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The Ebola outbreak that began in DR Congo is becoming a continental crisis after authorities initially underestimated its spread, the head of Africa’s public health agency told Semafor as new cases were reported as far afield as Nigeria.
More than 4,600 people have died in the outbreak of the Bundibugyo strain which was first detected in DR Congo in May, though health experts believe it had been circulating undetected for weeks. It has now spread further across Africa than any previous Ebola outbreak, with cases in the continent’s central, eastern and western regions. Nigeria, Africa’s most populous country, confirmed its first case of the Bundibugyo strain, for which there is no proven vaccine, despite being absent from the agency’s initial list of 15 countries at risk, he said. Kenya has reported nine cases while Uganda, which recorded 20 cases, was declared free of Ebola in August.
“We could see every region of Africa affected, and that is beginning to happen,” Jean Kaseya, director-general of the Africa Centres for Disease Control and Prevention, said in an exclusive interview. He said the outbreak had initially been viewed as less dangerous and easier to contain, with little expectation that it would spread to other African regions, which had proved to be wrong.
Ebola is changing how African governments organize their response, Kaseya said, with Nigeria’s case prompting stronger solidarity across the continent. Health, finance and transport ministers will meet next week with regional organizations invited, to discuss national and cross-border measures.
Kaseya said he expects a response plan dividing responsibilities among regional organizations and other partners to be ready by then, ahead of a summit of African leaders where he hopes to secure funding commitments.
As Ebola spreads across Africa, Kaseya warned against closing borders to contain it. “We do not recommend border closures,” he said, arguing that the measure had already proved ineffective. “People will start using informal, unofficial routes, and they will still cross.”
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The patient diagnosed in Nigeria, a woman who had traveled from Uganda, went roughly 10 days undiagnosed. “The patient was in one private facility, then another, without being tested,” Kaseya said. That delay posed a greater risk of further spread than in Kenya, he said. Kenya isolated its first patient soon after arrival.
The Nigerian government has pledged funding for the response, Kaseya said, without specifying an amount. Africa CDC has sent a team to support Nigeria’s response, where Kaseya said aid partners must report their funding and activities to the government.
Nigeria’s health minister, Muhammad Ali Pate, said authorities had found no evidence that the virus had spread into communities. “This is a contained single case, and we are diligently working to ensure that it remains so,” he told reporters at a press conference late on Thursday.
Step Back
The spread of the Bundibugyo strain comes against the backdrop of deep cuts to Western aid budgets, which has prompted health experts to argue that a lack of resources reduced the presence of health workers on the ground, slowing the response to the outbreak.
Jullien Harneis, the UN’s senior Ebola coordinator, said the outbreak’s expanding reach required more teams, coordination and logistical support. “Its geographic spread is a real management challenge,” he told Semafor.
Africa CDC warned last week that aid organizations had not reported more than $700 million in donor funding to Congolese authorities. It backed government sanctions, including withdrawing permission to operate, against organizations that continued to refuse to account for their funds.
“We have now traced $450 million,” Kaseya told Semafor. “We will never again manage an outbreak in Africa the way we managed it in DR Congo,” he said, referring to the funding dispute.
This latest Ebola outbreak is the second deadliest in history after the 2014-16 epidemic which killed more than 11,300 people, mostly in West Africa. There is no known vaccine for this species of the virus, known as Bundibugyo, but Ervebo, effective against another species, is being tested. The Ervebo vaccine has been administered to 9,000 frontline workers.
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- African governments should raise more domestic health funding through taxation, Kaseya told Semafor last month.