Via The New York Times, a highly informative article: Congo Draws Up a New Battle Plan Against Ebola Amid Power Struggle. Excerpt:
Faced with an Ebola outbreak that sprawls over a vast swath of the Democratic Republic of Congo, public health officials are conceding that their battle against the virus is failing and have proposed a comprehensive new strategy for ending the epidemic.
The plan envisions reframing the epidemic as a regional humanitarian crisis, not simply a health emergency. That may include more troops or police to quell the murders and arson that have made medical work difficult, and food aid to win over skeptical locals. And Congo will deploy a second vaccine to form a protective “curtain” of immunity around outbreak areas.
The outbreak, which began almost exactly a year ago and was declared a global health emergency this month, is now the second-biggest in history, with more than 2,600 cases and more than 1,750 dead. The outbreak has persisted in part because of a fierce but hidden power struggle for control of the response inside Congo, according to documents obtained by The New York Times and interviews with Ebola experts.
The country’s health minister, Dr. Oly Ilunga, resigned on Monday after a public dispute with donors at a World Health Organization meeting over whether to roll out the second vaccine, which he opposed. The effort to contain the outbreak will no longer be overseen by the country’s health ministry but by an expert committee reporting directly to Congo’s new president, Felix Tshisekedi.
Dr. Ilunga was the target of a scathing internal government report produced in April, just as new cases began soaring above 100 per week. The report was written by a commission convened by Congo’s new president, some of whose members are now overseeing the response.
The report said “arrogant” national health officials took “an aggressive and ostentatious attitude” when they visited the outbreak area, renting deluxe hotel rooms and expensive cars and “brandishing large dollar bills” while local health workers went unpaid.
A spokeswoman for Dr. Ilunga called the report “weak.” She said he had resigned not because of it, but because the president had split the authority to oversee the outbreak response between his office and an independent commission, which she claimed was a violation of the Congolese Constitution.
Dr. Ilunga’s departure pleased some donors and agencies supporting the fight against Ebola. The United States is by far the biggest donor. Tibor P. Nagy, the State Department’s top official for African affairs, told a Senate subcommittee on Wednesday that Dr. Ilunga’s resignation “may be an improvement to the situation.”
The country is seeking $288 million to implement its new Ebola strategy, and is likely to get it. The World Bank recently offered $300 million, and the United States increased its previous giving by $38 million this week.
The new plan may include a campaign to win the hearts of the area’s traumatized population by vaccinating against other diseases, offering hot meals and bulk food, deworming schoolchildren, and even creating thousands of jobs.
International assistance efforts will no longer be directed solely by the W.H.O. and its director general, Tedros Adhanom Ghebreyesus, but by David Gressly, a former head of U.N. peacekeeping troops in Congo who was recently given charge of the entire U.N. response.
The strategy also envisions greater efforts to win the support of local officials, chiefs and religious leaders in the isolated eastern provinces, to negotiate a truce with armed groups, and to persuade people to accept vaccines and go to treatment centers.
Some 500,000 doses of a new Johnson & Johnson vaccine against Ebola will be introduced, and it will be used differently from the current vaccine, made by Merck. While Merck’s single-dose vaccine is used to “ring-vaccinate” everyone around each known case, the new vaccine — which requires two doses given two months apart — will be deployed in areas farther away.
