The Reemergence of Ebola Virus (EBV): of International Silence and African Resilience

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Nearly ten years after the Sudan Ebola virus (SUDV) was first discovered in Uganda in 2012, the deadly Ebola virus disease (EVD), also known as Ebola hemorrhagic fever, has resurfaced in a new outbreak.

Following the confirmation of the first of over 55 fatalities, the World Health Organization’s Regional Office for Africa (WHO-AFRO) and the Ugandan Ministry of Health jointly declared an EVD outbreak in the Mubende District of Central Uganda on September 20, 2022.

How has Uganda fared with its management?

Nigeria in 2014 proved that successful Ebola containment can be achieved with limited resources, via careful collaboration between the private sector, resilient healthcare workers and the international community.

Following the 1st confirmed case, the Ugandan President announced a 21-day lockdown from 15 October in the districts of Mubende and Kassanda to contain the EVD outbreak. Other temporary measures employed were an overnight curfew, the closure of places of worship and entertainment, and restrictions on travel in and out of the affected districts. Additional measures involved sensitization campaigns via media and religious influence, as well as the enforcement of safe burial practices. The most pressing concern for this outbreak is that it is caused by the Sudan strain of Ebola, for which there is no approved vaccine, unlike the more common Zaire strain.

Originating in Sudan and the DRC in 1976, there have been several EBV outbreaks; between 1976 – 2008, the total case fatality rate for EVD victims has been 79%. The largest outbreak (Zaire strain) was in 2014–2016 with over 11,000 fatalities, which started in rural southeastern Guinea and within weeks had spread past land borders to Sierra Leone, Liberia, Nigeria, and Senegal, then overseas to Spain, and the US to become a global epidemic within months.

EBV is considered one of the deadliest viral diseases, with a mortality rate ranging between 53 – 88%. The disease is recurrent in central Africa and the Philippines, with a high rate of contagiousness and transmissibility, permitting rapid spread via contact with bodily fluids and/or tissues of infected animals including chimpanzees, gorillas, monkeys, antelopes, and porcupines – all commonly handled as bushmeat. Fruit bats are thought to be the main host of the disease. It then spreads through human-to-human transmission via direct physical contact with infected bodily fluids and indirectly via contact with contaminated environments.

Its initial symptoms according to the World Health Organization (WHO), include a sudden fever, intense weakness, muscle pain, headache, and a sore throat – most of which are difficult to distinguish from other common diseases like malaria, meningitis and typhoid. With subsequent stages, vomiting, diarrhea, development of rash, impaired kidney and liver function set in, then incidences of both internal and external bleeding, and the risk of death.

The incubation period lasts for 2 – 3 weeks, and from the findings of a 2020 study, diseases with longer incubation periods, such as Ebola, cause more long-distance sparking events and less predictable disease trajectories, compared to more predictable short-incubation, wave-spread patterns as seen in cholera.

These multiple factors shape EVD as a high-risk infection which should be of utmost importance for containment to the international community. The WHO recommends that 42 days from the last infection pass (double the incubation period) to declare the end of an outbreak; the countdown has begun for this as at December 2nd, when the last known patient was discharged from the hospital.

Can it be treated?

The primary treatment is supportive clinical care, in form of rehydration with oral / intravenous fluids, and is dependent on the infected individual’s immune response, but there are vaccine candidates and therapeutics for the Zaire strain, and vaccine candidates in trial for the Sudan strain.

But is this outbreak being treated with any sense of urgency?

Some manufacturers of EBV vaccines have pledged to give their still-experimental vaccines free of charge to Uganda, totaling an estimated 160,000 doses to curb further transmission of the virus. The Serum Institute of India and the University of Oxford pledged to produce up to 30,000 doses by the end of November 2022 – over 40,000 of which were shipped to Uganda in mid-December, supplying an additional 10,000+ doses. The Sabin Vaccine Institute is also ahead with its candidate; the Institute promised 40,000 doses and has supplied 1,200 doses, and there are up to 100,000 doses from cold storage due to arrive from Merck.

These are commendable efforts to curb the outbreak, but local production of vaccines for EBV needs to be prioritised.

What needs to be done?

We must acknowledge the foremost of the myriad lessons learned from the COVID-19 pandemic; that being – “diseases do not respect man-made borders”.

It is imperative that adequate funding for local manufacturing of Ebola therapeutics lands on the decision tables, existing therapeutics supplies should be targeted at affected countries and investment into continuing research on treatments should become a priority for international organizations. The lingering risk of the infection spreading to other African states – and overseas – remains a threat, and with the supply of treatments tied to unpredictable external supply chains and overseas manufacturing, additional difficulties are placed upon affected states. Given the world’s ongoing experience with COVID, it bears stating that a disease should not need to go global to count as a priority.

 

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EDMOND BOSILONG

Research Analyst

Edmond is a research analyst who is passionate about sustainable development, innovation, and the environment. Passionate about climate financing, he firmly believe there is a more reliable system to promote equality, growth, and welfare in societies without affecting the ecosystem. Through his skills, knowledge and experienced gained over 7 years, he wants to make an impact in the world of development. Edmond holds a Master’s Degree in Public Policy from Korea Development Institute and a BA Degree (Honors) in Business from University of Derby.

   HANNAH RYDER

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Hannah Ryder is the Founder & CEO of Development Reimagined. A former diplomat and economist with 20 years of experience, named one of 100 most influential Africans in 2021, she is also Senior Associate for the Africa Program of the Center for Strategic International Studies (CSIS), sits on the Board of the Environmental Defence Fund, and is a member of UAE's International Advisory Council on the New Economy. Prior to her role at DR, Ms Ryder led the United Nations Development Programme (UNDP)’s work with China to help it scale up and improve its cooperation with other developing countries, including in Africa. She has also played various advisory roles for the UN and OECD and co-authored the seminal Stern Review of the Economics of Climate Change in 2006.

LEAH LYNCH

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Leah Lynch is Deputy Director of Development Reimagined (DR), and head of the China office. Leah has over 10 years of experience in development and has lived in China for over 8 years. Leah has also travelled extensively around Asia and Africa for research. Leah supports the strategic direction of the team across China, with a mission to deliver high quality research on sustainable development and poverty reduction. Leah is also Chair of the Sustainability Forum at the British Chamber of Commerce in China, providing direction on sustainability initiatives for British and Chinese business. Leah has also consulted on various evaluations on UK aid (ICAI) and is a specialist on development cooperation from the UK and China. Leah has also consulted on various UN projects, including providing support to the UN China team during the COVID-19 Pandemic. Prior to DR, Leah was at the United Nations Development Programme (UNDP) China, supporting the UN’s portfolio on communication strategies, China’s South- South Cooperation and the Belt and Road Initiative (BRI). Before UNDP, Leah lived and worked in Kenya developing sustainable water policies for the Kenyan government.

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Yike Fu is a Policy Analyst and has been responsible for leading numerous areas of work, including on debt analysis in Africa and beyond, and China-Africa trade and investment logistics and analysis. She is the co-author of “African Debt Guide”, in which she challenged the narrative that Africa is in the midst of a new debt crisis by analysing data back to the 1970s and adopting new metrics to present the real story behind the data. She also developed a benchmark to compare the financial distribution of development partners such as the UK, US, Japan, France and China in Africa. Prior to her role at DR she worked at the International Finance Corporation and African Union Representational Mission to the US. She holds a Masters in International Affairs from George Washington University.

JUDITH MWAI

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Judith is a Research and Policy Analyst, where she specialises in Africa-China relations, international development, and diplomacy. During her time at Development Reimagined, Judith has co-authored several articles published in The Diplomat on debt and China-Barbados relations and was quoted by China Daily in a piece on Women Rights in China. Previously, Judith worked as a research analyst for an Advocate and Commissioner and Oats office in Kenya.

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JING CAI

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Jing leads China-African health and agriculture cooperation research at Development Reimagined, having managed our FOCAC Policy Analysis and Advocacy project. She is also the co-author of “China-Africa Health Cooperation under FOCAC Umbrella”, in which she analysed China’s commitments around health cooperation since the first FOCAC summit and deepdived into four African countries’ health overview, challenges and cooperation with China as cases studies. Before DR, Jing worked at GIZ Cambodia on M&E of a disability advocacy project. She also worked as a translator with Chinese medical team in Benin.

PATRICK ANAM

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Patrick is an International Trade Policy and Trade Law Expert with over 5 years of experience. His expertise includes trade law, trade policy analysis and regional integration. He is currently engaged with Development Reimagined as a Senior Trade Analyst and was the lead author of Development Reimagined's recent Report on Africa-China Relations titled "From China-Africa to Africa- China: A Blue Print for a Green and Inclusive Continent-Wide Strategy Towards China." and “Reimaging FOCAC Going Forward.” Patrick has previously consulted for the East African Community, UNECA and for the Kenya Ministry of Trade.

ROSIE FLOWERS

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Rosemary is our Senior Policy Analyst. She is a skilled policy analyst and has previously worked as a UK civil servant. She is studying Human Rights at Birkbeck, University of London with a research focus on international law in the context of health crises such as the COVID-19 pandemic.

JADE SCARFE

Project Manager and Africa-China Communication Assistant

Jade is a Project Manager for Development Reimagined’s flagship project Africa Unconstrained, which focuses on financing needs and debt vulnerabilities of African countries. Her research focuses on China-Africa development finance alongside debt vulnerabilities, infrastructure needs and South-South cooperation. She has worked with a breadth of stakeholders from China, Africa and the wider international community, including governments, private sector, NGOs and civil society. Her writing has appeared in a number of publications, including The Africa Report, The China-Africa Project, The Diplomat and more. Jade holds a Master’s in China and Globalisation studies from King’s College London.

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Rosie is the Project Manager of Africa Reimagined (AR) at Development Reimagined (DR) where she supports high-end African brands with entering the Chinese market by operating services such as trademark protection, Chinese market research, Chinese partnership building, and Africa to China logistical support and import/export services. Rosie has worked with DR for over two years now with proven success in helping high-end African brands navigate the Chinese market. She is extremely passionate about her work because more African brands selling in the Chinese marketplace means African countries can export MORE value-added goods, create MORE jobs and foster MORE innovation in African countries.

Rosie is also alumni of the School of International Studies at Peking University in Beijing where she is also an editor at the Peking Africa Think Tank. PATT is led by a diverse group of scholars who specialise in African Studies within the context of Sino-Africa relations.

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Lauren has lived in six countries from the Americas to Europe and Asia and speaks both French and Spanish proficiently. At Development Reimagined, Lauren’s research focuses on climate action both in the Asia-Pacific and in Africa, and how countries are using tools such as SDGs and Covid-19 action to build a more climate-resilient future. She holds a Masters in International Relations from Leiden University.

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Ferdinando’s research at Development Reimagined is centred on South-South Cooperation dynamics, specifically on the analysis of Chinese investment and debt flows in Africa and their linkages to African industrialisation. He is currently a Yenching Scholar at Peking University, after having graduated from the University of Cambridge with an MPhil in Development Studies.

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Chensi Li is a research analyst. She has previously worked for local NGOs in Nigeria and Cameroon and think-tanks in China.  Her research areas include Sino-African relations, African foreign affairs, public diplomacy, state-building and national governance.

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HANNAH RYDER

Founder and CEO

Hannah Ryder is the Founder & CEO of Development Reimagined. A former diplomat and economist with 20 years of experience, named one of 100 most influential Africans in 2021, she is also Senior Associate for the Africa Program of the Center for Strategic International Studies (CSIS), sits on the Board of the Environmental Defence Fund, and is a member of UAE's International Advisory Council on the New Economy. Prior to her role at DR, Ms Ryder led the United Nations Development Programme (UNDP)’s work with China to help it scale up and improve its cooperation with other developing countries, including in Africa. She has also played various advisory roles for the UN and OECD and co-authored the seminal Stern Review of the Economics of Climate Change in 2006.