Intended for healthcare professionals


Congo sees rise in deaths from malaria, measles, and cholera as Ebola outbreak swallows up resources

BMJ 2019; 366 doi: (Published 03 July 2019) Cite this as: BMJ 2019;366:l4522
  1. Sophie Arie
  1. London

While a massive international aid operation tries to control the Ebola outbreak in the Democratic Republic of Congo (DRC), more people are dying from diseases like malaria, measles, and cholera in the same part of the country and receiving almost no assistance, the humanitarian aid charity Médecins Sans Frontières (MSF) has said.

“People are dying because of a lack of basic services such as water, shelter, and access to healthcare,” an MSF spokesperson told The BMJ. “We have been calling on various UN agencies to scale up the assistance, but there has not been sufficient action.”

The Ebola outbreak centred in the north eastern Ituri province has killed over 1500 people since it began in August 2018, but interrupted vaccination programmes mean that measles has now killed as many people in the same part of the country. In June the DRC government declared a measles emergency.1

The situation has been described as unprecedented owing to a combination of public fear of Ebola, mistrust of international aid workers, and a conflict between communities in Ituri province that has forced thousands to flee their homes and made it dangerous for aid teams to go to some areas.

Those displaced by fighting are receiving very little assistance, and malaria, respiratory tract infections, and diarrhoea are killing them at rates above internationally recognised emergency levels, according to MSF, which has carried out three surveys on displaced communities in the area.2 Cholera has killed over 240 people.

Yet international funding for aid efforts in DRC has been almost entirely focused on Ebola, leaving aid agencies unable to do enough to help people with other needs.

“People are afraid of Ebola treatment, but they actively want treatment for things like measles and malaria and they cannot get it,” said Trish Newport, MSF’s emergency coordinator in DRC.

“There is more funding for Ebola because the world is scared of it. But in terms of life saving, we really need to take into account the reality on the ground,” Ibrahima Soce Fall, assistant director-general for emergency response at the World Health Organization, told The BMJ.

“Support we’ve received so far to respond to outbreaks of cholera and measles has been very limited. But you cannot just say ‘you can have money for Ebola but we cannot help with other diseases,’” he said. “In the end more people will die of those other diseases.”

The international community’s focus on Ebola has contributed to the lack of trust among local people in foreign aid teams, which has been a major reason that Ebola has continued to spread, said Newport.

“It is not possible to gain the trust of the population if you are not addressing all of their key health needs,” Newport told The BMJ. “We need to be looking at not just Ebola but the other things that are killing people. To people whose children are dying of measles, it looks like international responders don’t care. They are just doing Ebola because that’s what brings in the money.”

The United Nations has appealed for $212.3m (£168m; €188m) for all emergency health assistance in DRC this year but has only received 25.7% of that funding so far.2 It has received $144m for Ebola since August 2018, but donations in recent months have started to fall short of requirements. Of the $98.3m the UN required for Feb-July 2019, only $43.6m has been received.


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