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The Ebola outbreak that began in the Democratic Republic of Congo is becoming a continental crisis after authorities initially underestimated its spread, the head of Africa’s public health agency told Semafor, as new cases were reported as far away as Nigeria.
More than 4,600 people have died in the outbreak of the Bundibugyo strain that was first detected in the Democratic Republic of Congo in May, although health experts believe it had been circulating undetected for weeks. The Ebola outbreak has now spread further across Africa than any previous outbreak, with cases in the central, eastern and western regions of the continent. Nigeria, Africa’s most populous country, confirmed its first case of the Bundibugyo strain, for which there is no proven vaccine, although it was absent from the agency’s initial list of 15 at-risk countries, he said. Kenya reported nine cases while Uganda, which recorded 20 cases, was declared Ebola-free in August.
“We could see every region of Africa affected, and that’s starting to happen,” Jean Kaseya, director general of the Africa Centers for Disease Control and Prevention, said in an exclusive interview. He said the outbreak had initially been seen as less dangerous and easier to contain, and there was little expectation that it would spread to other African regions, which turned out to be wrong.
Ebola is changing the way African governments organize their response, Kaseya said, with Nigeria’s case sparking stronger solidarity across the continent. Ministers of Health, Finance and Transport will meet next week with invited regional organizations to discuss national and cross-border measures.
Kaseya said he expects a response plan dividing responsibilities between regional organizations and other partners to be ready by then, ahead of a summit of African leaders where he hopes to secure financial commitments.
As Ebola spreads across Africa, Kaseya has warned of closing borders to contain it. “We do not recommend closing the borders,” he said, arguing that this measure had already proven ineffective. “People will start to take informal and unofficial routes, and they will continue to cross.”
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The patient diagnosed in Nigeria, a woman from Uganda, went about 10 days without a diagnosis. “The patient was in a private facility, then another, without being tested,” Kaseya said. This delay presents a greater risk of spread than in Kenya, he said. Kenya isolated its first patient shortly after arrival.
The Nigerian government has committed to funding the response, Kaseya said, without specifying an amount. The Africa CDC sent a team to support Nigeria’s response, where Kaseya said humanitarian partners must report their funding and activities to the government.
Nigerian Health Minister Muhammad Ali Pate said authorities had found no evidence the virus had spread in communities. “This is a unique case and we are working diligently to ensure it remains unique,” he told reporters at a news conference Thursday evening.
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The spread of the Bundibugyo strain comes amid severe cuts to Western aid budgets, prompting health experts to say a lack of resources was reducing the presence of health workers on the ground, slowing the response to the outbreak.
Jullien Harneis, the UN’s senior Ebola coordinator, said the growing scope of the outbreak required more teams, coordination and logistical support. “Its geographical distribution constitutes a real management challenge,” he explained to Semafor.
The Africa CDC warned last week that humanitarian organizations had failed to report more than $700 million in donor funding to Congolese authorities. He has supported government sanctions, including withdrawal of authorization to operate, against organizations that continue to refuse to account for their funds.
“We have now traced $450 million,” Kaseya told Semafor. “We will never again manage an epidemic in Africa the same way we managed it in the Democratic Republic of Congo,” he said, referring to the funding conflict.
This latest Ebola epidemic is the second deadliest in history after the 2014-2016 epidemic which killed more than 11,300 people, mainly in West Africa. There is no known vaccine against this species of virus, known as Bundibugyo, but Ervebo, effective against another species, is being tested. The Ervebo vaccine has been administered to 9,000 frontline workers.
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African governments should raise more national funds for health through taxation, Kaseya told Semafor last month.
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