Ebola fight has new science but faces old hurdles in restive Congo

A doctor cares for a patient inside an isolate cube at The Alliance for International Medical Action (ALIMA) treatment center in Beni, North Kivu province of the Democratic Republic of Congo September 6, 2018. REUTERS/Fiston Mahamba

By Fiston Mahamba

BENI, Democratic Republic of Congo (Reuters) – When Esperance Nzavaki heard she was cured of Ebola after three weeks of cutting-edge care at a medical center in eastern Democratic Republic of Congo, she raised her arms to the sky with joy and praised the Lord.

Her recovery is testament to the effectiveness of a new treatment, which isolates patients in futuristic cube-shaped mobile units with transparent walls and gloved access, so health workers no longer need to don cumbersome protective gear.

“I started to feel sick, with a fever and pain all over my body. I thought it was typhoid. I took medicine but it didn’t work,” Nzavaki told Reuters in Beni, a city of several hundred thousand, where officials are racing to contain the virus.

“Then an ambulance came and brought me to hospital for Ebola treatment. Now I praise God I’m healed.”

The fight against Ebola has advanced more in recent years than in any since it was discovered near the Congo River in 1976. When the worst outbreak killed 11,300 people in West Africa in 2013-2016, there was no vaccine and treatment amounted to little more than keeping patients comfortable and hydrated.

Now there’s an experimental vaccine manufactured by Merck which already this year helped quash an earlier outbreak of this strain of the virus on the other side of the country in under three months. And there are the cube treatment centers, pioneered by the Senegalese medical charity, ALIMA.

“With this system … where there are not people donning masks, the patients feel reassured and perceive that there is life here,” said Claude Mahoudeau, the coordinator of ALIMA’s treatment center in Beni.

In addition, three experimental treatments have been rolled out for the first time, offering patients additional reason to hope that their diagnosis is not a death sentence.

Yet even the smartest science can do little about the marauding rebel groups and widespread fear and mistrust that could yet scupper efforts to contain Congo’s tenth outbreak of the deadly haemorrhagic fever.

The latest outbreak is so far believed to have killed 90 people since July and infected another 40.

The stakes are high, not just for health reasons. Ebola could complicate Congo’s first democratic change of power, the holding of a Dec. 23 election to replace President Joseph Kabila that is already two years late.

FILE PHOTO: Congolese officials and the World Health Organization officials wear protective suits as they participate in a training against the Ebola virus near the town of Beni in North Kivu province of the Democratic Republic of Congo, August 11, 2018. REUTERS/Samuel Mambo

FILE PHOTO: Congolese officials and the World Health Organization officials wear protective suits as they participate in a training against the Ebola virus near the town of Beni in North Kivu province of the Democratic Republic of Congo, August 11, 2018. REUTERS/Samuel Mambo

REBELLION, FEAR, MISTRUST

The affected North Kivu and Ituri provinces have been a tinder box of armed rebellion and ethnic killing since two civil wars in the late 1990s. Some areas near the epicenter require armed escorts to reach because of insecurity. Two South African peacekeepers there were wounded in a rebel ambush last week.

And last week, authorities confirmed the first death from Ebola in the major trading hub of Butembo, a city of almost a million near the border with Uganda, dampening hopes that the virus was being brought under control.

Insecurity aside, the biggest challenges the government faces could be panic and downright denial, as they were during the catastrophic West Africa outbreak.

“Ebola does not exist in Beni,” resident Tresor Malala said, shaking his head. “For a long time, people got sick with fever, diarrhea, vomiting and they healed. Now someone gets a fever, they get sent to the Ebola treatment center and then they die.”

Taxi driver Mosaste Kala was equally skeptical: “The only people dying are the ones going to the … treatment center.”

Tackling these perceptions will be crucial if authorities are to halt the epidemic.

At a news conference on Saturday, Health Minister Oly Ilunga Kalenga admitted that “community resistance is the first challenge to the response to the epidemic”.

In the district of Ndindi, in Beni, Ebola is spreading due to the community’s reluctance to cooperate with health workers, the ministry says. Some locals have hidden sick relatives or refused to be vaccinated.

The problem, says school teacher Alain Mulonda, many of whose pupils were being kept at home by anxious parents, is that locals have little understanding of Ebola.

“If the population of Beni continues to show this distrust,” he said, “this disease will consume the whole town.”

(Additional reporting by Amedee Mwarabu in Kinshasa and Aaron Ross in Dakar; Writing by Alessandra Prentice; Editing by Tim Cocks, David Evans and Peter Graff)

More than 18 million on AIDS treatment a million more than 2015

A nurse (L) hands out a red ribbon to a woman, to mark World Aids Day, at the entrance of Emilio Ribas Hospital, in Sao Paulo

By Kate Kelland

LONDON, Nov 21 – More than 18 million people now have access to life-saving AIDS treatment, 1.2 million more than at the end of last year, the United Nations said on Monday.

In a report on the AIDS pandemic, which has infected 78 million people and killed 35 million since it began in the 1980s, UNAIDS said the consistently strong scale-up of treatment has seen annual AIDS-related deaths drop by 45 percent to 1.1 million in 2015 from a peak of about 2 million in 2005.

But, as more HIV-positive people live longer, the challenges of caring for them as they get older, of preventing the virus spreading and of reducing new infections are tough, UNAIDS said, even though drugs can reduce virus levels in a patient’s blood to near zero and significantly reduce the risk of passing it on.

“The progress we have made is remarkable, particularly around treatment, but it is also incredibly fragile,” UNAIDS’ executive director Michel Sidibe said as the report was published.

With detailed data showing some of the many complexities of the HIV epidemic, the report found that people are particularly vulnerable to HIV at certain points in their lives.

It called for “life-cycle” approach to offer help and prevention measures for everyone at every stage of life.

As people with HIV grow older, they are at risk of developing long-term side-effects from HIV treatment, developing drug resistance and requiring treatment for other illnesses such as tuberculosis and hepatitis C.

The report also cited data from South Africa showing that young women who become infected with HIV often catch the virus from older men. It said prevention is vital to ending the epidemic in young women and the cycle of HIV infection needs to be broken.

“Young women are facing a triple threat,” said Sidibe. “They are at high risk of HIV infection, have low rates of HIV testing, and have poor adherence to treatment.”

The report, saying the number of people with HIV getting life-saving drugs was 18.2 million, also showed that the rapid progress in getting AIDS drugs to those who need them is having a significant life-extending impact.

In 2015, there were 5.8 million people aged over 50 living with HIV – more than ever before.

UNAIDS said that if treatment targets are reached – the U.N. is aiming to have 30 million HIV positive people on treatment by 2020 – that number will soar.

(Editing by Louise Ireland)