The Democratic Republic of Congo's Ebola outbreak had more than 10 major instances of violence since being declared in August, contributing to new Ebola cases outside of known transmission chains, which calls for a new strategy, according to an op-ed published in The Harvard Business Review.
The op-ed is written by Ranu Dhillon, MD, physician at Boston-based Brigham and Women's Hospital and professor at Harvard Medical School, and Devabhaktuni Srikrishna, founder of Patient Knowhow, which curates patient educational content on YouTube.
Here are four things to know:
1. Eastern parts of the Congo have some of the deadliest conflicts in modern history, with potentially more than 50 armed groups active in the region. These militia groups were originally formed to protect communities, but have been "entangled in the messy web of politics, shifting allegiances and underhanded mining deals that fuel the conflict," the authors write.
2. The CDC aims to stop the outbreak by using a method called "contact tracing," which identifies people exposed to people infected with Ebola for the virus' 21-day incubation period. The "ring" vaccination method then distributes experimental vaccines to those contacts and those close to them. This is the approach that contained the Ebola outbreak in the Western Congo in August.
3. The authors point out contact tracing, ring vaccination and mass vaccination efforts are not effective with the current Ebola outbreak due to the violence. For a mass vaccination to be successful, the authors suggest it would require the buy-in of the communities. Anthropologists are working as neutral mediators between community leaders and armed groups to help communities understand there is not a political agenda and that medical intervention would be to their benefit.
4. Mass vaccination will require a hefty supply of the Ebola vaccine from its manufacturer Merck. The company has already committed to maintaining its supply of 300,000 doses at all times. These vaccines are experimental, but health officials deem the vaccine's potential health risks do not outweigh the threat of contracting the Ebola virus.
"After the West African Ebola epidemic spiraled out of control, many wondered why more aggressive measures were not taken sooner. We may be at a similar make-or-break point in this outbreak," the authors write.
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