Race to contain rare Ebola strain as cases explode in war-torn DRC

本站添加: 2026-05-28

[00:00:00]An Ebola outbreak in Africa has killed more than 200 people with 900 cases now confirmed. It involves a rare strain of the infectious disease for which there's no approved vaccine. So, how worried should the world be about Ebola spreading further a field?

[00:00:32]Hello and welcome to Round Table. I'm Enda Brady. Now, the World Health Organization has declared the Ebola outbreak in Africa a public health emergency of international concern.

[00:00:42]Cases of the rare but deadly disease were confirmed in the Democratic Republic of Congo earlier this month, and it has since spread to neighboring Uganda.

[00:00:55]Health workers in the Democratic Republic of Congo raced to contain the latest outbreak of the deadly virus Ebola. As cases climb and more people die from the disease. The virus was first detected in the northeastern province of Italy earlier this month and has now spread to neighboring regions and cross the border into Uganda.

[00:01:19]The World Health Organization has since raised the risk of this rare strain of Ebola turning into a national outbreak to very high. The Ebola outbreak in the Democratic Republic of the Congo is spreading rapidly. We're now revising our risk assessment to very high at the national level, high at the regional level, and low at global level.

[00:01:46]The last Ebola epidemic to impact the continent was in West Africa in 2014, which was the largest in history, claiming over 11,000 lives. Ebola is a severe and often fatal disease, spreading from human to human. The WHO says the virus moves fast in areas with limited health infrastructure, especially when care is delivered without proper protection. Congalles authorities are intensifying health screenings at checkpoints near the reported epicenter of the outbreak as charities warned that a third of people believe the virus isn't even real.

[00:02:26]>> It started with rumors supposedly that coffins were killing people and that made many people coming from that side believe it was something mystical when in reality it was the disease an epidemic.

[00:02:39]In neighboring Uganda, flights with the DRC have been cancelled, and officials have urged the international community for more money to contain the virus.

[00:02:49]This is the first Ebola outbreak since the Trump administration's cuts to global health programs. But in the Eastern DRC, the still active war between government forces, local militias, and armed rebel groups is likely to make the situation even worse.

[00:03:10]Well, let's meet our guests. In New York City, we have Saleem Abdul Karim. He's special adviser to the director general of the World Health Organization. And in Balagio, in Italy, we have Ahmed Agwell.

[00:03:22]He's former deputy director general of Africa Centers for Disease Control and Prevention. You're both very welcome to this round table. Salem to you. First of all, we've just been hearing from the DRC that this virus is spreading.

[00:03:36]There's no cure. There's no vaccine. How worried are you?

[00:03:42]Well, when we look at the numbers, it is quite concerning in that the nu was identified in a nurse back on the 24th of April. And if you take that, we've now had about four weeks of cases.

[00:03:58]uh we now have just around a thousand suspected cases and about 120 confirmed cases.

[00:04:07]The doubling time that that translates into is around 6 to 9 days which is far faster than anything we've seen in previous aics.

[00:04:20]Normally the ding time will range from around 15 to 20 days. So this seems to be spreading at a faster rate. Now we're not really sure about that statement because we don't have a diagnostic that can confirm our cases uh readily. So in order to diagnose a patient in the laboratory with this bundo strain that means we have to send the blood to a central lab for gene sequencing. There's no simple test that we have available and that was one of the reasons why this epidemic was only discovered quite late in that the patients were being tested on the routine diagnostic for Ebola were coming up negative because it does not pick up this bundy bushwire strain. So I think that we are on the back foot. Uh but I'm very pleased that we've got now several teams on the ground and so we will get more accurate data and hopefully more laboratory confirmed data so we know where we stand. Well, let's bring in Ahmed on this. Ahmed, your assessment of the handling of this outbreak so far. There are some reports that people feel it was mishandled initially, delays in reporting cases and now the virus is just so far ahead.

[00:05:44]and and thank you for having me. I think the the context is important.

[00:05:49]Um we are having an outbreak in an area of insecurity um a relatively difficult to reach part of the country. Um we are working with um a community that is moving depending on how safe they feel. Um we do not have a vaccine as has already been described and um the uh global health situation has been very challenging with resources becoming uh less available and uh relatively slower uh during this time.

[00:06:24]So rather than mishandling what I would say is we have a complex outbreak um which was discovered a little bit late and with um uh extensive movement of people in this particular area and the security uh it becomes um very difficult to have precise data that one can be able to use to plan with. Uh what I see um really as urgent is for the community engagement to be expanded. Um so that uh even areas that are surrounding the immediate outbreak area, we already engaging the community and they know uh what to expect so that we limit this spread um uh in a way that involves the communities that are that are affected.

[00:07:14]wise um it's um moving as Lim says moving a little bit faster than we are used to but it could also be that the numbers are being seen later um as a result of the relatively more inefficient health system in this area which has insecurity >> come in on that idea of community engagement because we know with previous outbreaks of Ebola it has been very difficult to get communities to engage with the author authorities. Many people don't even believe Ebola exists. They see it as a a white man's invention to make money. There is severe distrust of the medical authorities in some of these areas.

[00:08:00]>> Yeah, I think you in addition to all of those issues you've raised, we also have a situation where the health care system is under huge strain in that area. It was under strain before the Ebola outbreak. uh it's now you know dealing with this additional burden. So I think that given that there is no vaccine or treatment that's available for this particular disease the main stay of our approach is what we call public health measures and public health measures revolve around three things. The first is the identification of every case.

[00:08:39]That's critical because if you're missing cases then it'll spread before you know that uh that you you even have a problem. So the identification of cases at this point is based largely on clinical suspicion. So that means you have to engage with communities, you have to inform communities, you have to inform healthare workers. Anybody seeing a patient that has these kinds of symptoms is a it needs to be treated as a suspect immediately. And why that's important is because Ebola is not spread through the respiratory route. It's not spread like COVID 19 that you cough or you uh you know uh sneeze on something.

[00:09:24]The way in which Ebola spreads is from person to person through contact with blood and secretions like saliva. So that means that carers are very high risk whether that carer is in a hospital setting in a clinic setting or at home any carer is at risk. So educating the community, educating healthare workers to identify cases and as soon as identify that they take precautions to protect the carers is quite important and making uh you know protective equipment available to them will be quite important. And then the third issue is about ensuring that every time there's a suspect that bloods are collected and samples are collected to send to the laboratory to get a definitive diagnosis because once you have a definitive diagnosis then you need to find all the contacts you need to isolate the individuals and so on. So at this point uh education to identify every case to protect carers to isolate individuals that are suspect and to send samples off to the laboratory to get a diagnosis. Those are the fundamental elements that will help us bring this epidemic under control. Ahmed, can I ask you about the level of distrust then in some communities when people don't even believe Ebola exists and yet they are dying. We're seeing hundreds of cases.

[00:10:55]What is it do you think that people are fearful of or why do they not even believe Ebola exists?

[00:11:02]Um I I think the communities in these areas know that there is a disease um that presents in this way because uh I mean since 1976 when it was first characterized it has been seen on and off. Um what is important is the approach of engagement with the communities. If it is top down, we know and you must do what we say. Then it becomes a challenge uh for the communities to accept that easily. And in a con in the context of conflict, therefore uh there is general apprehension uh uh within the community.

[00:11:44]The approach needs to be one of co-creating uh solutions uh with the community rather than informing them what needs to be done. Um uh and this is where the challenge lies because trust is built of time and trust uh is often um u you know a mirror of what the culture within that community accepts and doesn't accept. So if we understand the culture of the community, if we have language that will be able to accommodate their beliefs and their ways of life, uh then we can be able to make um progress in reducing the distrust and therefore increasing um uh the levels of knowledge and therefore protection uh of the of the population. It's a very complex area uh as a result of what we've already discussed. Uh and I think um the the key thing here is for the government of the DRC to continue to be the one that coordinating every activity that is happening in this area so that uh it is um uh walking a path um that is public health compliant and walking a path that is also culturally um understandable by the communities uh that are affected. you will see a little bit of a difference. Um for the cases that for example have been imported exported outside of this area into Kinshasa into Uganda the management there is different because the way the community trusts um the health system is different. The strength of the health system itself is also different. So the permutations go beyond just the committee. It also goes into the trust the community has in the health system within their own uh context. And it has been very challenging for this area because the health system uh is not only weak but it is also uh disintegrated depending on who is controlling which area within the conflict zone.

[00:13:51]>> Thank you Ahmed Salee to you. Can I ask about the impact of international aid cutbacks in particular to USAD, the American aid program? Has that played a factor here in the funding of healthare workers and detecting diseases?

[00:14:09]I think we've been uh dealing with this challenge now for just over a year. The situation came to a head in January of last year when the one of the key US institutions USAD was closed down and all of their involvement in the EMOX uh control program was acutely affected. I mean to give you a very simple example uh USA had taken responsibility for logistics on the pox vaccine and one day it just turned out that person who was responsible who had the key for the warehouse where the vaccines were kept had lost his job and so we're not available. So just little things like that do impact but since uh the Americans have pulled out of the emp response uh that gap has now been filled by many other players know we haven't been sitting around hoping that uh where's the USA we've had carry on and do what was necessary and what we are seeing now is a much stronger uh African-led response as a result. So yes, we really benefit from US support and US assistance, but in the absence of that, we've carried on and the US right now is just missing an action and the other players that have come to the party have made amazing contributions not only from the DRC government but from foundations from UN multilateral organizations, WHO, UNICEF and so uh the banks have been involved, the foundations, the Doti Foundation, the Gates Foundation have all contributed.

[00:15:57]So others have been making up some of those gaps as a result. Thank you, Ahmed. To you, how much of an issue is the M23 rebels who are in some of the areas where the outbreak has taken place, the government clearly not in full control of these areas. Is that an issue? The big issue is access irrespective of who is in charge uh access. How can health workers access the community to work with them? How do we get health products those health centers uh that are looking after those communities? How do we get samples out of the communities into laboratory centers where they need to be diagnosed?

[00:16:42]Access is the key. and uh whoever it is that will be responsible for an area if they're providing that safe access um for all these uh getting in and getting out uh processes for products and for samples uh and for health workers if that can be assured then we are that much faster in providing support that is required. If that access is not assured then for we will be seeing a situation where um uh the communities are not being um supported effectively. So irrespective of who's in charge safe assess for health workers and then um collection of the necessary samples to come back for diagnosis uh is really the key. Now you will need coordination. If the areas are being uh controlled by different um uh entities then you need some level of coordination uh so that um when health workers are moving from one area to the next area they doing so safely uh and when communities are being engaged they're being engaged in an environment where they can actually be able to listen. So it is assess that is the key irrespective of who is in charge. Thank you, Salem. How important then is crossber cooperation? We're seeing South Africa's president Sirill Rama pledging $5 million to the aid efforts. How much more needs to be done from other partners?

[00:18:14]>> Well, crossber communication and collaboration is absolutely critical. I mean, there's no way this epidemic is going to be restricted just to the DRC.

[00:18:25]They already imported cases in Uganda.

[00:18:28]they are probably imported cases in South Sudan which is just neighboring it province. So u the way in which the IMT and the Afric has been looking at this is that they've uh listed the countries in Africa and tiers and so the first first tier comprises eight countries that are what they regard as high risk of getting imported cases largely due to their proximity uh to the DRC that includes countries like Bundi and so on.

[00:19:01]So we can expect that there are likely to be imported cases in some of uh those eight countries uh because of their proximity and because people are moving all the time uh and those borders are quite poorous. Then there's a second tier of countries in Africa that are have a lot of communication connections with the DRC. For example, South Africa is just one of those uh where there are flights to the DRC and there are people moving back and forth. There are companies and businesses operating in both countries. So people uh there's always that risk that individuals who are traveling to the DRC might bring in an imported case into South Africa. So these other countries need to put in border screening measures and those are pretty well tried and trusted and we know how to do them and in the event that a health care worker sees a patient with signs and symptoms you know just got to make sure that they remember to ask you know have you traveled recently to central Africa. So I think that based on those measures uh risk of importation is there but can be contained as we saw previously in the 2014 outbreak where there were imported cases in several European countries US and elsewhere the imported cases themselves uh become they don't become a source of a new outbreak in those countries because they can be read contained.

[00:20:39]Ahmed, that leads me to my next question. At what point do you think Ebola jumps continents? Has it got the potential to move out of Africa?

[00:20:50]>> Um, viruses move through people. I mean, after it has left the reservoir, which we know is the the fruit bad, when it has gotten into the human population, then the virus would be moving through people. And so long as people are moving there is a risk a risk of uh the virus um also moving and as Salem says it is really the strength of our surveillance systems. It is the strength of and the confidence we have in the health system that if a case is identified it will be um arrested uh without being allowed to spread into the population. And we have seen that happen effectively during this outbreak. Um especially in areas where the health system is functioning properly. Um it is the weak health system that really should be wording us.

[00:21:42]Um uh because uh irrespective of the number of cases, if you have a strong health system, it will contain the outbreak. If you have a weak health system then uh cases will sleeping through uh and causing uh uh you know spread into into other parts of the country and even other parts of Africa.

[00:22:03]But I must add that closing borders you know uh these have never been shown to be good public health measures. um uh it it s panic and in a situation where there is panic you end up making mistakes that um could have been avoided. So what we should be doing is strengthening our crossber surveillance systems um and having our health systems ready to receive any suspected case supporting that individual uh to become healthy again. This is what needs to be done in this situation to avoid panic and uh uh to really avoid all these travel advisory I mean the travel bans uh for particular individuals from particular countries. Uh the risk is there for spread uh but it is a strong health system and um a strong surveillance system and a strong health system to receive those who may be suspected. This is what is going to stop um uh the spread across the continent and beyond.

[00:23:06]>> Thank you. Final point to you Salem. Can this outbreak be contained quickly or are we looking at very difficult months ahead for the DRC and her neighbors?

[00:23:17]>> Well, based on our past experience and remember this is a different strain of Ebola, but based on what we know previously, this is quite a serious epidemic.

[00:23:30]uh serious enough that it requires quite a lot of concerted action by many players if we're going to contain it. It is not going to get contained if left by itself. It is going to spread. So I think we need to treat it with seriousness but not with panic just seriousness. And we got to take action in a way that's quite clear, prioritized and concerted in a single initiative that allows us to bring it under control. That means going to bring resources to bear supporting the actual public health measures on the ground. If we are to do that, if if based on what we know from the past, we can expect that the epidemic will continue to grow. Right now we will see several more weeks months of cases rising. We will likely to see imported cases in distant countries uh and then it'll reach a plateau and then we can expect it to dissipate thereafter. That's pretty much how EA tends to tends to spread. How much it spreads is dependent on quick action and I am at this point uh quite confident that the actions that have been taken put us on a path that we will see a shorter outbreak rather than a long one.

[00:24:58]>> So Salem just briefly you don't think this is going to be the next global pandemic?

[00:25:04]>> No I don't think so. I think we're likely to see cases in many countries imported but we won't see seeding in those kind countries and so no I don't anticipate uh that we will that it will become a global pandemic Abdul Karim thanks for your time and Ahmed Ogwell as well thank you both gentlemen fascinating round table remember you can see more discussion and debate on our YouTube channel search for roundt tot world and you can listen to select episodes wherever you get your podcasts but for now from me and Brady and all the team here. Goodbye and thank you for watching.