29 May 2019 | Rebecca Ratcliffe | The Guardian
The UN has been urged by charities to ramp up Ebola prevention work in the Democratic Republic of the Congo to the highest level of emergency response.
Only three crises – Yemen, Syria and Mozambique – are treated as the equivalent of a level-three response, activated when agencies are unable to meet needs on the ground.
Charities including Mercy Corps and Oxfam said the same declaration should also be made in DRC, following a recent acceleration in the spread of Ebola.
Almost 2,000 cases of Ebola have been recorded since the outbreak began in August. As of Monday, 1,287 people have died from the disease.
Violence by armed groups and community mistrust have severely undermined attempts to halt the epidemic, forcing health workers to suspend vaccination and treatment work.
Whitney Elmer, country director of DRC for Mercy Corps, said that declaring the equivalent of a level-three emergency would bring “manifold benefits” by clarifying the roles of agencies, allowing greater access to resources and attracting greater global attention.
“There has never been an epidemic of this complexity or size in the DRC,” said Elmer, adding that the crisis requires a new structure in line with its scale.
The global humanitarian coordination body, Inter-Agency Standing Committee, will consider the call when it meets on Wednesday. Among the factors to be considered are the scale and complexity of an epidemic, and the risk of a failure to respond effectively.
A level-three emergency, now known as a system-wide scale up, does not indicate the severity of the crisis, but is activated where there is a mismatch between need and agencies’ ability to respond.
On Tuesday, Mike Ryan, assistant director-general of the World Health Organization’s emergency preparedness and response programme, said progress had been made in fighting Ebola, including a drop in transmission of the disease in health facilities.
But insecurity has continued to undermine the response, he added, repeatedly preventing work to identify and vaccinate people at risk of Ebola. There have been 174 attacks on health facilities so far this year, a threefold increase compared with the period from August to December 2018.
In some areas, health workers are afraid to wear protective equipment because they fear they will be targeted by armed groups, according to the WHO.
Médecins Sans Frontières warned it is “extremely worried” about the unpredictability of new cases.
The vast majority of new confirmed cases – more than 80% – have not been identified as contacts of people known to have Ebola, according to MSF. “This means that the listing of contacts and surveillance are not effective,” the charity said in a statement.
Since the start of the outbreak, there have been 1,926 confirmed or probable cases of Ebola. A third of those who have fallen ill are children, which is a higher proportion than in previous outbreaks.
Last week, the UN announced several measures to strengthen its response, including the appointment of a new emergency coordinator, David Gressly.
Tamba Emmanuel Danmbi-saa, Oxfam’s humanitarian program manager in the DRC, said the announcement was a step forward. “This demonstrates the importance that is being placed on the response,” he said. “Now having this translated into concrete actions to enable to us to deliver services and access funds as required will be critical.”
“The profile of the response needs to be raised,” he said, adding that more funding needs to be allocated to humanitarian and community engagement work, and that greater efforts should be made to negotiate safe access for charities.
“The approach does not have to be a normal approach … if it means engaging with leaders of militias, we need to do that,” he said.
The risk of Ebola spreading to other provinces in eastern Congo and to neighbouring countries remains very high.
Russell Geekie, spokesman for the UN Office for the Coordination of Humanitarian Affairs, said the UN was introducing measures in Goma, as well as in four neighbouring countries.
He added that the broader, protracted humanitarian crisis in DRC also requires urgent attention. “A tenth of the global caseload of people in need of humanitarian assistance is in the Democratic Republic of the Congo,” Geekie said in a statement.
The humanitarian appeal for DRC, which requires $1.65bn (£1.3bn) to assist 9 million people this year, is only 16% funded.