United Nations officials on Thursday named an emergency Ebola response coordinator to help bolster efforts to contain the growing outbreak in the eastern Democratic Republic of the Congo that has killed more than 1,200 people in 10 months.
David Gressly, the U.N. deputy special representative for the Democratic Republic of the Congo, has been appointed to the new position, in which he "will oversee the coordination of international support for the Ebola response and work to ensure that an enabling environment -- particularly security and political -- is in place to allow the Ebola response to be even more effective," according to a statement from the World Health Organization, the global health arm of the U.N.
“The Ebola response is working in an operating environment of unprecedented complexity for a public health emergency -- insecurity and political protests have led to periodic disruptions in our efforts to fight the disease," Gressly said in a statement Thursday. "Therefore, an enhanced UN-wide response is required to overcome these operating constraints, and this includes moving senior leadership and operational decision making to the epicenter of the epidemic in Butembo. We have no time to lose."
Gressly will work closely with the WHO, which will continue to lead all health operations and technical activities in support of the Congolese government's response to the Ebola epidemic.
“This system-wide and international support is exactly what WHO has been calling for," Dr. Ibrahima Soce Fall, the WHO's assistant director-general for emergency response, said in a statement Thursday. "We know that the outbreak response must be owned by the local population, and this new approach reflects what they have asked for: better security for patients and health workers, wider access to vaccination, and a more humane face to the response.”
A total of 1,866 people have reported symptoms of hemorrhagic fever in the Democratic Republic of the Congo's northeastern provinces of North Kivu and Ituri since Aug. 1. Among those cases, 1,778 have tested positive for Ebola virus disease, which causes an often-fatal type of hemorrhagic fever, according to Wednesday night's bulletin from the country's health ministry.
A third of those who have fallen ill are children, which is a higher proportion than in previous Ebola epidemics, according to the WHO.
The current outbreak has a case fatality rate of about 66 percent. There have been 1,241 deaths so far, including 1,153 people who died from confirmed cases of Ebola. The other deaths are from probable cases, according to the Congolese health ministry.
The vast majority of cases have been recorded in the cities of Katwa, Beni, Butembo and Mabalako in North Kivu province.
So far, no cases have spread beyond North Kivu and Ituri provinces, nor across international borders. But the risk of national and regional spread remains "very high," according to the WHO.
The confinement of the virus to the two affected provinces has been aided by an experimental Ebola vaccine developed by American pharmaceutical company Merck. Since Aug. 8, more than 121,000 people have been vaccinated against Ebola in the outbreak zone in the Democratic Republic of the Congo, along with health workers in neighboring Uganda and South Sudan, according to the WHO.
However, access to communities is hampered by ongoing security issues in the region and community mistrust in the Ebola response.
North Kivu and Ituri, the two provinces where people have been infected, are awash in conflict. Health workers and other frontline personnel are being targeted in sporadic attacks from armed groups operating near the country's volatile, mineral-rich border with Uganda. This is the first Ebola outbreak in history to occur in an active war zone.
Response teams are also grappling with a population that's very mobile and has never faced an Ebola outbreak before. A quarter of people interviewed in the cities of Beni and Butembo in North Kivu province during a survey last September said they didn't believe the deadly virus was real, according to a study published in The Lancet Infectious Diseases journal in March.
Moreover, this outbreak came amid a fresh wave of violent political unrest over a long-anticipated election to replace the country's leader of 18 years. The turmoil peaked in late December when the Congolese government postponed voting in certain Ebola-hit communities.
This is the 10th outbreak of Ebola virus disease in the Democratic Republic of the Congo and the most severe seen in the Central African nation since 1976, when scientists first identified the virus near the eponymous Ebola River.
It's also one of the worst outbreaks ever, second only to the 2014-2016 epidemic in multiple West African nations that infected 28,652 people and killed 11,325, according to data from the U.S. Centers for Disease Control and Prevention.
The WHO has twice decided not to declare the current outbreak a public health emergency of international concern, as it did for the West African epidemic. The proclamation would mobilize more resources and command global attention.