Tag: DRC

1000 Deaths and Rising: The Complexity of DR Congo’s Ebola Outbreak

by pragmaticsolidarity, posted in APHA IH Section, Conflict and Health, Infectious Disease

The Ebola epidemic in the Democratic Republic of Congo (DRC) has officially taken the lives of over 1000 individuals, according to the country’s Ministry of Health. These statistics, which were released at the end of last week, have been accumulating since the outbreak’s onslaught in August 2018. This occurrence is considered the second deadliest in the history of this Filoviridae Virus in the world and the deadliest in the DRC. This specific incidence afflicting humanity is often referred to as the Kivu outbreak due to the initial emergence in this northeastern DRC province; however, the identified virulent strain is the Zaire Ebola Virus which happens to carry the highest rate of mortality of all strains.

The following is an up-to-date timeline of the current Ebola outbreak’s transition to an epidemic:

  • August 1st, 2018: The DRC’s Ministry of Health declares an Ebola outbreak in Mangina, North Kivu
  • August 7th, 2018: Laboratory findings confirm this outbreak is caused by Zaire Ebola
  • October 17th, 2018: World Health Organization (WHO) convenes a meeting about the Kivu outbreak. WHO declares this situation does not constitute the classification of a “Public Health Emergency of International Concern”
  • October 20th, 2018: An armed attack occurs in Beni, Kivu at a health care facility leaving 12 people dead
  • November 9th, 2018: The number of cases in DRC reaches 319 which marks the largest outbreak in the country’s history
  • November 29th, 2018: The Kivu epidemic becomes the second largest recorded outbreak of the Ebola virus in the history of the disease on this planet.
  • December 27th, 2018: There is an announcement of postponement of elections in Benin & Butembo which are two largest cities in Kivu.
  • February 24th, 2019: An MSF health care facility is partially burned down and MSF suspends activities in North Kivu by unknown militants
  • February 27th, 2019: A second MSF health care facility is attacked also by unknown militants and the NGO is forced to evacuate staff and suspend all operations in the province of Kivu
  • March 20th, 2019: The outbreak reaches the 1,000 confirmed cases mark of the Ebola Virus
  • April 12th, 2019: WHO holds an additional meeting but finds the Kivu outbreak still doesn’t qualify as a “Public Health Emergency of International Concern”
  • May 3rd, 2019: The number of deaths secondary to the Ebola virus reaches 1000

Although each explicit manifestation of this deadly communicable disease carries with it seemingly insurmountable barriers in the form of human resources, supply logistics, social tendencies, and global support, the Kivu is particularly devastating due to political uncertainty, lack of trust in the health care system, and civil unrest.

Despite the increase in novel innovations for treating Ebola and even a promising vaccine that can prevent the virus virology, the Kivu outbreak continues to surge ahead and torture the human species in large part to a break down of trust in the medical system. The surge has lead to identifying 126 confirmed cases over a seven day stretch at the end of April 2019 in addition to the aforementioned data confirming this outbreak to be the second largest in the history of Ebola. Despite this, the mistrust has amassed in a disbelief that the outbreak even exists. A study conducted by the Lancet in March 2019 revealed that 32% of the respondents believed that the outbreak did not exist in the DRC, it only served as a way serve the elite’s financial interests. Another 36% stated that the Ebola outbreak was fabricated to further destabilize the surrounding areas. With these sentiments, the responders marked that fewer than two-thirds would actually want to receive the vaccine for Ebola. These perceptions of fellow humans provides an additional barrier to overcome for health care professionals in addition to treating a high mortality rate disease in resource limited settings.

While the mistrust in the healthcare system provides a tremendous intrinsic challenge for the DRC, the civil conflict that has targeted Ebola treatment centers delivers a physical and emotional component of the devastatingly uniqueness of this outbreak. With over 100 armed groups thought to be estimated within Kivu province, this has led to widespread violence causing this area to be difficult to maintain access. Due to the high rate of armed groups and the political unrest, there has been 119 incidents of Ebola treatment centers and/or health workers that have been attacked since the start of this outbreak. A few shocking examples include the murder of Dr. Richard Mouzoko who was a Cameroonian WHO physician and the two torched MSF facilities in the northern part of Kivu that were mentioned in the timeline.

The Kivu Ebola outbreak has been unanimously christened one of the most complex humanitarian crises that faces this fragile planet today – the global health community is attempting to treat a disease with a 50% mortality rate, with inadequate but effective evidence-based treatment options in a resource-limited setting, all while in a treacherous war zone. Although these are insurmountable odds, health care professionals across Africa and other parts of the world are addressing the needs of their patients and communities to defeat this ailment. These physicians, nurses, pharmacists, and so many others are generating trust in the health care system at a grass-roots level in the DRC to combat the negative perceptions and the actual outbreak. This example, that the global health community can learn from, highlights the role each person dedicated to global health needs to undertake before an outbreak batters a part of this fragile planet. The vitality of trust can start to be built through having individual/group conversations truly listen to health beliefs, coming in with an open mind to acknowledge local health treatments to complement evidence-based treatment, providing patient centered care that encompasses their culture and values, supporting capacity-building initiatives that allow humanity to act accordingly, investing both time and resources in local public health care infrastructure, and expressing empathy ubiquitously socially and professionally.

Being part of the global health community, it is imperative that this outbreak is adequately supported by humanity. As fellow humans striving towards a healthier society, health care professionals and public health experts must accompany those tormented by the social factors associated with Ebola and the actual virus through global awareness of the situation, an un-stigmatized compassion for those who contract the disease, and a pragmatic solidarity to address this humanitarian crisis.  

MSF Video – HIV/AIDS in the DRC

by ihsection, posted in Information and Social Media


The number of HIV-positive people in DRC is currently estimated at more than one million, 350,000 of whom could benefit from antiretroviral (ARV) treatment. However, only 44,000 people are currently receiving treatment, translating into a 15 percent ARV coverage rate, one of the lowest in the world.

Global Health News Last Week

by ihsection, posted in News

May 12 was International Nurses Day.
USAID’s Frontlines magazine is running an exclusive interview with Dr.

Margaret Chan, the WHO Director-General, in which she discusses current global health priorities and systems strengthening.

Peoples-uni, an open-access education initiative, offers open-access resource and online learning materials for capacity-building in low- and middle-income countries.

POLICY

  • Excessive bleeding following childbirth is the leading cause of maternal deaths in the developing world, but the World Health Organization (WHO) has now approved the use of misoprostol, a drug that considerably reduces this risk.
  • Shanghai’s health authority and local hospitals are seeking to reduce the rate of births by cesarean section this year after a recent report showed that far more Shanghai women are undergoing the procedure than is recommended by the World Health Organization (WHO).
  • For the fifth time, at next week’s WHO General Assembly, countries will debate whether or not to destroy the last two known stockpiles of smallpox.
  • The Director General of Nigeria’s drug and food regulator, Dr. Paul Orhii, was in London last week where he lodged a strong case before members states of the World Health Assembly to institute a legal platform to combat the spread of counterfeit drugs.

PROGRAMS

  • Humanosphere’s Tom Paulson writes that funding for childhood vaccinations is not keeping up with the need and is struggling to compete with more high-profile priorities.
  • The phenomenon of “poverty tourism” – in which charities and aid organizations take donors on trips to “experience poverty” and meet their beneficiary – is coming under increased scrutiny and generating controversy.
  • John Donnelly, writing in GlobalPost, characterizes the Obama Administration’s Global Health Initiative as off to “a slow, stumbling start” in a short series called “Healing the World.”
  • Last Wednesday, the WHO launched a campaign to reduce the huge but largely unrecognized burden of traffic deaths and injuries over the next decade.

RESEARCH

  • An HIV-positive person who takes anti-retroviral drugs after diagnosis, rather than when their health declines, can cut the risk of spreading the virus to uninfected partners by 96%, according to a study.
  • New research has revealed that a bacteria present in the gut of mosquitos may be another tool to fight the spread of malaria.
  • An experimental drug helped monkeys with a form of the Aids virus control the infection for more than a year, suggesting it may lead to a vaccine for people, or even a cure.
  • A study by US scientists, published in the American Journal of Public Health, found that 400,000 females aged 15-49 were raped over a 12-month period in the DRC 2006 and 2007. That comes out to an average of 48 women and girls being raped every hour.
  • A new report by MSF argues that switching from using quinine to artesunate to treat malaria could save up to 200,000 lives a year.
  • A US study has suggested that homosexual men are more likely to have had cancer than heterosexual men.
  • According to the findings of the last Pakistan Demographic and Health Survey, getting pregnant soon after childbearing, miscarriage or abortion places mothers and newborns at a higher risk of health complications or even death.
  • Results announced today by the United States National Institutes of Health show that if an HIV-positive person adheres to an effective antiretroviral therapy regimen, the risk of transmitting the virus to their uninfected sexual partner can be reduced by 96%.

DISEASES AND DISASTERS

  • According to statistics released by the National Coordinator of the Nigeria’s National Malaria Control Program (NMCP), Dr. Babajide Coker, Nigeria contributes a quarter of the malaria burden in Africa, and a staggering 90 per cent of its citizens are at risk for contracting the disease.
  • Johnson & Johnson’s recalled at least 11,700 bottles of HIV/AIDS drug Prezista in several countries, after discovering trace amounts of a chemical emitting offensive odors in five batches of products sold in the U.K., Ireland, Germany, Austria and Canada.
  • In China, around 1.5 million people require organ transplants, but just 10,000 receive them each year, as few Chinese agree to donate their organs upon death. Illegal organ traffickers have stepped in to fill that gap.

TOTALLY UNRELATED TO ANYTHING ELSE: Princess Beatrice’s atrocious weird attention-grabbing hat, worn to the royal wedding, is now being auctioned on eBay for UNICEF and Children in Crisis. Um, yay?

Global Health News Last Week (plus interest in a new working group!)

by ihsection, posted in News

Attention IH Section Members: Dr. Kaja Abbas, MPH student at the University of Rochester, is gauging interest in forming a working group focused on using system science to improve global health, similar to the intitiaves being promoted by NIH. Her interests are in conducting system science research on global health policy by modeling population and disease dynamics and economic evaluation of public health interventions and systems, with a focus on HIV and TB. Dr. Malcolm Bryant, our section chair, has encouraged the expansion of our section’s activities in areas of technical expertise, and Dr. Abbas is enthusiastic about a working group within the section that promotes system science methodologies for global health solutions. She welcomes your thoughts and suggestions at kaja [dot] abbas [at] gmail [dot] com.

Global Health Delivery online’s HIV prevention community is hosting a “virtual expert panel” March 7-11 to continue the dialogue around PrEP as a novel approach to prevention. Panelists from Uganda, South Africa and the United States will lead the online discussion, highlighting various barriers and opportunities to implementing PrEP in clinical settings; how to encourage long-term adherence; and what additional research questions need to be answered. Panelists include (1) Douglas Krakower, MD, a fellow in Infectious Diseases at Beth Israel Deaconess Medical Center/Harvard Medical School, (2)Andrew Mujugira, MBChB, MSc, the East Africa regional medical director for the Partners PrEP study, and (3) Vivek Naranbhai, PhD, who was involved in CAPRISA microbicide gel study. All GHDonline members can participate in this online discussion. You can sign up here if you are not currently a member.

POLICY

  • Paramount Chief Mpezeni of the Ngoni people in the Eastern Province of Zambia has urged his subjects to get circumcised in order to reduce the chances of spreading HIV/AIDS and other communicable diseases in his land.
  • Britain is threatening to pull out of the Food and Agriculture Organization due to “patchy” performance.
  • Due to uncertainty in past estimates, the Indian government has formed a 16-member expert group to determine the annual death rate caused by malaria in the country each year.
  • The breakdown of the air conditioning in the plenary hall of the Philippines’ House of Representatives stalled the heated debate of a controversial reproductive health bill. The bill is vehemently opposed by the Catholic Church and pro-life groups and has caused a stir in the largely Catholic country.
  • A massive demonstration rally was held in New Delhi to protest a free trade agreement between India and Europe, which many fear may threaten the production of low-cost generic drugs, particularly HIV medicines.

RESEARCH

PROGRAMS

DISEASES