Lack Of Funding Takes Major Toll On Ebola Response

A festering civil conflict fueling rampant fear and distrust has been a major obstacle in the World Health Organization’s efforts to end the Ebola outbreak in the Democratic Republic of Congo (DRC). But now, funding shortages could further cripple the already strained response – unless the global community steps up quickly, Director-General Dr Tedros Adhanom Ghebreyesus warned yesterday.

The WHO Director-General spoke in the wake of a visit by a high-level WHO delegation to DRC last weekend, following the death of a WHO staff member Dr Richard Mouzoko, in an attack by armed gunmen on Butembo University Hospital on 19 April.

Dr Matshidiso Moeti greets Ebola responders during a WHO delegation trip to Butembo over the weekend of April 27-28.

Only about half of the approximately US$ 148 million that had been budgeted for the current stage of response activities (February-July) through the global Contingency Fund for Emergencies (CFE), has actually been received, a WHO spokesperson told Health Policy Watch.

“Only US $83 million have been received …out of a total requirement of US $148 million,” the spokeperson said. “Moreover, there are now additional costs not envisaged – for example, the cost of re-building treatment centres destroyed during attacks – which means that the overall gap is significantly bigger. For example, WHO alone needs US $30 million immediately.”

Established by WHO member states in 2015 to fund immediate responses to global health crises, the CFE has faced financing challenges that have limited its effectiveness during the ongoing Ebola crisis.

Without adequate financing, WHO and other Ebola response partners will face severe challenges in covering the costs of healthcare workers, medical supplies and security required to provide both an adequate response to the DRC outbreak as well as ensure security of responders.

“We are entering a phase where we will need major shifts in the response. WHO and partners cannot tackle these challenges without the international community stepping in to fill the sizeable funding gap,” warned Dr Tedros in a WHO statement, released after returning from the high-level visit.

“Dr Mouzoko’s death moved me profoundly. On this mission, he was on my mind the whole time as we met with other dedicated colleagues. I am also profoundly worried about the situation. Cases are increasing because of violent acts that set us back each time. We have already begun to adjust our response.”

A total of 970 deaths and 1480 cases, confirmed and probable, had been reported as of 29 April, with a case fatality rate of 65 percent, according to the latest Ebola situation report.

The number of new cases of the virus, which had been declining, began to rise again about two months ago in the wake of a series of attacks on Ebola treatment facilities maintained by the government and supported by WHO and Médecins Sans Frontières.

The uptick in the rate of infections since then can be attributed to the ways in which the attacks slow down response activities, the WHO statement acknowledged. The process of identifying Ebola patients’ contacts; carrying out vaccinations of those exposed; and bringing in suspected Ebola cases for diagnosis and treatment is impeded when communities are already fearful, due to the ongoing civil unrest in DRC’s North Kivu region between rebel groups and the government.

Armed groups that have resorted to violent attacks against facilities and officials, have also sometimes claimed that the Ebola crisis is just a political ploy. The attack on Butembo University Hospital on 19 April injured two people as well as killing Mouzoko, a Cameroonian epidemiologist deployed by the WHO. Dr Mouzoko is among several others who have died while working to stabilize the crisis.

In the wake of Dr Mouzoko’s killing, Dr Tedros along with WHO Regional Director for Africa, Dr Matshidiso Moeti, visited Butembo to express gratitude to Mouzoko’s fellow responders for their continued efforts, despite the series of violent events and dwindling funds.

“We found it very important to be with them in this very painful moment after they have lived through the murder of one of our colleagues. We are absolutely determined to remain here, and I was really very touched by their commitment despite the pain they have lived through,” said Dr Moeti, speaking in a WHO video filmed during the trip.

The delegation also met with local Butembo political, business and religious leaders, and called on them to accelerate their efforts to stabilize the security situation.

“We need the security situation to be under control for them and for the local people. During our mission, we had fruitful discussions with the partners who provide security cover to see what more could be done. Meanwhile, we will continue to work with various groups and embed our response at the community level,” Dr Moeti added in yesterday’s WHO statement.

But without sufficient financing, WHO and its partners will face even greater challenges in maintaining an already overwhelmed response programme.

“We will continue to adjust the response, as we have done for each context in each community,” said Dr Moeti. “This worrisome rise in cases is a further call to action. […] We can only defeat it if we all work together.”

Image Credits: WHO.

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