New Delhi: As the world battles the coronavirus pandemic with a rising death toll, the entry of the virus in the epidemic-prone Democratic Republic of Congo (DRC) has posed even graver concerns given it was already dealing with cholera, malaria, measles and ebola.
As of 30 March 2020, ebola virus disease (EVD) had claimed 2,264 lives in Congo — the second largest outbreak of the disease on record that began in August 2018. The tenth time an EVD outbreak took place in DRC, it was finally declared a public health emergency of international concern on 17 July 2019.
While the last ebola patient was reportedly discharged on 9 March 2020, the country continues to run a high risk of the virus from reemerging. The World Health Organization presses on this concern, noting that to declare a region EVD-free, “heightened surveillance and response activities should be sustained during, and for at least 6 months beyond, the initial 42-day period”.
The WHO also advises restriction of travel and trade with the DRC, though no country has put such restrictions in place.
Cholera and measles outbreak in DRC
The cholera and measles outbreak in DRC moved hand in hand with 31,000 cases of the former and nearly 100,000 suspected of the latter. Cases of cholera, which began in early 2016, are most prevalent in 20 of 26 provinces, with Haut-Katanga, South Kivu, Tanganyika, Haut-Lomami and North Kivu being the most affected. Incidentally, North Kivu was also a hotspot for ebola.
With the help of the WHO and The Vaccine Alliance GAVI, DRC has vaccinated 350,000 people, as of 1 June 2019. As many as 260 people have reportedly died of cholera in Congo.
More than 6,000 people have been killed by the measles epidemic in DRC and 310,000 infected, according to the WHO. The epidemic began in 2019, and a vast majority of its victims are children. While a two-dose vaccine for measles has been available since the 1960s, the DRC has not been able to eradicate it.
What has proven to be the largest and fastest growing epidemic in the world, can be credited to “a low vaccination coverage among vulnerable communities, malnutrition, weak public health systems, outbreaks of other epidemic-prone diseases, difficult access by vulnerable populations to healthcare and insecurity that has hampered response in some areas”.
The DRC also has the largest number of malaria cases in the world, second only to Nigeria, accounting for “11% of the 219 million cases and 435 000 deaths from malaria in 2017”.
A malaria control campaign was launched, targeting 4,50,000 people in the Northern Kivu province town of Beni. The province has been the epicentre for other viral diseases such as ebola and cholera.
The campaign was aimed at helping “reduce the pressure on the overall health system, which is currently striving to protect people from the ongoing Ebola threat in the region,” according to Dr Yokouide Allarangar, WHO’s Representative to the DRC.
The country had the highest number of cases in all of Central Africa and accounted for “13% of deaths in children under 5 years of age and 19% of deaths in children aged 28 days – 12 months old”.
‘Coronavirus will divert the available national health capacity’
“Coronavirus will most likely divert the available national health capacity and resources, and leave millions of children affected by measles, malaria, polio and many other killer diseases,” said UNICEF Representative Edouard Beigbeder, speaking from the capital, Kinshasa.
So far, Covid-19 has infected 100 people and claimed eight lives in the DRC. The country’s fight against measles, malaria and cholera hardly received any international attention, though the same cannot be said for the ebola outbreak. But the attention it did receive “had unfortunate side-effects as resources to fight childhood killers like measles, cholera and malaria, instead went towards stemming the disease”.
With coronavirus dominating headlines across the world, it is to be seen how Congo will deal with it.
Currently, less than six per cent of the country’s annual budget is allocated to public healthcare systems. With the United Nations International Children’s Emergency Fund (UNICEF) calling on the Congolese government to make changes that will better protect its pregnant women, newborns and young children, prioritising “the strengthening of routine immunization” is essential.
Xavier Crespin, the agency’s Chief of Health in the country, suggests, “Instead of expending huge efforts and resources on an ad hoc response to individual health emergencies, those same resources should be directed towards strengthening the national health system.”