If 30 people died from a virus within 10 days anywhere else in the world it would have been described as a public health emergency. Not when it is the Democratic Republic of Congo.
Since May 8, an estimated 26 people have died from Ebola out of 45 suspected to have the virus.
According to Doctors Without Borders (MSF), 514 people who may have been in contact with infected people are being monitored.
The latest incarnation of the virus started in a rural part of north-western DRC, before it moved to Mbandaka, a city of 1.2million people. Ebola is highly contagious and is spread through physical contact with infected bodily fluids.
The virus induces a haemorrhaging fever that can lead to fatal bleeding.
There is still no cure for the virus.
“It is concerning that we now have cases of Ebola in an urban centre, but we are much better placed to deal with this outbreak than we were in 2014,” Dr Tedros Adhanom Ghebreyesus, the WHO director-general, said on Monday.
Between 2014 and 2016 the virus spread through West Africa killing at least 11000 people in mainly Guinea, Liberia and Sierra Leone. A wry mix of arrogance, complacency and racism led to the Ebola crisis of 2014 with the disease running out of control.
When the first cases were reported in 2014, both West African nations and the WHO downplayed the virus, calling it “relatively small” and “sporadic”. It was only when two US health workers in Liberia had contracted the virus that it was deemed an international concern.
By the time the WHO declared a health emergency, at least 1700 people had been infected; 932 were dead. The virus had spread so far in some countries like Liberia that it was only in June 2016 that the WHO declared Ebola over in that country.
Incidentally, the DRC was also hit by incidents of Ebola in 2014. But given its longer history with the virus (811 people have died from Ebola since 1976 in eight previous outbreaks), the authorities’ ability to contain isolated and areas of lower population densities, the virus did not cause the damage it did in West Africa.
“This is the ninth Ebola outbreak in Congo in the last 40 years. So far, all of them have occurred in remote and isolated areas, as was the case last year in Likati, when the epidemic didn’t spread.” Henry Gray, MSF Emergency Co-ordinator in Mbandaka, said.
“With the new case confirmed in Mbandaka, the scenario has changed, and it has become most serious and worrying, since the disease is now affecting an urban area. It is paramount to trace the suspect case to have a clearer view on how it reached the city,” Gray added.
Early signs are that the WHO is acting faster and with more gusto. Ghebreyesus has already visited the country in a bid to ensure they are on top of the crisis.
The World Bank also announced the provision of $3million (nearly R38m) to support the DRC’s Ebola Virus Disease Response Plan.
This time there is also a vaccine. And the roll-out has begun. Tested in Guinea in 2015, and touted to be 100% effective, it is still only part of the solution.
The vaccine comes with its own set of challenges. First, it needs to be stored in temperatures between -60 and -80°C. This means vaccines need to be carried in special freezers with their own power source. Second, each patient needs to provide written consent as well; given the legitimate scepticism for parachute medication in rural or ignored parts of the continent or in this case, the DRC, this can be time-consuming and labour intensive.
Third, and possibly most importantly, is the logistics. Roads are poor, maps outdated or not accurate. With the way Ebola spreads, and the traditional fear of villagers towards authorities, getting to the affected communities and those who may have been in contact with them before it spreads, or before Ebola victims are buried, is crucial. Many of the deaths in West Africa were a result of unsafe burials during the 2014-16 outbreak.
That Ebola has now moved to Mbandaka, a bustling port city on the Congo River means that the virus could be on the move - anywhere between Kinshasa and Brazzaville. Then, it is a matter of expertise and international support.
Incidentally, the day the latest Ebola outbreak was announced the US government disbanded its global health security division, known for its important work in tackling 2014-16 Ebola epidemic. The US has also been warning of cuts to aid and global health security funding; the undervaluing of global health preparedness has come to define the Trump administration.
Given the challenges and all that we know about Ebola, we know the death toll will rise. Hopefully, it won’t reach the scale of the West African epidemic.
Still, 26 people have died within 10 days and the WHO has yet to call it a“public health event of international concern”.
I am sure there are guidelines and protocols and rationales (all of which failed in the past), but I’ve got to ask: How many people need to die in the DRC before it is a matter of international concern?
* Azad Essa is a journalist based in New York City. He is also author of Zuma’s Bastard (Two Dogs Books)
** The views expressed here are not necessarily those of Independent Media.