Six months after the World Health Organisation declared a public health emergency, the Ebola outbreak in the Democratic Republic of the Congo remains beyond control, as Doctors Without Borders sees it. The disease now runs through eight provinces, claiming more than 5,400 lives among roughly 11,000 infected, and many of its victims arrive at treatment centres carrying no traceable thread back to anyone else. The deeper trouble is less the virus than the fragile human machinery meant to meet it: workers unpaid, vehicles without fuel, and trust in accounting strained by hundreds of millions of d
Ebola Outbreak in DRC Not Under Control, MSF Warns of Response 'Dysfunctions'
The outbreak has killed more than 5,400 people and infected around 11,000, with most deaths occurring in communities rather than treatment centres.
"It's not slowing down, it's spreading out."
Mark
Why does MSF focus so much on "surprise cases"?
Mimi
Because they show the chain of transmission is invisible. If most patients have no known link to another case, tracers aren't finding contacts before they get sick.
Mark
And the deaths in communities?
Mimi
Those matter for the same reason. People dying at home or in the community are not isolated, so each death is another chance for the virus to spread.
Luke
Halford says it's not mathematically out of control. How firm is that?
Mimi
It's her characterisation, not a published model. She says it's slowly growing and spreading out rather than accelerating.
Luke
And the $700 million unaccounted for?
Mimi
That comes from earlier reports citing Africa CDC figures, out of $962 million. This article doesn't verify it, and unaccounted for isn't the same as misspent.
Mark
So is money the problem?
Mimi
Halford says no. Her point is that resources aren't reaching people: unpaid workers, motorbikes without fuel, staff in flip flops.
Luke
What's still unknown?
Mimi
How quickly this can be fixed, and whether the authorities' promised oversight changes will actually arrive. The risk to the wider world is rated low by the WHO, which is the basis for the outside analyst's view.
Le Pouls
- Most new Ebola patients at DRC treatment centres have no known link to any other case, meaning the virus is moving faster than the tracing meant to catch it.
- More than 5,400 people have died, and many are dying at home in communities rather than in care, each death a fresh chance for further spread.
- Health workers are unpaid and on the front line in flip flops, while surveillance motorbikes sit idle without fuel and ambulances stand without it too.
- Africa CDC figures show $700 million of $962 million passed to Ebola groups is unaccounted for, pressing authorities to prove transparency with real change.
- The outbreak has spread across eight provinces, five still active, and MSF warns it is not slowing but spreading out, so the coming months will show whether surveillance and pay improve.
Six months after the World Health Organisation declared a public health emergency, the Ebola outbreak in the Democratic Republic of the Congo remains beyond control, as Doctors Without Borders sees it. The disease now runs through eight provinces, claiming more than 5,400 lives among roughly 11,000 infected, and many of its victims arrive at treatment centres carrying no traceable thread back to anyone else. The deeper trouble is less the virus than the fragile human machinery meant to meet it: workers unpaid, vehicles without fuel, and trust in accounting strained by hundreds of millions of dollars that cannot be explained. For the wider world the danger is judged low, but for the Congolese communities at the centre of it, the question is whether the promises of better oversight will ever reach the ground.
Six months after the World Health Organisation declared the Ebola outbreak in the Democratic Republic of the Congo a public health emergency, Doctors Without Borders says it is still not under control. Anna Halford, the organisation's emergency co-ordinator, has spent many weeks in the country, and what worries her most is what arrives at treatment centres. Most patients are "surprise cases" with no known link to anyone else, a sign that contact tracing is failing to keep pace with the virus. Many deaths also happen in communities rather than clinics, where each one is another chance for spread.
The scale is grim. About 11,000 people have been infected and more than 5,400 have died, making this the second-largest Ebola outbreak on record after West Africa's 2014-16 epidemic. The strain is Bundibugyo, and the outbreak has now reached eight provinces, five still active, from remote rural areas to cities, each needing a different approach.
MSF describes a response hollowed out at the edges. Staff are untrained or unpaid, surveillance teams have motorbikes but no fuel, ambulances sit without it, and health workers lack supplies for suspected cases. Halford says money is part of the picture but not the cause, citing Africa CDC figures showing $700 million of $962 million passed to Ebola groups unaccounted for. "It's not a lack of money," she said. What is needed is sustained resources directed where they are required.
There are signs of progress, including better information flow, diagnostic facilities and community engagement. MSF employs nearly 1,500 staff on the response, most of them Congolese. For the wider world the risk is judged low, provided borders keep up early detection. The test now is whether surprise cases fall and whether pay, fuel and oversight finally reach the front line.
Six months after the World Health Organisation declared it a public health emergency, the Ebola outbreak in the Democratic Republic of the Congo is still not under control. That is the assessment of Anna Halford, emergency co-ordinator for Doctors Without Borders (MSF), who has spent many weeks in the country helping run the organisation's response and who spoke to The National.
Her clearest evidence is what arrives at treatment centres. Most cases, she said, are "surprise cases" with no known epidemiological link to any other case. Contact tracing, in other words, is not keeping pace with the virus. "You should not have the majority of your cases coming out of nowhere," she said. The second warning sign is where people die: most Ebola deaths are happening in communities rather than in treatment centres, and each one is another chance for the disease to spread.
The numbers are large. About 11,000 people have been infected and more than 5,400 have died, making this the second-largest Ebola outbreak on record, behind the 2014-16 West African epidemic, which had 28,600 reported infections. The WHO declared the emergency in May, though the disease is thought to have been circulating since the start of the year. This outbreak is caused by the Bundibugyo virus, one of three ebolaviruses behind most large African outbreaks, alongside the Sudan virus and the Zaire virus, the deadliest, which kills up to nine in ten of those infected.
MSF's international president, Javid Abdelmoneim, put the problem bluntly in a statement, saying staff were often left speechless by dysfunctions in the response. He called for urgent improvements in oversight, staffing and operational support, and MSF said statements from Congolese authorities about better transparency and oversight must become real change on the ground.
The organisation listed specific failures: untrained and unpaid personnel, no fuel for vehicles including ambulances, surveillance teams that are nowhere to be seen on the ground, and health workers without supplies or technical support for suspected cases. Halford described frontline staff on the edges of the outbreak lacking the most basic equipment. "They're in flip flops," she said. Surveillance teams have motorbikes but no fuel; community awareness workers and many health workers have not been paid.
Money is part of the backdrop, though Halford said it is not the cause. Earlier reports citing the Africa Centres for Disease Control and Prevention said that of $962 million (Dh3.53 billion) passed to organisations working on Ebola, $700 million was unaccounted for. Halford said: "It's not a lack of money." What is needed, she said, is sustained, consistent resources directed where required. "It is complex but we know what needs to be done. Somebody needs to make sure it is being done."
The geography has made everything harder. The outbreak began in North Kivu and Ituri provinces and has now reached eight provinces, five of them active, from deeply rural areas to cities, each needing a different approach. Conflict has hampered the effort, Halford said, but it is one difficulty among many. In her words, the epidemic is not mathematically out of control, but it is not slowing down, it is spreading out.
She also pointed to progress: better information flow, deployed diagnostic facilities and stronger community engagement. Surveillance still needs to improve. As of the end of October, MSF employed nearly 1,500 staff on the response, over 80 per cent of them Congolese, and funds more than 1,400 more working under the DRC health ministry. MSF epidemiologists in Dubai have helped track the disease.
For the wider world, the risk is considered low. Ebola is not highly contagious and does not spread through airborne particles. Ali Alessandro Ayach of Arthur D Little, a UAE-based health care analyst, said concern is modest as long as countries keep up early detection at their borders, and that he relies on the WHO's low-risk rating. What to watch next is whether surprise cases fall and whether pay, fuel and oversight reach the front line.
Citations marquantes
You should not have the majority of your cases coming out of nowhere.— Anna Halford, MSF emergency co-ordinator
It is complex but we know what needs to be done. Somebody needs to make sure it is being done.— Anna Halford, MSF emergency co-ordinator
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