By: Zachary Weiss
Ebola is in the news again. And this time, things are different. Very different. The Central African nation of the Democratic Republic of the Congo (DRC) is at the epicentre of what is now the second-largest Ebola epidemic in history. Though still a far-cry from the 11,000 deaths during the West African Ebola outbreak from 2014-2016, this current epidemic has already resulted in over 420 cases and 240 deaths. To make matters worse, numerous setbacks have caused officials to admit they are struggling to maintain control of the situation, and projections estimate the current epidemic could persist well into 2019.
So, what are we doing about this most recent outbreak? Not enough. What can we do to stop something like this from ever happening again? A whole lot. And lastly, why should you care? Because millions of lives are at stake.
Let’s get to it.
Step 1: Stabilize the DRC and surrounding area.
The DRC is at war. Since 2014, fighting has been ongoing between rebel and militia groups in the cities of North Kivu, a province of the DRC along the border of Uganda, Rwanda, and South Sudan. This area is no stranger to traumatic events, with war, outbreaks, and atrocities dating back to the Rwandan genocide of 1994. This history, along with over 4 million displaced persons, has created a perfect storm for Ebola to exploit.
With the rebel groups now targeting civilians, abducting children, and targeting aid workers, the situation is growing more grave by the day. This conflict has significantly impaired the WHO’s and other agencies’ ability to operate in the area and respond to the outbreak, even leading the WHO to temporality halt its response in Beni, the city at the centre of the current outbreak. Security concerns have even prompted the Trump administration to withdraw all CDC officials from the affected area, leading to further deficits in the ability to respond effectively to the growing crisis.
Though this may be the first time Ebola has entered a war zone, outbreaks in highly unstable regions are nothing new. If we are ever to stop this outbreak and prevent future outbreaks from occurring, stability is key. I’m not going to pretend I know how to solve this issue, but I can certainly offer some suggestions. To stabilize the area, tens of thousands of more UN Peacekeepers in addition . More aid will need to start flowing in. Roads to move that aid will need to be built. International observers and election specialists will need to supervise will be needed The DRC’s immense wealth of natural resources will need to be mobilized for the DRC, and not the West. Land will need to be redistributed to its rightful owners. Hundreds of millions of dollars will be required. And this is just step 1.
Step 2: Build trust with communities.
One of the biggest challenges to fighting Ebola (or any other disease, for that matter), is building trust in the communities affected. In the DRC, many civilians still refuse to believe in the existence of Ebola, and see the global response as nothing more than attempt to test new medications on Africans. Even among local healthcare workers, knowledge about Ebola remains abysmal. And all of this is understandable; in a region that has been under constant threat of attack by armed groups for over 20 years, distrust is rampant.
So how do we change this narrative? By asking a lot of questions. Learning from its huge missteps during the last Ebola outbreak, the WHO has recruited sociologists and anthropologists in the DRC to help the agency better understand the region. By further elucidating the root of the conflict in the region, the importance of local burial practices, and the local perceptions of the global response, the agency hopes to break down barriers and build trust with people of the DRC. It’s not enough. But it sure is a great start.
Step 3: Stop climate change.
PSA: The climate is changing, and fast. Now, without debating the undeniable, irrefutable, and truly terrifying reality of climate change, I’m sure you’re wondering—how does climate change have anything to do with Ebola?
The most well understood link between climate and disease can be seen through the spread of disease vectors like mosquitos and ticks. As I wrote about in my last piece, warming temperatures have resulted in an expanded range and an increased development rate of ticks, resulting in a huge rise in the incidence of Lyme disease over the last decade. In the case of Ebola, however, another interaction between climate and disease is taking place. In the DRC and surrounding nations, humans and animals are increasingly forced to compete for dwindling resources. As humans and animals, particularly primates and bats—the main animal vectors for Ebola—get closer together, the chance of Ebola spreading to humans dramatically increases. This can be stopped, however, through the painless act of reducing carbon emissions, developing tighter controls and management on food and water resources, and reversing deforestation as a method of carbon sequestration. In particular for the DRC, huge investment in rural access to clean water, sanitation, and healthcare will go a long way to reducing current migration to urban centres, and stop Ebola from migrating to these areas, too. I digress.
Step 4: Vaccinate, vaccinate, vaccinate.
This article has been very dark. So, I think it’s about time to talk about what may be the one and only bright spot of the current Ebola epidemic: we have a new, effective, and Canadian-made Ebola vaccine. rVSV-ZEBOV, a still-experimental vaccine developed at the National Microbiology Laboratory in Winnipeg, Manitoba, is currently being deployed to combat Ebola in the DRC. While human trials of the drug have been limited to past outbreaks scenarios with limited data and controls, early results suggest the vaccine could be close to 100% effective at stopping Ebola. With the help of a public-private partnership with the pharmaceutical giant Merck, this vaccine is now being used in the DRC through a process called “ring vaccination”, whereby officials vaccinate all those who may have come in contact with an Ebola patient. Another point of hope: vaccine acceptance in the region is (surprisingly) very high, with a recent survey finding 82% willingness to accept the vaccine. Now, Merck is stockpiling this vaccine, and is said to have hundreds of thousands of doses ready for combating this outbreak and the next one. If all of this is true, and if the vaccine is used appropriately, we may now have the capability of wiping Ebola off map—something that would have led to thunderous laughter amongst infectious disease specialists even 5 years ago.
Now, if at this point you haven’t notice the rampant sarcasm in this piece, let me confess: stopping Ebola is really, really hard. That’s the reason why Ebola pops up in similar outbreaks every couple of years, and that’s why it likely will again and again for the foreseeable future.
The point of this article is not to belittle the courageous efforts of the many who work on the front lines each and every day to control this outbreak. The point of this article is also not to make light of the fundamental structural issues in the way of preventing future Ebola outbreaks. Rather, the point of this article is to demonstrate that fighting Ebola is not a unique challenge. There are tangible, well understood solutions to each of the steps I’ve outlined above. Sure, many of these solutions will take Herculean efforts not seen since WWII. And yes, many of these solutions will take tremendous time, money, and effort. But, at the end of the day, this is a fight worth fighting. Ebola is not simply a virus or disease. Ebola is symptom of a much greater, widespread, and truly sad reality. It is a symptom of how we have forgotten how to work together to solve global problems. It is a symptom of a global healthcare and economic system that favours some nations (the West) over others. None of these solutions are out of reach, technically speaking. But politically and practically speaking, things are different. And I’m not naive to this. But I am hopeful. And maybe one day, you’ll be hopeful too. Because if we can’t even have hope for a solution, we certainly can’t even begin to solve the problem.
Author: Zach Weiss
Zach Weiss completed his B.Sc. in Microbiology & Immunology at UBC in Vancouver. Over the years, Zach has become increasingly fascinated with the world of politics and policy, and has spent way more hours listening to political podcasts than he’s willing to admit. As a first-year medical student at Schulich, He’s particularly interested in merging his interest in politics and policy with his growing medical knowledge to advocate for and bring awareness to issues that are often overlooked.