Ebola response in Congo runs into community resistance

CIDRAP notes that health officials haven’t announced any new outbreak totals. Last Thursday, the DRC health ministry said 12 people have died of the infection, and that there are 52 additional cases — 31 confirmed, 13 probable, and 8 suspected.

The DRC’s health minister Oly Ilunga Kalenga on Friday tweeted pictures of himself receiving the experimental Ebola vaccine, given that he’s a frontline health worker. “However, the most effective measures remain the respect of hygiene measures, the rapid management of cases, and the follow-up of contacts,” he added.

KFF: Funds help fill gap, but policies send mixed signals
The United States has played much less prominent role in the latest Ebola outbreak, raising some questions about the nation’s commitment to global health security but also reflecting that the global capacity to respond to such an outbreak has become much more robust following West Africa’s massive outbreak, the Kaiser Family Foundation (KFF) said Friday in a policy brief.

The authors of the report spelled out key changes since West Africa’s outbreak, including World Health Organization (WHO) reorganization, new leadership engaged in the response, and the group’s creation of an emergency contingency fund. Also, the international community and global health groups have stepped forward with $59.6 million in support for the DRC’s outbreak, far exceeding the WHO’s 18 May request of $26 million to support its activities.

Other differences in the current outbreak—the largest involving Ebola since West Africa’s epidemic—include the DRC’s past experience managing Ebola outbreaks and the availability of an experimental vaccine to help battle the disease.

The United States engaged early in the response, especially the Centers for Disease Control and Prevention (CDC) with epidemiological and other support and USAID with technical assistance and support totaling $8 million, an amount KFF said essentially filled the gap in the WHO’s donor request.

Though the United States is not leading the response on the ground, it is providing valuable assistance at a time when cases have risen past 50, KFF said. “Today, the increased capacity of WHO to address Ebola outbreaks and its quick response in partnership with DRC mean that the current landscape, as well as the potential role for the U.S., may be quite different from four years ago.”

However, recent U.S. policy has sent mixed signals about support for global health security, the authors note. Most of the emergency appropriation that Congress approved for West Africa’s outbreak, with a chunk of funds earmarked for to help countries improve their capacity to respond to similar outbreaks, is set to expire at the end of the 2019 fiscal year, and the White House has submitted a proposal to cut remaining USAID funds by $252 million, though Congress hasn’t acted on it.

But the group noted that the White House did request an increase for global health security programs at the CDC for the 2019 fiscal year. “Taken together, these recent funding moves have created an air of uncertainty about the U.S. commitment to global health security more broadly, brought into stark relief in the midst of a new Ebola outbreak,” KFF wrote.

Uncertainty over lack of US point person

The report also pointed out that though the DRC situation isn’t as dire as West Africa in 2014, the US government hasn’t designated a leader for its international outbreak response activities. The authors noted that the Trump Administration had appointed Tim Ziemer to lead biosecurity and global health efforts, but his position was recently eliminated in reshuffling within the National Security Council (NSC).

So far, no other NSC staff or the CDC director have made public statements, the report said, noting that in comparison, senior Obama administration officials had highly visible roles. “Whether and how to designate a point person on outbreaks is a debate that predates the DRC Ebola outbreak, but the ongoing outbreak has added some urgency to this discussion,” they wrote.

Though the outbreak in the DRC is unpredictable, if it expands and crosses borders, responders will probably need more international assistance, which might come with a request for the United States to ramp up its engagement, the report concluded.