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EDITORIAL: Stem societal factors fanning the spread of deadly Ebola



By The EastAfrican
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The announcement this week that scientists had made a possible breakthrough in the search for a cure for the deadly Ebola virus and the challenges that the same scientists have faced in the efforts to get the treatment to those most in need of it once again reflects the most enduring paradoxes of Africa.

More than 1,800 people in the Democratic Republic of Congo have succumbed to Ebola since the outbreak started there in August 2018. An outbreak that swept through Guinea, Liberia and Sierra Leone between 2013 and 2016 claimed more than 11,000 lives.

The mAb114 and REGN-EB3 experimental drugs developed from the antibodies of Ebola survivors have achieved cure rates above 90 per cent during recent trials on patients in the DRC. The developers however caution that the outcome is very much contingent on the timing of treatment, with patients who started early, when the viral load was low, showing better outcomes. That means that even with the option of treatment, for the best outcomes, communities need to be proactive and have faith in conventional approaches so that they can bring suspected cases early for treatment.

For a disease that demonstrated high geographical mobility, putting the entire global health system on tenterhooks, the news of a cure is cause for celebration. Uganda and Burundi, which tend to see heavy movement of people across their common borders with the DRC, have embraced an immunisation campaign for borderline communities.

Yet, as experience has shown, this medical breakthrough alone, however significant, should not be misconstrued for a panacea. Lacking a neutral flag acceptable to all actors, responders in the DRC have been blocked from reaching some communities at the centre of the outbreak.

In many instances, Africa’s social and governance challenges often mean that abundance can be as much a problem as scarcity. In this regard, earlier programmes to tackle diseases such as malaria and measles should offer valuable lessons. Malaria is a good place to start, because there have been some success stories in efforts to stem it, yet its persistence is an enduring metaphor for just how a governance deficit can neutralise the best efforts.

For East Africa and DRC’s other neighbours, therefore, the struggle with what is easily the world’s most virulent haemorrhagic fever is a lesson in progress. Political instability, violence and mistrust of authorities have made it difficult for medical workers to deliver interventions to the communities most in need of them.

The DRC demonstrates that beyond logistics and drugs, without adequate infrastructure, a state that is functional and present in the hearts and minds of the people in a positive way, interventions however well-intentioned can run into resistance. For instance, the existence of non-state actors who control vast swathes of territory in the eastern DRC has complicated healthcare service delivery efforts.

Beyond logistics and drugs, therefore, a tandem approach that incorporates a strategy that speaks to the societal issues fanning the Ebola spread will be necessary.

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