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Congo’s Ebola crisis threatens to spiral out of control

More than 1,100 people have died from Ebola in the Democratic Republic of Congo. Despite information campaigns, new treatment facilities that reduce disease transmission and an effective new vaccine, the outbreak is spreading because of ongoing violence and residents’ deep distrust of government. Nick Schifrin talks to International Rescue Committee's David Miliband about the growing crisis.

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  • Judy Woodruff:

    Today, the head of the United Nations' health agency called an outbreak of Ebola in the Democratic Republic of Congo one of the most complex emergencies that the WHO has ever faced.

    More than 1,100 people have died from the deadly virus in two provinces along the borders of three countries. That makes it the second worst Ebola outbreak ever.

    But, as Nick Schifrin reports, experts fear the outbreak is increasing and that the virus could soon spread.

  • Nick Schifrin:

    This is all that's left of a health clinic in Democratic Republic of Congo's North-Kivu. A local militia burned it down and threatened the doctors.

    Since January, there have been dozens of deadly attacks on clinics where beds now sit under open sky. In Geneva today, the WHO honored a murdered DRC health worker.

    And Director General Tedros Adhanom Ghebreyesus warned the risk that Ebola could spread to other countries was — quote — "very high."

  • Tedros Adhanom Ghebreyesus:

    We are fighting one of the world's most dangerous viruses in one of the world's most dangerous areas.

  • Nick Schifrin:

    For a quarter-century, the region's residents have fled from armed extremist groups and militias. They attack the military and anyone who collaborates with the government. That means the villages devastated by violence, now also wracked by disease, aren't safe for health workers, allowing the disease to spread.

    International organizations sit with villagers to fight deep distrust of foreign doctors and local authorities. Medical workers treat Ebola victims in new transparent cubes that reduce transmission risk. And they deliver a new, extremely effective vaccine. But it's not working.

    And health workers warn more people will die and the outbreak could spiral out of control.

    And with me now is David Miliband, president and CEO of the International Rescue Committee. He just returned from the Democratic Republic of Congo, where his organization has over 150 people working to combat Ebola.

    David Miliband, welcome back to the "NewsHour."

    The numbers themselves are staggering, 1,000 dead, 1,600 infected, but did you see a situation there that's actually even worse than these numbers suggest?

  • David Miliband:

    Yes, I think it's very important that people understand that, although this is already the second biggest Ebola outbreak in history, and it's the first Ebola outbreak to take place in a conflict zone, which is what the east of DRC is, the real situation on the ground is far more troubling.

    It's not just that the number of cases are probably much higher. It's that the level of violence, including violence directed against health centers,– three International Rescue Committee health centers have been targeted, and they have been — had to have services suspended — that means that there is a real danger of the disease spreading, of the number of cases spiking, and of the kind of upsurge in death rates that we have seen in previous outbreaks.

  • Nick Schifrin:

    I mean, that's alarming. So, from 2013 to 2016, over three countries, we saw more than 11,000 people die. Are you suggesting that that's the way we're heading right now?

  • David Miliband:

    The great danger at the moment is that the number of cases is already rising, but not being recorded.

    The suspension of services doesn't just relate to health centers. It's also affected some of the lab testing. It's also affected a critical part of the prevention and control system, which the International Rescue Committee has been working on, which is the contact tracing.

    Every time you find someone with Ebola, you need to make sure that the 10, 20 people who they may have come in contact with are taking the necessary precautions. And so my great fear is we end up in a situation where we do approach very significantly increased levels of death.

  • Nick Schifrin:

    You talked about violence against doctors, violence against IRC, International Rescue Committee, officials.

    The World Health Organization says there's been 119 attacks on health workers — 85 have been killed or wounded. And, as you know, there's a lot of disinformation about what those doctors are doing. So what's the solution to that right now?

  • David Miliband:

    Well, you're making a really important point.

    This is a battle not just against a disease. It's a battle against fake news and it's a battle for public opinion. Absolutely key, the central lesson of the Ebola outbreaks that have happened before is winning the confidence of the community.

    And what's happened in this case is, clearly, this is an area of historic opposition to central government, and it's an area where the rumor mill about Ebola and how it's being spread is going in precisely the wrong direction.

    We need to reset the response, so that, instead of the engagement of the community coming as the last thing, it's actually the foundation of the response. It needs to be local people who are trained to do the prevention and control. It needs to be local people who are going around with the vaccine, because there is a vaccine in this case — 100,000 people have had it, but many more need to do so.

    Without that, you have this massive trust gap, whose worst suspects are assaults on health service staff, who are only there, after all, to serve local people.

  • Nick Schifrin:

    The trust gap, do you believe that, in part, was created by a failure to engage local communities up front?

  • David Miliband:

    I think the short answer is yes, because 10 months into the disease, the trust gap has got worse, not better. The level of violence has got worse, not better.

    And so there's a very careful coalition that needs to be built. It's a coalition that includes the international organizations like the World Health Organization. It has obviously got to, at some level, include the DRC government and its Ministry of Health.

    But my point is, it has to start, this coalition, with local people. This battle isn't going to be won by jetting in more international aid workers. It's going to be one from the bottom up, with security and trust built from the bottom up.

  • Nick Schifrin:

    You're in New York. Let's talk about the U.S. response for a second.

    The Centers for Disease Control, the CDC, had to pull doctors from North-Kivu last year because it was too dangerous. The CDC says now it has about 17 people. They're trying to increase that. Do you believe the United States government is doing enough?

  • David Miliband:

    In this case, I think one can say with confidence that the U.S. is leading in a thoughtful, constructive, engaged way, and long may that continue.

    I think that the way the USAID team are explaining the work they're doing, the way they're engaging Congress, is all to the good, because it's going to be needed for sometime to come. This is also the message, I think, that's also very important.

    There's no quick fix for this now. The response plan that has been put together by the intelligence community ends in July. And there's no way that this outbreak is going to be over by July. We're going to need the U.S. to play a leading role well beyond then.

  • Nick Schifrin:

    And you are going to need the U.S. to play a leading role, but also the rest of the world.

    The World Health Organization says it has only about half of its requested funds.

    How critical is it in this moment that the world community step up?

  • David Miliband:

    You would expect someone who's running an NGO to come on and say, more money is needed.

    What I'm saying is, the first thing is to reset the response, but then more money will be needed. The response so far has consumed about $140 million. And just to put that in perspective, that's equivalent to the total health budget for the whole of the Democratic Republic of Congo.

    So you're talk about a significant sum of money, by DRC standards, a relatively limited sum of money by international standards.

  • Nick Schifrin:

    David Miliband, president and CEO of the International Rescue Committee, thank you very much.

  • David Miliband:

    Thank you so much.

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