The Ebola outbreak in eastern Democratic Republic of the Congo (DRC) has ended. Thursday marked 42 days since the last person with Ebola was discharged from care, double the maximum length of time it takes for symptoms to appear. Nearly two years of hard work and leadership by the communities in DRC has paid off, with the end of the first Ebola outbreak in a conflict zone.
It’s a time for celebration but not complacency. Viruses do not take breaks. DRC’s 10th Ebola outbreak may have come to a close but an 11th, in the north-west part of the country, was detected on 1 June. Cases are appearing 240km away from Mbandaka, the centre of this latest outbreak.
Yet Ebola is only one of the major health crises facing DRC’s leaders. In addition to Covid-19, the world’s largest measles outbreak is wreaking havoc, killing more than 6,850 people in less time than Ebola took to claim 2,280 lives. Only half of health facilities have access to water – this is a critical determinant for spreading infectious diseases.
Good responses outlast outbreaks. Ebola survivors need follow-up treatment and care for complications caused by the disease. They can lose both their sight and selfhood. The disease unleashes fear and grief, widely affecting mental health. Ebola survivors also often face stigma and need help to reintegrate into their communities; similar challenges with Covid-19 seem likely, with instances of discrimination seen around the world.
Having fought this outbreak, the DRC is better-equipped to address the other health emergencies it still faces, including the current pandemic. The Ebola outbreak led to improvements in the public health architecture. Five new labs, part of a recently strengthened surveillance system, will continue to operate. Healthcare workers trained in clinical management and infection prevention and control as part of the Ebola response are being redeployed to fight Covid-19.
But to prevent future outbreaks from posing regional threats, the strengthening of the health system must continue. Doctors, nurses, midwives and other health workers need better facilities and more supplies, training and support to safely and effectively do their jobs.
All this requires funding, at a time when governments are allocating billions of dollars to respond to the pandemic and mitigate its impact on livelihoods and the economy. However, I call on donor partners to continue to show solidarity. The Covid-19 pandemic shows that borders cannot protect us and we are only as strong as our weakest link. Investments to provide clean water in Ituri and keep vaccines cold in North Kivu will help protect us all.
As Covid-19 poses a threat to every region of the world, the DRC holds lessons for countries of all incomes. For example, its contact tracers should serve as a worldwide inspiration. They have used technology to overcome insecurity, swapping folders of forms for mobile phones to collect data on Ebola, to both help share information faster and ward off unwanted attention in areas where suspicions run high.
Further courage under fire also paved the way for the success of the Pamoja Tulinde Maisha study, a randomised controlled trial, conducted as part of the emergency Ebola response. Bravely carried out even as healthcare workers were being killed, the trial established that two out of four drugs gave Ebola patients a better chance of survival.
Yet, important as research has been to the Ebola response, engaging communities and influential figures, such as faith leaders and traditional healers, was critical. Communities should be respected as first responders, who can quickly detect cases and collectively work out how to isolate patients, even with minimal resources.
The DRC’s resilience and resourcefulness are proving invaluable in repurposing the Ebola response to tackle both new threats like Covid-19 and age-old challenges, such as malaria and cholera. The Congolese people ended a devastating outbreak through an unshakeable commitment to science, data and community, and with international solidarity. With health systems in even high-income countries still at risk of being overwhelmed by the pandemic, leaders would do well to heed the example of the DRC.
Dr Tedros Adhanom Ghebreyesus is the director general of the World Health Organization