This week has seen a heartening triumph of medical science: Ebola is now curable, doctors say. The announcement is also a timely one. The outbreak in the war-ravaged territories of the north-eastern Democratic Republic of the Congo, which began over a year ago, has defied the sustained efforts to halt it. Last month, with the death toll above 1,600 people, the World Health Organization declared it an emergency of international concern. The even deadlier West African epidemic of 2014 killed more than 11,000 people before it was extinguished, having prompted fear around the world. The high death rate and agonising nature of the deaths all add to the virus’s terrors.
So the news that two really effective treatments have been discovered and tested, and that they are being rolled out, could hardly be more welcome. International institutions and Congolese researchers and medics have performed a remarkable, almost impossible feat in trialling these drugs in epidemic conditions.
Just as important as the existence of these medicines, though, is the question of their use and effectiveness. Getting the science right is only the beginning. Ensuring that the drugs are delivered where they are needed and used by those who need them most is a task at least as difficult and now more urgent. The vaccine used in this outbreak came out of the 2014 epidemic – yet its limited success in containing the virus reflects the complexity of this crisis.
The scene of the latest outbreak is a province that has been fought over for the last 25 years by more than 120 armed groups and has seen grotesque human rights violations. Inhabitants have a deep and very understandable fear of outsiders. Those infected often hesitate to seek help from medics until they have been ill for several days – so relatives see someone go into a treatment centre and come out dead. These related factors help to explain the shocking attacks that have killed more than 170 health workers and burned down two treatment centres. The hope is that a virtuous cycle can now be created: when families see so many patients being cured, they will gain confidence in the centres, and spread the word.
Ebola attracts so much more attention than the other scourges of the north-eastern DRC not because it is lethal – violence, measles, cholera and malnutrition all kill more people today – but because it was regarded as incurable, and it potentially threatens outsiders too. In the case of the West African outbreak, this risk prompted huge financial and institutional support to flow into the region. The DRC still needs that kind of backing from outside. But local communities must lead the efforts to build trust in medics, because only they are trusted by the people who are falling sick. Effective drugs are a necessary condition for the epidemic to be beaten, but unless people are willing to go to the treatment centres when they are sick, the hope they raise will be once more extinguished.
