The Ebola outbreak in the Democratic Republic of Congo and Uganda could cost Africa as much as $3.6bn and lead to the loss of 328,000 jobs if it spreads further across the region, the UN has warned.
The outbreak has infected 1,307 people and killed 377 in DR Congo since it was declared on 15 May, according to government figures cited by the UN Development Programme (UNDP).
A smaller number of cases has been confirmed in neighbouring Uganda. Health experts have warned the virus could also spread to South Sudan.
“If we have the resources and we step up, we can contain this outbreak and prevent further losses,” said Damien Mama, the UNDP’s resident representative in DR Congo.
“If we do not, this health emergency risks becoming a much deeper and prolonged development crisis across the region and potentially the continent.”
The economic damage will depend on how quickly the outbreak is brought under control, the UNDP said.
In its best-case scenario, where the epidemic stays limited to DR Congo and Uganda, the cost to Congo’s GDP would be about $1bn.
In its worst-case scenario, the virus spreads to countries including Rwanda and Angola, while higher fuel prices linked to the Iran crisis add further pressure to African economies. That combination could cut continental GDP by $3.6bn.
No vaccine for this strain
The outbreak is caused by the Bundibugyo species of the virus. Unlike the more familiar Zaire strain, Bundibugyo has no licensed vaccine or specific treatment, though the World Health Organization (WHO) says work is under way to test new candidates.
The disease spreads from one person to another by contact with infected bodily fluids such as blood or vomit, or with contaminated materials and bodies during burial.
The WHO declared the outbreak a public health emergency of international concern on 17 May, two days after DR Congo and Uganda confirmed Bundibugyo virus disease in their territories.
Transmission in DR Congo is concentrated in Ituri, North Kivu and South Kivu – provinces where insecurity, poor access to health facilities and weak isolation systems are complicating the response.
By 28 June, Uganda had reported 20 confirmed cases and two deaths. Most were linked to travel from DR Congo, though five were associated with local transmission.
The US Centers for Disease Control and Prevention said the outbreak had become the third-largest Ebola outbreak on record by 22 June.
Conflict hampers response
The worst-affected areas of eastern DR Congo are already gripped by conflict and mass displacement.
Africa CDC chief Jean Kaseya said last week that almost 300 people who had tested positive for Ebola were unaccounted for, raising fears of wider community transmission in areas where armed groups operate.
Treatment centres are under severe strain, with bed occupancy reaching 95%, according to humanitarian agencies. Africa CDC and the WHO estimate $518m in health spending is needed to tackle the outbreak – a figure that rises to about $1.4bn once wider humanitarian needs are included.
DR Congo’s government has announced a $319m response plan
“Ebola is neither a rumour nor a source of shame,” President Felix Tshisekedi said in a televised address urging people to come forward with suspected cases rather than spread rumours.
But the response has turned politically sensitive. Public gatherings have been banned in several provinces – some of them nowhere near a confirmed case.
Opposition figures aren’t buying the official explanation. They say the bans are really aimed at planned protests against proposed changes to the constitution.
Fears of regional spread
Geography is working against the response. Ituri province borders both Uganda and South Sudan, and sits astride trade, mining and displacement routes that make tracking the virus difficult.
DR Congo’s risk level is “very high,” according to the WHO; Uganda’s is “high,” reflecting confirmed cross-border spread and the epidemiological links that run along the eastern DR Congo-western Uganda corridor. Even countries that merely share a land border with the two are at elevated risk, the agency says, given how freely people, goods and uneven health systems move between them.
By mid-September the outbreak could reach thousands of cases if transmission isn’t brought under control, according to a modelling study published in The Lancet Infectious Diseases – which also flagged a significant risk of the virus reaching South Sudan.
Travel and trade restrictions on DR Congo and Uganda are not the answer, the WHO has advised; such measures, it argues, tend to discourage transparency and disrupt the response rather than help it.
Visiting Bunia, the centre of the response in eastern DR Congo, WHO director-general Tedros Adhanom Ghebreyesus pointed to something less tangible: community trust. Without it, he said, and without safe burials, slowing the virus becomes far harder.