The WHO is "deeply concerned" about the Ebola outbreak declared in Congo

BarcelonaMore than 300 suspected cases and at least 88 deaths attributable to Ebola. This is the balance that the World Health Organization (WHO) currently makes of the outbreak declared in the Congo. On Friday, the public health agency of the African Union reported the new outbreak, and alarms have sounded because it is feared that it may have a wide geographical spread. The WHO declared on Saturday the public health emergency of international concern, the highest level of public alert that the organization can declare, but this does not mean that the outbreak has become a pandemic. In fact, experts are sending a message of reassurance to the world because the risk of transmission outside of Central Africa is very low.

However, the impact it may have on the region is concerning, where the Spanish government advises against travel. The President of the Commission of the African Union, Mahmoud Ali Youssof, expressed this Monday his "deep concern" about the outbreak, and has asked member states to "intensify support for preparedness, surveillance and rapid response initiatives in the affected and at-risk countries," while the European Centre for Disease Prevention and Control has announced the dispatch of a group of experts to the Congo to provide support in responding to the new outbreak.

The focus is on the Congo, in the Ituri province, bordering Uganda. In Kinshasa, the Congolese capital – 3,000 kilometers from ground zero – a case has already been detected, and South Sudan has also reported an affected person near the border with the Congo. "Probably, the transmission is much wider and more uncontrolled than is known," Quique Bassat, director general of ISGlobal, points out to el ARA. The Ituri province is a region where there are many mines and where most jobs are temporary, which facilitates high mobility among the population. "There is little control over what is happening, and public health prevention measures are fragile and quite dysfunctional," explains Bassat.

Daniela Manno, an associate clinical professor at the London School of Hygiene and Tropical Medicine, also agrees in pointing out that "transmission could have been taking place for several weeks before the outbreak was officially recognized." Speaking to the Science Media Centre (SMC), the expert recalls, however, that the Congo has "extensive experience" in responding to Ebola outbreaks, which has been increasing in recent years.

This is the 17th outbreak the country has faced since the virus was first detected in 1976. Factors such as insecurity in the region, population displacement, and high population mobility complicate surveillance, contact tracing, and healthcare delivery, but the fact that since this weekend the global spotlight has been cast with the WHO declaration will contribute, Bassat points out, to being able to conduct much stricter surveillance and prevent the virus from spreading further: "In the coming days we will see an increase in cases because Ebola will be proactively sought, and more will be diagnosed. It will seem like it is getting out of control, but an increase in diagnosed cases is within the realm of the predictable."

Even so, the reasons for concern, at least regionally, are solid, especially due to the geographical dispersion in detection. Furthermore, there is no approved vaccine or specific treatment for the variant responsible for the new outbreak, which is called Bundibugyo. Until now, it had only been identified in an outbreak in Uganda in 2007 and in another in the Congo in 2012. "It is one of the most serious variants. There is not much difference with those that have caused high mortality so far," explains Bassat, who estimates that the new outbreak will be "similar or worse" than the 2018-2020 one, when 2,280 people died, mainly in the Congo. Now, the figures known about the detected cases align with the mortality attributed to the virus, 30%, even though some experts suggest that the percentage may be higher.

A world less prepared for pandemics

The Ebola outbreak arrives just days after the hantavirus outbreak, which set off all public health alarms, and coincides with the publication of a report by the WHO and the World Bank concluding that the world is increasingly ill-prepared for a potential new pandemic. Despite efforts made during COVID, access to vaccines and other supplies worldwide has regressed.

In the report, experts recall that outbreaks of infectious diseases are becoming increasingly frequent. Despite scientific evidence, investments have not kept pace with the growing risk of pandemics, experts point out, also warning that initiatives focused on improving health responses to threats are undermined by geopolitical tensions, ecosystem disruption, increased global mobility, and cuts in international development aid.

One of the prime examples of these cuts is the United States, where Trump has halted humanitarian aid programs and has withdrawn the country from the WHO. On this matter, the Spanish Prime Minister, Pedro Sánchez, once again presented himself this Monday as the global antithesis to the US president. In his address at the 79th assembly of the United Nations agency, Spain was met with gestures of gratitude from Director-General Tedros Adhanom for its collaboration in managing the hantavirus outbreak. Sánchez, in a clear reference to the United States, criticized countries that cut health and development aid while simultaneously increasing military spending.