CDC’s Redfield: It could take another year to control Ebola in DRC

Controlling the difficult and dangerous Ebola outbreak in the Democratic Republic of the Congo may take another year or more, Dr. Robert Redfield, the director of the Centers for Disease Control and Prevention, warned Friday.

That projection is bleaker than one issued Thursday by the director-general of the World Health Organization, Tedros Adhanom Ghebreyesus, who said he hoped the epidemic could be stopped within the next six months.

But Redfield, who traveled to the Congo with the WHO director-general last week, said it would be a mistake not to plan for a more prolonged outbreak, given the evident complexity of stopping transmission of the virus in northeastern DRC.

“We cannot underestimate this outbreak. We need a long-term strategy,” Redfield told STAT.

“I would love to see this outbreak end in six months, like my friend Tedros continues to hope for. But I think the reality, the practical reality, is this is going to be a longer road. And we need to start planning for it,” he said.

That could prove challenging from a funding point of view. The WHO and other United Nations agencies involved in the outbreak are already struggling to raise the money needed to finance the response through July of this year.

Agencies and nongovernmental organizations working to stop the virus have estimated their efforts will cost $148 million — but have only been able to raise about 60 percent of that amount, Tedros said.

The epidemic, which may date back to late April of last year, was only recognized as an Ebola outbreak in late July. As of Thursday, there have been 932 cases and 587 deaths, making it the second largest Ebola outbreak on record.

In the months since the outbreak was declared, the Ebola response workers have faced extremely taxing conditions. Those include attacks on workers trying to trace and vaccinate people who have been in contact with known cases and on those attempting to ensure the corpses of Ebola cases are being buried safely.

In the past few weeks, Ebola treatment centers have also come under attack. Centers at Butembo and Katwa — side-by-side cities where most of the cases are now occurring — were partially destroyed by fire. The Butembo treatment center has been repaired and reopened, but came under renewed attack last Saturday, hours before Redfield and Tedros, as the WHO leader is known, arrived to tour it.

Redfield said he and the WHO director-general visited the outbreak zone to recalibrate the response. More efforts, he said, must be placed on gaining the community’s trust so that they will engage with outbreak response teams.

“We have not effectively engaged the community as a part of the response. Figuring out how to do that is critical,” Redfield said.

So is improving the skill sets of the people working on the response — a task CDC will contribute to, Redfield said.

The outbreak is occurring in a part of the Congo that has been enmeshed in conflict for decades. The insecurity prompted the State Department to order U.S. government employees out of the area last August; they have not been allowed to return to help with the response since.

Still, the CDC has had staff working on the outbreak in other locations — in the Congolese capital, Kinshasa, at WHO headquarters in Geneva and in neighboring countries where they’ve helped authorities prepare to deal with imported Ebola cases, if they should arise.

Redfield said the CDC currently has three people in Goma, a major city south of the outbreak zone where the outbreak response is being relocated. He said he hopes to get clearance to expand the CDC’s presence there, if the security situation allows for it.