Ebola: Democratic Republic of Congo
Changes from June 12, 2018 to August 3, 2018
This page shows textual changes in the document between the two versions indicated in the dates above. Textual matter removed in the later version is indicated with red strikethrough and textual matter added in the later version is indicated with blue.
On May 8August 1, 2018, the World Health Organization (WHO) reported that a new Ebola outbreak was detected in the eastern part of the Democratic Republic of Congo (DRC), about one week after having declared that a separate outbreak had ended in the western part of the country. This new outbreak is occurring in North Kivu, a province experiencing its own humanitarian crisis with over 1 million displaced people. WHO will shift staff that had just completed working to contain the previous outbreak in the Equateur province to North Kivu. Health experts have reportedly determined that the strain in North Kivu is the same one for which a vaccine is available and has been used to control past Ebola outbreaks, though ongoing conflict in the province may complicate control efforts. As of August 2, press reports indicate that 20 people, including two health workers, died after showing symptoms of hemorrhagic fever. Four of six samples collected tested positive for Ebola.
About one week ago on July 24, 2018, WHO reported that an Ebola outbreak in the DRC had ended after having infected 54 people, 33 of whom died. The outbreak began on May 8, 2018, when DRC health officials reported to WHO that two Ebola cases had been detected in the Equateur province, a rural area in the northwestern portion of the country. The disease later spread to Mbandaka, a city that holds 1.2 million people and serves as a regional trade hub. This was, health officials from the Democratic Republic of Congo (DRC) reported to the World Health Organization (WHO) that two Ebola cases had been detected in the Equateur province, a rural area in the northwestern portion of the country. The disease has since spread to Mbandaka, a city that holds 1.2 million people and serves as a regional trade hub. As of June 10, 2018, WHO reported a total of 55 cases, including 28 deaths. Of these cases, 69% were confirmed through diagnostics. WHO asserts that 14 of these cases were probably Ebola, but could not collect laboratory specimens before the burial. This is the ninth Ebola outbreak in DRC since the disease was discovered in 1976, when an outbreak infected 318 people and killed 280 (Figure 1). WHO considers the public health risk of transmission to be very high at the national level due to the serious nature of the disease, insufficient epidemiological capacity, and delayed detection of the first case. At the global level, however, the risk is considered low. The outbreak appears to have been contained in the most populous areas and active transmission appears to be occurring only in rural areas
In contrast to the 2014-2016 West Africa Ebola outbreak, the WHO response was swift. On the same day that the outbreak was reported, WHO released $2 million from its Contingency Fund for Emergencies (CFE), deployed a team to the region, and activated an emergency incident management system. WHO also issued a $57 million appeal to control the outbreak. The international community exceeded the request, having provided $63 million. The largest contributions were provided by Germany (€5 million), United Kingdom (£5 million), and the United States ($5.3 million). Other types of support included in-kind contributions for medical evacuations and intercountry air transport from Norway and the European Union, respectively; technical assistance from Germany, Guinea, the United Kingdom, and the United States; and the provision of vaccines to protect over 3,300 people.
|
Figure 1. Ebola Virus Outbreaks in the Democratic Republic of Congo |
 |
|
Source: Adjusted by CRS from World Health Organization, Ebola Outbreak Response in The Democratic Republic of The Congo, Briefing to Committee A at the World Health Assembly, Geneva, Switzerland, May 23, 2018. Note: CRS adapted the graphic to include information on Ebola cases and deaths in May 2018 and to identify the location of North Kivu and its proximity to Uganda, Rwanda, and Burundi. |
The DRC's Ministry of Health, WHO, and other stakeholders are takingtook several steps to contain the outbreak. Notably, a new vaccine, which was used for the first time in the field during the 2014-2016 West Africa Ebola outbreaks, is now beingwas provided to all primary and secondary contacts to prevent disease transmission. Merck provided more than 7,500 doses for the vaccination effort. In addition, health officials approved the use of investigational drugs to treat those infected with Ebola. This marks the first time in which investigational drugs are beingwere used in the field during an outbreak.
Health experts arewere particularly troubled by this outbreak, as it is occurring in a citybecause it occurred in a province that is densely populated (2.5 million people) and hosts a portion of the Congo River that is vital for regional transportation. Previous outbreaks occurred primarily in sparsely populated, rural areas. The only other urban outbreak occurred in Kikwit in 1995, which held 400,000 people at the time. WHO has conducted operational readiness and preparedness assessments in the nine countries bordering the DRC, placing and placed particular emphasis on the Central African Republic, due to its proximity to the outbreak area. The assessment plans arewere aimed at identifying operational needs should anthe outbreak occurhave spread to the country and providing technical support for the development and implementation of contingency plans. WHO has "cautious optimism" that ongoing containment measures are working. The disease was once present in three health zones (Bikoro, Wangata, and Iboko) in Equateur province, and since May 17, all new cases were detected in the Iboko Health Zone.
WHO is seeking $56.7 million to control the Ebola outbreak through a coordinated approach across several international actors. As of June 3, 2018, donors have pledged $25.7 million.
U.S. Support
The United States committed to provide $8.0 million in support of Ebola control efforts in the country, drawing on $5.0 million in FY2017 appropriations for USAID-administered Global Health Program (GHP) funding. It is also drawing and $3 million in GHP funds appropriated in FY2015 for Ebola response in West Africa. Roughly $5.0 million of the funds is to bewere provided to WHO for case management, entry screenings, diagnosis testing, and support for other laboratory functions. About $2.0 million iswas for the United Nations Children's Fund (UNICEF) to implement Ebola awareness communication campaigns and water, sanitation, and hygiene (WASH) projects. An estimated $700,000 is to bewas used by the International Federation of the Red Cross/Red Crescent Societies (IFRC) for promoting safe burial practices and Ebola prevention education campaigns.
On June 5, the White House withdrew proposed rescissions of $252 million in unobligated emergency International Disaster Assistance (IDA) funds appropriated in 2015 to control the West Africa Ebola outbreak and bolster response capacity in affected countries. These funds may be made available for ongoingfuture Ebola control efforts.
Ebola control efforts in the DRC.
In addition, the U.S. Centers for Disease Control and Prevention (CDC) is working with partners to support the development and implementation of an outbreak response plan, as well as to provide technical assistance in communications, logistics, operational and personnel support, and laboratory capacity building. The United Nations peacekeeping operation in the DRC, to which the United States is the largest financial contributor, is also providing logistical support to response efforts.