In any country in the world, the resignation of the health minister days after the declaration of an international health emergency should not only be worrying but alarming.
Dr Oly Ilunga Kalenga, an experienced epidemiologist who was leading the fight against Ebola in the Democratic Republic of Congo (DRC) during the second biggest outbreak ever, has stepped down from his post. He says he resigned because international agencies and donors were interfering with his work, accusing them of unnecessarily pushing for the introduction of a new vaccine.
MP Muhindo Nzangi Butondo, from the most affected eastern region, backed Ilunga saying he does not want residents to be the "guinea pigs" for a new vaccine fronted by the World Health Organization (WHO).
Five years since the worst Ebola outbreak killed 11,000 people in Sierra Leone, Liberia and Guinea, there's little assurance that lessons were learned, especially in the African response to the outbreak. The crafting of policy and strategy have been outsourced to international, mostly Western, agencies.
This failure to lead by the African Union (AU) and the blatant sidelining and undermining of African experts and local agencies could be fuelling the myths similar to those that surround the HIV virus - that it was manufactured to wipe out Africans. With foreign actors now entering the scene and forcing ministers to resign, fertile ground for similar myths to flourish, claiming that Ebola is a Western invention and pharmaceutical companies are scrambling to cash in.
One of the key challenges of containing the current outbreak is the distrust of the affected communities. This has seen nearly 200 health workers and facilities attacked since January according to the WHO.
Instead of taking the lead and showing that the AU is finally free from working under the shadows of the UN, whose barely noticeable intervention is only attributable to access to resources rather than contextual competence, the AU has once again decided to hand over the realm of responsibility to the WHO, potentially shattering the legitimacy credentials that it stood to claim.
Frustratingly, this has been neutered by the AU not completely abandoning the policy of non-intervention in member states, preferring instead to wait for an invitation letter.
Following the West Africa Ebola outbreak, failures jolted by the “African problems, African solutions” mantra, the AU formed a special team, suitably named the Centers for Disease Control and Prevention (Africa CDC).
There is already confusion in the public sphere regarding who is in charge; one would expect AU to be in charge, but the UN’s WHO has the mandate, however the WHO has now fallen out with one of the most locally respected epidemiologist - Kalenga. DRC President Felix Tshisekedi’s office has now taken over the coordination of the Ebola campaign.
"As in any war, because that is what this is, there cannot be several centres of decision-making for risk of creating confusion," the health minister said following his resignation.
The loss of Kalenga, an experienced medical doctor who oversaw a successful containment of Ebola in Equateur Province between May and July 2018, is a huge blow to the campaign.
The medic criticised outside pressure thought to be from the WHO, which insists on trying a new vaccine from US-based firm Johnson & Johnson. Kalenga, a qualified epidemiologist says that the vaccine is not proven and will add more confusion.
The previous vaccine made by Merck & Co, a rival of Johnson & Johnson, is said to be 97 percent effective and had been used successfully in the DRC. Kalenga and the MP Butondo argue that pushing for a new vaccine which has to be administered twice will be complicated given the on-going unrest in the region.
It should be quite alarming that a locally-trusted former minister with a good record dealing with outbreaks resigned citing “an obvious lack of ethics by voluntarily hiding important information from medical authorities”. It is worrying that the trending hashtag in the DRC lately is #NorYourGuineaPigs.
Kalenga has been on the ground since 2000 and taken the vaccine himself to help demystify the conspiracy and stigma surrounding Ebola. Being forced to resign under circumstances involving Western agencies does not only fuel the mistrust on the ground but also has the potential to intensify attacks against health workers.
With the ‘multi-disciplinary’ team coordinating the campaign ordered to report directly to Tshisekedi, one cannot help but wonder what input a career politician can have during such a medical emergency.
The epidemic has already been politicised to disenfranchise parts of Congo. It is now becoming clear that a president who came to office without a credible mandate is looking to use Ebola to get some legitimacy. He is, however, becoming a pawn in the battle of multinationals to influence the future of the Ebola vaccine.
The AU must move on from looking for a mandate and getting the people to trust it. The union has indeed progressed since 2002 when it scrapped its long-held non-interference policy regarding member states during the Organisation of African Unity (OAU) times. The new AU has been on peacekeeping missions across the continent but mostly on ‘peace and security matters’.
Its approach to intervening in matters of ‘peace and security’ should now extend to a non-military crises that could escalate on a huge scale or those that should be given a unique status requiring military intervention.
It has learned from the Economic Community of West African States (ECOWAS), which unlike other regional blocks, has a mechanism for military intervention. That's why the AU created the African Standby Force (ASF).
Uganda's approach may provide a glimpse into the situation we have at hand. When Ebola crossed to Uganda recently, its containment was not down to luck. The army is usually employed to quarantine the affected areas, under tight security, experts move in and stop the virus from spreading.
Can the AU build from this, instead of seeking comfort from its non-interference policy in non peace and security issues? As Africa seeks to integrate and facilitate the movement of people on the continent, the AU has to be hands-on; leading, intervening, fixing, building and restoring. The Africa CDC should be an elite unit ready to control and quell disease outbreaks - not providing statements of support.
Conflict-affected health systems have to deal with increased levels of violence. The ability to quarantine the affected areas is paramount to containing the spread. With the DRC now lacking effective health systems and an ineffective state, the AU and regional blocks now have an opportunity to intervene and end the UN decade of inaction to flush out insurgents and start rebuilding community trust and health systems.
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