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As Ebola spreads in West Africa, Canada's role in question

Tuesday July 30, 2019

A Congolese health worker administers ebola vaccine to a child at the Himbi Health Centre in Goma, Democratic Republic of Congo, earlier in July. OLIVIA ACLAND / REUTERS

Four years ago in West Africa, during the biggest Ebola outbreak the world had seen, Canada was considered a leader in the global fight against the deadly virus, with a Canadian-developed vaccine considered a game-changer. Today Canada is largely on the sidelines — even being called out internationally for it — as a new deadly epidemic spreads across the Democratic Republic of Congo and beyond.

Where is Canada this time around?

The answer, like the epidemic that has infected more than 2,500 people in the conflict-ridden DRC, is complex.

The vaccine originally developed in Canada, now produced by Merck, is being used in the DRC, although it has not stopped the spread of the disease.

Canada has deployed emergency management specialists to work on the outbreak with the World Health Organization in neighbouring Congo. It has also provided $4.75 million in humanitarian aid to the UN, The Red Cross and Red Crescent and other NGOs working on the ground in the DRC.

Canada has contributed $4 million to the World Health Organization’s contingency fund for emergencies since 2015.

It has also offered direct technical help to the DRC but has been turned down, according to a Canadian scientist.

Still, observers say the overall global response to the outbreak that began on Aug. 1, 2018, has been disappointing and countries including Canada have not met financial commitments, which is slowing the response. Last month, former UK development minister Rory Stewart singled out Canada as a G7 country that needs to pull its weight in the fight against Ebola. He told BBC radio that he would be asking Canada to make more generous contributions.

A spokesperson for Global Affairs Canada did not respond directly to questions about whether Canada is doing enough, but said the government is closely monitoring the situation and is committed to working with partners “to support global public health.”

With the Ebola outbreak now declared a public health emergency, observers say it is past time for Canada and other countries to do more.

“The world was way too slow in responding to this outbreak,” said Steven Hoffman, scientific director of the Canadian Institutes of Health Research’s (CIHR) Institute of Population and Pubic Health. “We can’t respond to everything with lightning speed, but it has been many months since it has been known that this is a very serious public health emergency.”

That could soon change, said Gary Kobinger, one of the Canadian scientists who helped design a vaccine against Ebola.

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And Kobinger, who is based at the Centre for Research in Infectious Diseases at Laval University in Quebec City, said the recent resignation of the health minister in the DRC could set the stage for other changes in the outbreak response.

The declaration earlier this month that the outbreak is a public health emergency has brought more focus — and money — to the fight. The World Bank announced $300 million to fight the epidemic soon after it was declared a health emergency. There is no word on whether Canada will increase its contribution.

Kobinger said he believes it is time to change the approach to fighting the outbreak, which has been hampered by ongoing conflict and mistrust.

He believes the Ebola vaccine should have been used to vaccinate everyone in a region when the outbreak began. Instead, health officials have employed the so-call ring-vaccine technique — tracing contacts and vaccinating everyone in a “ring” around the person infected with Ebola. The vaccine has saved lives — especially among health workers — but the technique is not working to stop the outbreak from spreading, he said. Kobinger said it is too late now to vaccinate everyone, given the amount of vaccine available and the number of people involved.

Kobinger was part of a group of people who evaluated the response to the outbreak recently. Kobinger said there have been missed opportunities to shut down the epidemic in the past year, especially when it comes to engaging the public and coordination. He said he hopes a new focus on engaging the public will help turn things around in the DRC.

Kobinger has been to the DRC multiple times each year for the past decade to help train workers there to manage an Ebola outbreak. Some of the labs and equipment used are from Canada. Kobinger offered his help during the current outbreak, but was turned down.

The goal has been for the DRC to handle the outbreak themselves, but doing so right now has been a “huge challenge,” he said. Kobinger said he is hoping that will change, and that it will not be too late to get the outbreak under control.

“Canada contributed a lot, now the goal is to let them do it. There are a lot of good people who are working really hard,” he said.

“Canada is really keen on helping. They have never given up on supporting the DRC and the outbreak, but they can’t impose that help.”

Hoffman, of the CIHR Institute of Population and Pubic Health, said he has been frustrated that the initial response to the outbreak didn’t seem to fully factor in how crucial it was to have the trust of the community, given the complex social environment.

But that could change, he said. The recent shift suggests the DRC may be more welcoming of outside help.

“This might be the time Canada could be well-placed to step up to make the kind of contributions it historically has.”

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