The current Ebola outbreak in the Democratic Republic of Congo is only the second-largest inhistory, but undoubtedly the most frustrating.
Scientists are fairly certain they have the medical tools needed for victory: one vaccine that appears to work about 98 per cent of the time, another that has worked well in monkeys, and four therapies that may block the virus if they are given early enough.
Instead, scientists are being thwarted by the nightmarish conflicts and politics of eastern Congo. Health workers have been murdered, treatment centres have been torched, rumours have repeatedly outwrestled the truth. An overwhelming sense of divisiveness and fear has undone almost every effort to save the stricken and protect the vulnerable.
Three previous Ebola outbreaks have demonstrated how a response can succeed — or how, in an atmosphere of suspicion, it can go badly wrong.
The outbreak just before the current one ushered in a new era in the war against Ebola: a new Merck vaccine stopped the outbreak in just three months, after only 33 deaths.
The virus was thwarted even after it had slithered down the dirt tracks from its rural birthplace and had appeared in Mbandaka, a city of 1 million people that — like Goma, the eastern city the virus recently reached — was a major transportation hub near an international border.
Geography was important. The northwestern province where the outbreak occurred had a relatively peaceful, ethnically homogeneous population with good relations with the national government in Kinshasa.
Radio messages about the virus were taken seriously, there was little violence, and most victims’ families cooperated with contact-tracers and vaccinators. The first cases were diagnosed in April 2018, and the last were seen in June, after less than 4,000 doses of the vaccine were given out.
By contrast, the provinces along the Congo’s eastern borders with Uganda, Rwanda, Burundi and South Sudan are today a maelstrom.
Those nearby countries have had periodic explosions of fratricidal violence between ethnic groups, including the 1994 Rwandan genocide. Refugees from the butchery fled to the volcanic plains and deep forests of eastern Congo and often settled.
They speak a variety of languages, and some groups have formed their own militias, which sometimes clash. Distrust of the national government and its police and army are widespread in these areas; it was aggravated by the government’s decision to not let three eastern cities vote in the last national election, ostensibly for fear that long lines would spread disease.
Rumours are rife that the Ebola virus was made up by government officials hoping to get rich on Western aid, that the vaccine is dangerous, and that bodies of those killed by the virus are being dissected and sold to practitioners of witchcraft.