below the recommended level for the second dose.

As for Ebola, the 29 latest confirmed cases were reported from eight health areas in four health zones: Mabalako (62%, n=18), Butembo (14%, n=4), Kalunguta (17%, n=5), and Katwa (7%, n=2). As of the end of 2019, a total of 3380 Ebola cases had been reported, WHO said.  This included some 3262 confirmed and 118 probable cases. Among these, 2232 people had died for an overall case fatality rate of 66%.

Image Credits: WHO/African Region, WHO/John Kisimir, WHO .