The Democratic Republic of Congo (DRC) requires “critical” support to fend off a growing Ebola outbreak in the western Province of Équateur, warned WHO’s Regional Director for Africa Matshidiso Moeti on Friday.

Her warnings came as Équateur’s Ebola cases have almost doubled to one hundred in the past five weeks, of which 96 are confirmed and four are suspected.

Only US$6 million of the $40 million required for the Ebola response has been pledged so far, as international donors remain distracted by the COVID crisis. The DRC government has committed $4 million, and WHO has pledged $2 million. 

“Without extra support the teams on the ground will find it harder to get ahead of the virus,” said Moeti. “COVID-19 is not the only emergency needing robust support. As we know from our recent history we ignore Ebola at our peril.”

Since the DRC’s eleventh outbreak was declared on 1 June 2020, it has spread to 11 of the province’s 17 health zones, and claimed the lives of forty-three people, said the WHO Regional Office for Africa in a press release.

Healthcare Worker Strike Complicates Efforts

In addition to the havoc triggered by COVID-19, a health worker strike in the area has limited the response.

“The situation has been further complicated by a strike by health workers, which is affecting activities, including vaccination and safe burials. DRC has the best trained workforce in the world of for Ebola – this situation needs to be resolved as soon as possible,” WHO Director-General Dr Tedros Adhanom Ghebreyesus told reporters on Friday. 

Healthcare workers in the Ebola response entered a three day strike last week, demanding the government pay and raise their salaries in light of the dangers of facing the virus. Healthcare workers have experienced a high risk of infection and death in previous Ebola outbreaks, including in the 2014-2016 West Africa outbreak.

However, part of the strike involved blocking off access to Ebola testing laboratories, according to Mory Keita, a WHO Ebola incident manager. A number of samples collected two days prior to the strike were unable to be processed.

“When health workers protest or strike, it should be done in a way that doesn’t affect the service they provide to those who need it most,” said Dr Tedros on Friday.

Significant Logistical Challenges Delay Identification Of New Cases

And responders are grappling with ‘significant logistical challenges’ to respond to the ongoing Ebola outbreak. Not only has Ebola spread across a whopping 300 km area both from east to west and from north to south, most affected communities also live in remote, densely forested areas that take ‘days’ to reach by river boat, increasing the time it takes to identify potential cases.

“There is currently a delay of about five days from the onset of symptoms to when an alert about a suspected case is raised. This is concerning, because the longer a patient goes without treatment, the lower their chances of survival, and the longer the virus can spread unseen in communities,” said Dr Tedros.

“The virus is spreading across a wide and rugged terrain which requires costly interventions and with COVID-19 draining resources and attention, it is hard to scale-up operations”, added Moeti. “With 100 Ebola cases in less than 100 days, the outbreak in Équateur Province is evolving in a concerning way.” 

Since the outbreak began, the DRC Government has led the ring vaccination of over 22,600 people at high risk of contracting the deadly virus. It has also screened about 640,000 across 40 points of control, in collaboration with 90 WHO experts on the ground and about 20 partner organizations.

Image Credits: WHO/Junior D. Kannah, WHO/Junior D. Kannah, WHO.