Ending Ebola Provides Lessons For COVID-19 Response

Today the government of the Democratic Republic of the Congo (DRC) declared the end of an Ebola outbreak in the eastern part of the country that began almost two years ago and cost far too many lives and livelihoods.

In total there were 3,470 cases and 2,287 deaths, and many more people suffered because of the impact on access to other health services, like routine vaccination. As the DRC battles a new outbreak of Ebola in the west of the country while also confronting the COVID-19 pandemic, here are five key takeaways from the outbreak that I believe can inform future responses:

Health workers are the heroes of every outbreak response

Stopping Ebola is hard. Stopping Ebola in the midst of conflict is brutally difficult.

The outbreak response was severely hampered by attacks on health workers. Since August 2018, WHO documented 420 attacks on health facilities in the DRC and this prolonged the outbreak.

I visited DRC ten times during this outbreak in order to stand with my sisters and brothers and commend them for their bravery and professionalism in the face of almost impossible odds. As I traveled throughout the region to review the response, I heard heart-wrenching stories of frontline responders escaping death by hiding under beds or by riverbeds until it was safe for them to move. The mental toll for those who had lost close friends was clear.

I will never forget learning of the death of Dr. Richard Valery Mouzoko Kiboung. Richard was an WHO epidemiologist deployed from Cameroon. He was tragically, senselessly killed during an attack on a hospital in Butembo in April 2019, leaving behind a beautiful family and many bereft friends and colleagues.  

To all those on the frontlines, including those who paid the ultimate price, there is no way that I can adequately express my deep gratitude for your service to public health and humanity. Health workers should never be attacked. As the world enters a dangerous phase in the COVID-19 response, this is why I and other United Nations leaders call on all countries to commit to a global ceasefire.

When there’s health, miracles can occur amid chaos

The outbreak took an immense toll on WHO, government employees and on the people of eastern DRC. Despite the hardship, there were moments that reaffirm why health matters – why health services must be expanded, improved and defended. In 2020, it is shocking that hundreds of millions of people still have no access to quality health services.

In January 2019, when cases of Ebola were rising in DRC and threatening to spread across the region, I remember this baby girl, born healthy to a mother who had recovered from Ebola. Sylvana was a message of hope. Her story energised the whole WHO team.

“If you want to go fast, go alone. If you want to go far, go together.”

I want to acknowledge the strong leadership of the DRC’s Government and Ministry of Health, as well as the partnership of multiple organizations. From the outset of the outbreak, WHO worked with the Global Outbreak Alert and Response Network (GOARN) on international alert and risk assessment, strategic planning, and weekly operational coordination; as well as on deployment of additional technical support and expertise.

Major GOARN partners directly operational in the field included: Alliance for International Medical Action (ALIMA); International Federation of Red Cross and Red Crescent Societies (IFRC), and the Red Cross of the Democratic Republic of the Congo (DR Congo Red Cross); Médecins Sans Frontières (MSF); Africa Centers for Disease Control and Prevention (Africa-CDC); US Centers for Disease Control and Prevention (US-CDC), UNICEF; and the International Organization for Migration (IOM). 

By joining together – and engaging communities – we were able to end the outbreak. I am grateful for all that our partners did to save lives in one of the toughest Ebola outbreak settings the world has ever faced.  

 As we are now seeing with COVID-19, the world will only be safe when we are all safe. The pandemic exploits any and all cracks in solidarity. United, we need to accelerate the science, find solutions to overcome bottlenecks and share lessons learned and best practices so that they can be scaled up quickly to save more lives. I urge countries, companies and civil society to work together in partnership against COVID-19. I know it’s not always easy, but it is the best chance we have of overcoming this pandemic and building a better and safer world for all.

Continual learning and innovation are key 

In most outbreaks, you typically begin on the back foot, playing catch up with the virus. The key is to learn as you go; to fine-tune the response as it progresses and carry lessons over to future outbreaks.

Following on from the Ebola outbreak in West Africa, where there were very few tools for us to respond with, an Ebola vaccine was developed by hard-working researchers, including those in the private sector. The safe and effective vaccine was accessible to those most at risk in the eastern DRC outbreak and was an integral part of the response.  Combined with strong community engagement and improved contact tracing, including technology like Go.Data, the outbreak was slowed before ultimately being suppressed.

A similar fusion of technology and boots-on-the-ground outreach can improve surveillance and contact tracing for COVID-19, which is key to identifying where the virus is hiding and slowing the spread to protect health systems and save lives.

Ebola and COVID-19 demonstrate the need for Universal Health Coverage

Since January 2019 more than 6,870 people – mostly children –died in the DRC as a result of one of the world’s largest ongoing measles outbreaks. While fighting Ebola, WHO and partners have vaccinated millions there against measles. I have engaged communities and listened to their concerns about health, poverty and overall development and one thing is clear: everyone wants to be able to access quality health services.

Global health is only as strong as its weakest link. Whether it’s Ebola, COVID-19, measles or another pathogen, universal health coverage is our best defense. This means investing in surveillance, the health workforce, and primary health care as key components to ensuring quality health services for all. 

 I commend the Government of the DRC and all partners for their efforts to end one of the most challenging Ebola outbreaks ever seen. We should celebrate this moment, but we must resist complacency. Viruses do not take breaks and we must build on this momentum to stop the latest Ebola outbreak in the west of the DRC. During this critical time, I call for national unity there as well as solidarity around the world so we can ensure equitable access to new health technologies, suppress COVID-19 and build back better in the future.