Since the start of the 10th Ebola epidemic in the country’s eastern region almost two years ago, the DRC has faced the second-largest Ebola outbreak in history, with over 3,400 cases and 2,200 deaths. In this fight, the Congolese government has understood the importance of investing in more robust health systems and reliable surveillance tools to deal with the epidemic. The fight against Ebola shows how difficult it is to contain this kind of outbreak.
Professor Jean-Jacques Muyembe, the eminent Congolese virologist who discovered the Ebola virus in 1976 and who is leading the national response to Ebola and COVID-19 in DRC, answers our questions.
What are your takeaways from the past two years combating the Ebola virus, and how can you use this experience to eradicate COVID-19?
We actually thought we could announce the end of the 10th Ebola virus outbreak on April 13. Unfortunately, a new case was detected two days earlier in Beni. The teams had to remobilize in the field to deal with the resurgence of the epidemic. Meanwhile, we recorded the first COVID-19 case in the capital, Kinshasa, on March 10. So far, the coronavirus is mainly concentrated in Kinshasa, with just a few cases reported in the Ituri, Nord and Sud Kivu, Kwili, Haut-Katanga, and Kongo Central provinces.
I think that the eastern provinces will be able to apply the lessons learned from their experience fighting the Ebola virus. This has already been borne out by the speed with which the authorities have reactivated all the mechanisms that we had put in place to fight Ebola: the surveillance system and the communication system to mobilize people and engage communities. We are more concerned about the less-prepared western provinces. The introduction of the virus in these regions could spell disaster. But, generally speaking, we are optimistic. The DRC is capable of dealing with this COVID-19 epidemic.
Well, some of the measures to fight the Ebola virus worked, while others didn’t. What advice would you give to other countries about the pitfalls to avoid in this type of epidemic?
Don’t declare victory too early. We must not think that, just because we have made significant strides in combating Ebola, it will be easy to beat COVID-19. But we can see similarities in the response strategies.
We have seen the importance of community engagement and awareness-raising campaigns to get people to understand the gravity of the situation and get involved. And community-based organizations, traditional leaders, and opinion leaders play an instrumental role in these mobilization efforts. People must become aware of this disease and understand how to avoid it and not spread it.
It is also important to take each country’s specific context and customs into account when implementing measures adopted by the public authorities. The African way of life sometimes differs from that of other cultures. We must bear this in mind to adjust our COVID-19 response strategies, whether they relate to applying lockdown measures or practicing social distancing. One of the important lessons learned from the Ebola response is that response teams also need to work with traditional leaders from the outset, because they serve as critical links to the communities.
One of the challenges with the Ebola epidemic has been the provision of emergency assistance in fragile, insecure provinces. How can the health system be strengthened and frontline response teams supported?
Most of Africa’s health systems are extremely fragile, and epidemics such as Ebola and COVID-19 only underscore this fact. Our previous experiences have shown us that if we hope to succeed, the mainstay of our strategies to combat epidemics in general and Ebola in particular must be the existing health systems, which should be strengthened when epidemics surface. This is critical, and it must not be allowed to weaken the national health system.
National leadership in the response, which is recognized by everyone and supported by all partners, is another extremely important aspect of health emergency management.
What type of support has the international community provided to combat Ebola? And what are your expectations of development partners for the coronavirus response in the DRC?
The Ebola virus response in eastern DRC was a prime example of the importance of partnerships. Each partner played its role. The WHO assumed responsibility for epidemiological surveillance and vaccinations, while the United Nations took care of logistics, transportation, and security. The World Bank marshaled the necessary financing to the tune of almost $300 million to support the Ebola response strategy, including financing for primary health care and the supply of essential medicines in virus-affected areas, and provided technical assistance to the coordination team and the health system. We were all committed, with each institution leveraging its area of expertise and comparative advantage, and we all worked together to achieve tangible results.
As part of our COVID-19 response, we have implemented a plan valued at $135 million, almost 75% of which has already been mobilized. I would like to wholeheartedly thank the partners who are supporting us in these difficult times. The COVID-19 health crisis is frightening because the countries that usually help us are themselves grappling with the pandemic. Added to this are the challenges related, for example, to flight suspensions and border closures that make the prompt supply of protective medical equipment difficult. These are some of the challenges that we face and that require everyone to get involved.
This health crisis is very quickly morphing into an economic and social crisis because of the lockdown, the decline in international trade, the hike in staple food prices, and the fall in revenues. We have proposed a plan that will be based primarily on subsidies to access such basic social services as health and food, and microcredits to support the informal sector, which accounts for more than 80% of the Congolese economy. This will certainly require additional resources in the form of budget support to revive the economy. That’s why we are calling on technical and financial partners such as the World Bank to support these efforts, which would also strengthen the solidarity fund launched by the head of state.
With the Ebola epidemic and now COVID-19, we have seen rumors and fake news circulating, especially on social media. How can communication be improved to stem the spread of this misinformation and improve public understanding?
Social media is a double-edged sword. While we were tackling the Ebola epidemic in the eastern region, social media really helped us track the public’s response so that we could know in real time how our messages were being received. Unfortunately, social media also spreads misinformation that goes viral, and this significantly disrupted the response effort.
In my opinion, the best way to address this issue is first for us to occupy these spaces by developing credible, dynamic, and popular multimedia platforms and then establish teams of professionals to track this fake news, refute it, and correct it in real time. The same approach that we adopted to combat the virus must be used to combat this misinformation, because the epidemic response must be based on reliable and scientifically proven information.