Countries bordering Ebola-hit DRC among the least prepared to fight disease outbreaks

Anne Gulland
Gentile Kahunia (right) and Yvette Katungy (left), both survivors of Ebola, care for twins  affected by the disease at a treatment centre in Butembo, DRC. - Simon Townsley

The countries bordering the region where an Ebola epidemic has been raging for the last year are among the least prepared in the world to deal with a disease outbreak, an independent analysis has found. 

According to a review of countries' disease defences those neighbouring the Democratic Republic of Congo (DRC) scored the lowest in terms of ability to respond to an epidemic. 

This is a huge worry in an area with porous borders and where the Ebola outbreak, first declared last August, shows no sign of slowing down. There have so far been 2,800 cases of the disease, including 1,900 deaths.

Burundi and South Sudan - which neighbour the regions affected - both scored just 30 marks out of a possible 100 in the Joint External Evaluation, a scorecard assessing a country’s epidemic preparedness.

The analysis, carried out by Resolve to Saves Lives, an initiative of United States non-profit organisation Vital Strategies, measures a country’s ability to find, stop and prevent an outbreak and protect its citizens from other public health threats. It is a voluntary, independent assessment used by the World Health Organization. 

Other countries neighbouring the Ebola-affected areas fared better. Rwanda, which sparked international criticism by temporarily closing its border with DRC when three cases of the disease were diagnosed in the frontier city of Goma, scored 59 out of 100 for preparedness. 

And Uganda, which managed to contain the disease after three cases emerged in June, scored 51 out of 100.

Other countries found to be unprepared to cope with an outbreak include Central African Republic - which scored just 26 out of 100 - and Republic of the Congo which scored 28. Both these nations border the DRC but not the regions directly affected by the current outbreak. The DRC itself scored 35 out of 100.

Dr Tom Frieden, president and chief executive of Resolve to Save Lives, said that no country in the world was fully prepared to cope with an epidemic.

"Lower-income countries are much less prepared and this is a risk to these countries and neighbouring countries, but also to the rest of the world," he said. 

The assessment was launched in 2016 and when the first 65 countries were analysed last year just nine nations were found to be well prepared. 

Now, 102 countries have been assessed and the analysis found that in total 28 per cent are not prepared for an epidemic, 57 per cent have more work to do and 15 per cent are well prepared. 

Not surprisingly, countries in the Americas and Europe were best prepared, scoring an average of 87 and 73 respectively.

However, researchers focused on low income countries and have only looked at five countries in the Americas and 15 in Europe. The UK carries out its own assessment of epidemic preparedness. 

Dr Frieden said that shoring up disease defences costs roughly $1 per person per year.

"That's not a lot of money. But if you're a country with 50 million people that's $50 million you may not have. One thing that has become clear is that it's not easy to step up - it's going to take years.

"When it comes to addressing epidemics the world has attention deficit disorder. When there's a crisis resources flow in. But when the headlines fade resources recede. It's hard to get the sustained commitment to building health systems to work and respond to health threats," he said.

Dr Frieden added that he was encouraged that countries in Africa were well engaged with the process and said Tanzania, Sierra Leone, Liberia, Nigeria and Senegal in particular had begun to step up their efforts.

"They have really taken this to heart and worked to improve their level," he said. 

The new scorecards were released as the UK pledged an additional £8 million to countries bordering DRC to help bolster their ability to stop transmission of Ebola.

The funding will deliver more temperature checks at border crossings, support Ebola treatment units, provide clean water and sanitation, and enable engagement with local communities to raise awareness of the dangers of Ebola.

International development secretary Alok Sharma said the funding would help prevent further spread of the disease.

“Livelihoods depend on people being able to cross borders safely so it is essential we continue to put in place the tools to contain Ebola. If we don’t, the outbreak will spread and many thousands more could suffer – ultimately Ebola is a potential threat to us all,” he said.  

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