Chronic instability in the Democratic Republic of the Congo threatens to make Ebola and similar crises a recurring nightmare, as the embattled African country lacks the institutional capability needed to tackle such issues.
Ebola is the latest calamity to plague DRC, which is facing over 900 suspected cases of the deadly virus and over 220 suspected deaths. Health professionals fear systems are lacking to address the crisis, as the World Health Organization warned that violence and sweeping internal displacement in the country have made it “challenging” to keep it from spreading. With conflict constantly ripping the DRC apart, it has been unable to build the conditions enjoyed by countries such as the United States that allow officials to quickly address crises.
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“Health systems are critically important, and they need investment,” Dr. David Brett-Major, an epidemiology professor at the University of Nebraska Medical Center, told the Washington Examiner. “What makes that possible is that communities are able to act in ways that allow them to prosper and act without a fear of loss of life or loss of capital.”
“You gotta have safety, security, food. You have to know fundamentally that you can function, you have to be able to have a community that’s able to thrive on all of the usual kindergarten rules,” he said. “It’s certainly true that in complex emergencies, that shouldn’t be minimized in any sort of DRC, that that impacts every aspect of life.”
In recent decades, rampant corruption, civil war, and the Rwandan genocide in its neighbor to the east have been among the factors that have led to nearly 7 million people being displaced. Between 1996 and 2022, warring in eastern DRC led to approximately 6 million deaths.
The country remains embroiled in conflict, as government forces, the ISIS-linked Allied Democratic Forces, CODECO, a terrorist militia operating primarily in the Ituri province, M23 rebels, and other groups grapple for control. M23 is believed to be backed by Rwanda as a group of ethnic Tutsis whose origins are deeply intertwined with the Rwandan genocide. The group has long operated in DRC, but resurfaced a few years ago.
The chaos threatens to make Ebola endemic to DRC, warned Dr. Imamu Tomlinson, the CEO of a $2.6 billion provider called Vituity, which serves over 12 million patients a year. While the U.S. has the ability to orchestrate complicated and holistic responses to potential crises, war-torn DRC does not, he told the Washington Examiner.
“Think about what we went through with COVID, and you know what we had to do from an infrastructure, and from a political, and from an integration standpoint between communities, states, the federal government,” Tomlinson said. “You can imagine if you have unrest, civil unrest, and you know, in some cases, war and violence, how that would decrease the ability to do that well.”
The last major Ebola epidemic occurred between 2014 and 2016, primarily within West Africa, when nearly 28,000 people were infected with the virus. The disease eventually spread to the U.S., the United Kingdom, and Italy, killing over 11,000 people before it died out.
The latest outbreak, the 17th recorded Ebola epidemic in DRC, is believed to have begun around March 27, when the Red Cross said its volunteers seemed to have contracted the virus while working in Ituri, DRC’s most northeastern province, which borders South Sudan and Uganda. The virus flew under the radar for weeks and was not declared a public health emergency by the WHO until May 17. Though it has spread across the Congo and into Uganda, Ebola remains primarily concentrated in Ituri, where nearly 1 million people have been displaced due to conflict, according to the U.N.’s humanitarian office.
Officials have struggled to respond to Ebola, as violence from CODECO, ADF, and other militant groups in Ituri has complicated the situation.
“We cannot build community trust or isolate the sick while bombs are falling,” WHO Director-General Tedros Adhanom Ghebreyesus said earlier this week.
Dangers faced by health workers, scant medical supplies for communities, and multiple attacks on clinics, including in a hospital in Ituri, are a sampling of the difficulties faced by the country’s effort to respond to and contain Ebola, which WHO says has a death rate of between 30% and 50%.
“Conflict and displacement make everything harder,” Tedros said during a visit to DRC on Friday. “I am making a direct appeal to all warring parties in this region: Please declare a ceasefire. No cause, no conflict, no grievance is worth condemning innocent people to death from a preventable disease.”
Brett-Major, who works at the renowned University of Nebraska Medical Center, said the Ebola outbreak holds a critical message.
“There’s a lot to love about living in DRC, but this conflict area in the East is really an issue,” he said.
“The message that communities that are well and resilient have had less issues when things like this occur is an important one, and we keep forgetting to say it out loud,” he warned. “Where is our U.S. and international diplomacy regarding peace and stability in that area — that is the core question every single time these outbreaks enlarge.”
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While DRC will likely continue to grapple with Ebola for at least the near future, Tomlinson said the public in the U.S. shouldn’t be too concerned about the threat it poses to them.
“I don’t think this is a situation where we need to be panicked,” he said. “In Congo and those kinds of places, it can become sort of endemic because of the systems, or maybe the lack of systems that are in place. For America, and other sorts of countries that have more systems and structures in place, more infrastructure, I wouldn’t say that it’s a high threat level.”
