Ebola Outbreak: DRC

Part of the debate – in the House of Commons at 4:10 pm on 20th May 2019.

Alert me about debates like this

Photo of Rory Stewart Rory Stewart The Secretary of State for International Development 4:10 pm, 20th May 2019

Ebola is back—this time in the eastern DRC. This is the largest outbreak in the country’s history, the second largest in the world and the first in a conflict zone. So far, 1,209 people have died, and we must do much more to grip the situation. It is not a simple question of virus control. If it were, we could simply repeat what we were able, at huge cost and risk, to do in Sierra Leone and Liberia, and even to some extent what the DRC Government and the World Health Organisation were able to do in Équateur and western DRC over the first six months of last year—that is, to get out into village after village, identify all the cases, trace all their contacts and the contacts of those contacts, and contain the outbreak through preventing further chains of transmission. But this situation is not like that.

This outbreak is in North Kivu, which is the centre of a conflict and is dominated by dozens of separate armed groups, largely outside Government control. Such groups have begun to attack and kill health workers, meaning that key international experts have had to be withdrawn from the epicentre of the virus. The decision not to allow this province to participate in the recent elections—partly on the grounds that it was an Ebola area—has fuelled suspicion that Ebola is a fabrication developed by hostile political forces. As a result, communities are reluctant to come forward when they have symptoms, to change burial practices or to accept the highly effective trial vaccine. The Congolese army and Government, which have successfully contained nine previous Ebola outbreaks over the last 45 years, are struggling to operate in the epicentre of this outbreak, as are the UN peacekeepers and the WHO. Although this area is dangerous and difficult to access, it is not sparsely populated. The epicentre of the outbreak is Butembo, which has a population of 1 million people, and the surrounding areas contain almost 18 million people.

According to all our expert analysis here, the current disease profile poses only a low to negligible risk to the United Kingdom, so this statement should not be a cause for panic here at home. However, this outbreak is potentially devastating for the region. It could spread easily to neighbouring provinces and even to neighbouring countries. I commend all those—both in the Congolese Government and the international community—who are working in very difficult situations to bring this disease under control. My predecessor, the current Defence Secretary, paid tribute to Dr Richard Valery Mouzoko Kiboung, who was killed in an attack by an armed group on 19 April while working on the frontline for the WHO’s Ebola response. I am sure the whole House will join me in expressing our deepest condolences to the family, friends and colleagues of Dr Richard and to all those who have lost loved ones as a result of this outbreak.

We now need to grip this situation and ensure that the disease is contained. As Members can imagine, this has been my key priority in the emergency field since I was appointed to this role just over two weeks ago. I spent the weekend in discussions with UN humanitarian co-ordinator Sir Mark Lowcock and with the Director General of the WHO, Dr Tedros, who has personally paid eight visits to the affected area so far. I have also spoken about the response to the Deputy Secretary-General of the UN, Amina Mohammed. I am pleased to see that there has been a real step-up in terms of the UN staff on the ground regarding co-ordination and the seniority of those staff, particularly in places such as Butembo. Both the Health Secretary and the Foreign Secretary have been supporting this agenda in meetings over the past four days—the G7 health ministry meeting and the WHO meetings in Geneva.

I have convened a meeting with a number of international experts in the field, including Brigadier Kevin Beaton, who helped to lead the UK military response in Sierra Leone and Liberia, and the chief medical adviser to the UK Government. I have concluded, on the basis of their advice, that we need to provide more money immediately, not only to support the frontline response—the health workers—but to support the vaccination strategy and to put more of our expert staff on the ground into the response. This is not just about recruiting doctors. We need people who understand and can work with the DRC Government, the military and even the opposition forces in order to create the space for us to work. We need people who know the UN system well so that they can drive and shape the UN response.

These people need to be not in London but on the ground, because they need to be able to learn and adapt very quickly as the disease spreads. We are already deploying epidemiologists through our public health rapid support teams, in partnership with the Department of Health and Social Care. I am also now considering deploying officials with specialities in information management, adaptive management, anthropology and strategic communications. It is, however, important for us all to understand that this is not a problem that the international community can solve from a distance. This is a political and security crisis as much as a health crisis, and the response must, in the end, be driven by local health workers and leaders.

There are some positive signs. DFID has been a key player in developing a new experimental vaccine for Ebola that is proving highly effective. Over 119,000 doses have been administered in eastern DRC—an achievement that has probably saved thousands of lives. Modelling from Yale suggests that the use of the vaccine has reduced the geographic spread of Ebola by nearly 70%. This is not just about statistics. It is about, for example, Danielle, a 42-day-old baby in eastern Congo who survived Ebola last week thanks to the inspiring work of community volunteers, themselves Ebola survivors, and frontline health workers, supported by UK Aid.

Of course, we cannot do this alone. It needs grip and urgency, but it also needs humility. One of the reasons I have been talking in detail about this issue to Mark Green, my US opposite number, is not only that we share the US’s analysis but that the Americans will inevitably be major players in this response in terms of finance and expertise, as indeed they were in the Liberia Ebola outbreak. We need many more international donors to match our financial contributions and to sustain the international and local health operations in the field. That is why the UK has just hosted an event specifically on Ebola to build support for the response in the World Health Assembly in Geneva. It is also why I have agreed that my colleague, the Africa Minister, should visit eastern DRC immediately.

This is a very dangerous situation where the Ebola virus is only one ingredient in a crisis that is fuelled by politics, community suspicion and armed violence. We need to act fast and we need to act generously. But above all, we need the right people on the ground who are completely on top of the situation and able to come up with quick solutions and to guide us in keeping up the support for—and, yes, sometimes the pressure on—the UN system, on non-governmental organisation, on opposition politicians and on the Government of the DRC to get this done. The stakes are very high. I will keep the House updated on our response.