This article is published in association with United Nations.
Facing a fast-moving Ebola outbreak caused by a rare strain of the virus, the World Health Organization (WHO) is relying on a rapid, community-centred response to halt transmission in eastern Democratic Republic of the Congo (DRC) and Uganda, a senior official has told UN News.
The UN health agency on Wednesday assessed there is a high risk from the Bundibugyo strain at the national and regional levels, but a low risk globally.
Low pandemic risk – so far
However, the UN agency’s emergency committee believes that, at this stage, it does not meet the criteria for a pandemic emergency.
To date, 51 cases have been confirmed in the Congolese provinces of Ituri and North Kivu, even though the scale of the epidemic is much larger. WHO has tallied nearly 600 suspected cases and 139 suspected deaths so far, with two cases linked to the outbreak detected in Kampala, Uganda.
Because no licensed vaccine or specific treatment currently exists for this rare strain the health authorities are seeking to quickly interrupt transmission in a region marked by insecurity and population displacement.
With support from UN peacekeeping mission MONUSCO, the World Food Programme (WFP), Doctors Without Borders (MSF), and other partners, experts and medical equipment have already been deployed to the affected areas, while treatment centres are being set up.
Speaking to UN News, Dr. Marie Roseline Belizaire, the WHO Emergency Director for Africa, emphasized the importance of a response built on community trust. “The speed of the response in the first days is essential to interrupt transmission and avoid a wider spread of this epidemic,” she stressed.
Community-centred
For the WHO, public trust is at the heart of the response. Health authorities are particularly trying to prevent people with symptoms from feeling too afraid to report themselves or refuse isolation.
“Every emergency, every epidemic begins in a community and ends in a community,” reminds Dr Belizaire. “If we don’t have this community trust, no matter what actions we take, they will not be accepted.”
The WHO insists on a participatory approach based on lessons learned from previous outbreaks in the region. “We are not going to come and dictate our science…but rather work with them,” she explains.
Lessons learnt
The WHO aims to bring the response to the community, drawing lessons from previous outbreaks where many families hesitated to report cases or let their loved ones go to treatment centres.
Care and monitoring structures must be set up as close as possible to the affected populations to ensure care for confirmed patients, monitor suspected cases and contacts, and maintain links with families.
“Families could visit their patients who are hospitalised in these treatment centres,” emphasizes Dr. Belizaire.
According to her, the objective is to ensure comprehensive management including medical care, psychosocial support, and food needs for patients, while also supporting families and contacts followed as part of the response.
‘A Complex Security Context’
The outbreak is evolving in a region marked by insecurity, population displacement, and high mobility linked to mining areas.
These factors complicate early case detection, contact tracing, and the rapid implementation of control measures.
Delivering aid also represents a major logistical challenge. “We are working with other partners to facilitate the transport of equipment by air,” says Dr. Belizaire. More than 11 tonnes of equipment have already been shipped to Bunia to support the response.
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The WHO considers the experience gained during the 2018–2020 Ebola outbreak in this same region – which was contained despite a similar security context – to be a major asset. “This is not the first time (…) we have already had outbreaks in this region and they were controlled,” recalls Dr. Belizaire.
Challenges of rare strain, no vaccine
Unlike the Zaire strain, which is more frequent, more virulent, and causes more regular epidemics, the Bundibugyo strain remains poorly understood and currently has no licensed vaccine or specific treatment.
“We have to find the right formula to explain to the community that the vaccine you received in 2018, 2020 only protects you against this [Zaire] strain. And now, you are not protected against this one,” she explains.
Drawing on her extensive field experience responding to Ebola outbreaks across Africa, Dr. Belizaire notes that discussions have already begun within the WHO research and development programme to accelerate potential medical developments.
Research efforts had previously focused on the Zaire strain, which is responsible for the most frequent Ebola outbreaks and for which vaccines and therapeutic tools are now available.
Self-protection
The WHO says several simple measures should be adopted on a community level to limit the risk of transmission: avoid any contact with the bodily fluids of a sick or deceased person, and rigorously apply hygiene measures, notably regular handwashing.
The health agency also stresses the importance of promptly reporting any suspected case and consulting a health centre without delay if symptoms appear suddenly, including “a high fever, great fatigue, muscle aches,” as well as vomiting or diarrhoea.
Dr. Belizaire also insists on the importance of allowing health teams to conduct contact tracing in communities as soon as a suspected case is reported, as well as the need to protect health workers.
Those who are sick also need to be protected from feeling stigmatized. Rely only on information coming from health authorities, she warns, and avoid rumours “which can really complicate the response and put their lives in danger.”
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