Trust deficit

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MARY REICHARD, HOST: It’s Thursday the 4th of June. So glad to have you along for today’s edition of The World and Everything in It. 

Good morning, I’m Mary Reichard.

MYRNA BROWN, HOST: And I’m Myrna Brown.

First up: slowing the spread of Ebola.

More than 300 people are infected with a rare strain of the Ebola virus in central Africa. It’s been about a month since the first case was confirmed in the Democratic Republic of the Congo.

REICHARD: The DRC’s outbreak is already the second largest Ebola outbreak ever. But it is spreading faster than the largest outbreak did.

WORLD’s Mary Muncy has the story.

MARY MUNCY: Etienne Ezo contracted the Bundibugyo strain of Ebola earlier this year.

ETIENNE EZO: [French] I was vomiting badly. At one point, I started to feel tingling. I was scratching myself from head to toe.

His symptoms started with vomiting and tingling.

EZO: [French] I was scratching myself from head to toe.

Then he was scratching from head to toe.

EZO: [French] I didn't even have hope of finding myself here, and seeing my friends, my family, everyone else again.

Another survivor says he didn't think he would see his friends and family again. They went to a medical center that gave them medicine and tried to keep them comfortable, but they could only treat the symptoms and wait until they pulled through. 

TOM FRIEDEN: This is an outbreak of Ebola that's probably gone on for months, where we only began a global response in the past couple of weeks.

Tom Frieden is the president of Resolve to Save Lives, and he was the director of the U.S. Centers for Disease Control and Prevention during the Ebola outbreak in 2013 and 2014, the largest in history. He says the response that time started sooner.

FRIEDEN: There were about forty or fifty cases by the time we began the response. This time there are between four hundred and five hundred cases by the time the response is beginning.

Surging healthcare professionals and medical supplies to the area can help slow the outbreak.

FRIEDEN: It requires almost perfection in how well we manage, and any lapse can result in the infection of a healthcare worker or the spread of infection to a new community.

That perfection is almost impossible in the DRC.

Armed groups have displaced about six million people since 2022. Putting the DRC in the top five countries with internally displaced people. President Donald Trump said he had ended the conflict in December, but so far, the fighting has continued.

Even without the conflict, hospitals may not have adequate equipment or space. And then there are cultural factors too. 

FRIEDEN: One of the ways that Ebola spreads most explosively is by traditional burial practices, where people—out of love and devotion—will wash, touch, sometimes kiss the body of the deceased.

The virus spreads through direct contact with bodily fluids and it’s at its most contagious right before and immediately after someone dies.

But that burial tradition is deeply ingrained in the culture, and last month, people burned an Ebola treatment center in the DRC to retrieve a body for burial. Other treatment centers have been attacked as well.

FRIEDEN: The level of trust in government is very low, and change happens at the speed of trust. Trust is the one thing you can't surge in to a community during a crisis.

The African Centres for Disease Control and Prevention estimates that about ten percent of the population believe the outbreak isn’t real or that a vaccine is being kept from them.

Right now, there is a vaccine for the more common Zaire strain of the virus, but not for the Bundibugyo virus.

Darryl Falzarano is the principal scientist at the Vaccine and Infectious Disease Organization. About ten years ago, he studied whether the Zaire vaccine could work for other Ebola strains in non-human primates.

DARRYL FALZARANO: And it turned out it did… It's about a 50% increase in in survival. What you normally see with a matching vaccine is 100% protection.

That’s where the research stopped, because outbreaks of Bunibugyo have been relatively small and rare.

But Falzarano says that while a vaccine for Bunibugyo doesn’t exist yet, the structure, research, and technology to fast-track one does. There are currently three in the works.

FALZARANO: The timelines that are being stated right now is around nine months.

For now, John Hopkins scholar Amish Adalja says this outbreak shouldn’t cause anxiety for the general US population, where we have access to state of the art care facilities and equipment.

AMISH ADALJA: Even though Ebola finds it very hospitable in certain circumstances to spread, like it did in West Africa, it wasn't really able to do much outside of that outbreak zone. It didn't find other parts of the world hospitable.

There was no vaccine for Ebola during that outbreak and more than 20,000 people contracted it and 10,000 died. This outbreak is currently bigger than the one in West Africa was at this stage, but it’s still far behind in total cases and deaths.

Adalja says the most important thing for global officials is to work through the trusted people on the ground. Resources and manpower will only help if citizens believe it’s for their good.

Reporting for WORLD, I’m Mary Muncy.

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