MSF Warns Ebola Outbreak in DRC Not Under Control Due to Response 'Dysfunctions'

Doctors Without Borders (MSF) has warned that the Ebola outbreak in the Democratic Republic of the Congo (DRC) remains uncontrolled six months after its declaration. Anna Halford, MSF's emergency co-ordinator, noted that the prevalence of "surprise cases" indicates a failure in contact tracing efforts to keep pace with the disease's spread.

The World Health Organisation (WHO) declared the outbreak a public health emergency in May, though the virus is believed to have been spreading since early this year. Javid Abdelmoneim, MSF's international president, expressed frustration over "dysfunctions" in the response, stating that urgent improvements in staffing, operational support, and oversight are essential. MSF emphasized that promises of transparency from Congolese authorities must result in tangible changes.

Financial discrepancies have also come to light. Reports from the Africa Centres for Disease Control and Prevention suggest that $700 million of the $962 million allocated to Ebola response organizations remains unaccounted for. MSF reported critical shortcomings, including front-line workers lacking basic equipment—some wearing flip flops—and surveillance teams lacking fuel for their motorbikes. Additionally, many healthcare and community awareness workers remain unpaid.

Anna Halford identified two primary indicators of the failing response: the high number of "surprise cases" without known epidemiological links and the fact that most deaths are occurring within the community rather than in treatment centres, increasing the risk of further transmission. While the epidemic is not mathematically out of control, she noted it is spreading out rather than slowing down.

The current outbreak, caused by the Bundibugyo virus, has infected approximately 11,000 people, making it the second largest in history after the 2014-16 West African outbreak. MSF's Dubai offices have provided epidemiological support to staff in Africa. The response is further complicated by conflict in the North Kivu and Ituri provinces, as well as the spread into eight provinces, five of which remain active.

Despite these failures, Halford acknowledged progress in community engagement, diagnostic facilities, and information flow. As of October, MSF employed nearly 1,500 staff in the DRC, with over 80% being Congolese, and financed an additional 1,400 health ministry staff.

While the risk to the global population remains low because Ebola is not airborne, Ali Alessandro Ayach of Arthur D Little warned that early detection at borders is crucial. This comes amid a report from the Independent Panel for Pandemic Preparedness and Response suggesting the world remains vulnerable to health emergencies due to a failure to learn from Covid-19.