The political games that punctuated DR Congo's Ebola scourge

There is often little positive news coming out of war-fatigued Democratic Republic of Congo. This week though, the last patient of the latest Ebola outbreak walked out of hospital, discharged and free of the virus.

The event was celebrated with jubilation as the medical community in Beni, North Kivu discharged their last admitted patient whom they declared fully recovered.

Nurses marked the event with song and dance, and awarded the patient, a woman identified as Masiko, a certificate to show that she was free of the disease.
This victory was 19 months and several deaths later.

According to figures from the Congolese ministry of Health, the latest outbreak had killed 2,264, making it the worst in the country.

This was the tenth such outbreak in the DR Congo, and medical experts were warning this week there should be no celebration yet of conquering the virus.

In fact, the World Health Organisation showed cautious optimism, declaring that the last patient discharge was “good news,” but said more will be done to ensure the DR Congo was over the outbreak.

Medically, the country will need at least 42 consecutive days of reporting no new case to declare the outbreak over.

“There are currently zero cases of Ebola in DR Congo after over a year of fighting this outbreak,” declared Dr Matshidiso Moeti, WHO’s Regional Director for Africa.

“[I am] So proud of all involved in the response. We are hopeful, yet cautiously optimistic that we will soon bring this outbreak to an end.”

The story of Ebola started 40 years ago in DR Congo. Yet the epidemic that raged since 2018 was different, in various reasons.

It begun in August 2018 as the DRC prepared for elections that marked the end of Joseph Kabila’s tenure. The disease struck in North Kivu and worsened the security situation prevailing in east of the country. There was an obvious risk of the epidemic running out of hand as politics preoccupied everyone’s mind.

The elections went ahead and the disease ravaged the countryside. In parts of Mangina, in North Kivu, the disease spread to Butembo, Ituri, Beni, Kalunguta. With the danger and political risk involved, authorities decided not to hold elections in the Ebola-hit regions.

With a mortality rate of 66 per cent, this is DRC’s worst Ebola outbreak and the second worst in Africa, after West Africa 2016 epidemic that killed 11,000 people.

On July 17, 2019, the WHO had declared the DRC outbreak a global health emergency, placing the entire Great Lakes region on permanent alert, to include Rwanda and Uganda.

How did the Kinshasa government react?

Months later, after he took power, President Félix Tshisekedi activated plans to stop the deaths in Beni, Butembo, Mangina and Ituri.

His 'pilot' response involved a technical secretariat but led by Dr Jean-Jacques Muyembe, famous epidemiologist and Director General of the National Institute of Biomedical Research.

Dr Muyembe is remembered for pioneering a response to the inaugural epidemic 40 years ago. He is also remembered for leading a research that isolated Ebola as a separate haemorrhagic fever.

Meanwhile, the World Bank had granted DRC some $300 million to enhance the battle. Still, Ebola appeared in need of proper politics, not just money.

In Kivu, health workers encountered resistance from local communities. First there was the rumours: That the emergence of Ebola was suspect. That the quarantine was initiated to lock them out of the elections.

Mbussa Nyamwisi, a local politician and former minister who was leading the Forces for Renewal Party and a member of the Lamuka Coalition criticised the handling of the crisis.

Locals in Ebola-hit areas alleged that health workers arriving in droves were “foreign agents” and that recovery centres were actually death centres. There was violence and militia groups sporadically targeted these centres.

Dr Valery Mouzoko Kiboung, a Cameroonian epidemiologist, who was killed in such an attack on Butembo University Hospital. There were more than 100 incidents of violence in the provinces of North Kivu and Ituri, hampering recovery efforts.

It was months before WHO Director General Tedros Adhanom Gebreyesus called for the involvement of political leaders.

He said "committed political leadership is the only way for communities to understand the threat of Ebola and to get involved to end the epidemic,” he said in a statement.

Ebola’s politics though transcended DR Congo. The question of the vaccine and its availability soon became the talking point. When the president appointed Dr Jean-Jacques Muyembe to pilot "the response," the then Minister of Health Oly Ilunga resigned from his post.

His reasons were that some “actors who have demonstrated a manifest lack of ethics” were hampering the fight against Ebola.

Dr Ilunga, a Belgian-Congolese, had in fact opposed the introduction of a second vaccine in the fight against Ebola by a global pharmaceutical and hygiene products company. Ilunga did not name the company in his resignation, but that tag was immediately linked to a US pharmaceutical giant.

“There has been strong pressure for several months to implement a new experiment in the DRC," he had said in the resignation.

A further bulletin from the Ministry of Health concluded: "the only vaccine to be used in this epidemic is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck.”

Nineteen months later, the DRC may have paid dearly with lives and money, mostly because of political lethargy. But it showed Big Pharma may flourish in this type of chaos.