An additional 12,000 cases of measles have been reported in the Democratic Republic of the Congo (DRC) over the past two weeks, bringing the total number of cases in the current outbreak to 222,939. It is the world’s largest measles outbreak this year.
There have been 4,435 fatalities in the Central African country — more than double the deaths reported in the current Ebola outbreak. The mortality rate of people infected with measles is 2%, which is much lower than that of Ebola at 60%.
But the measles outbreak has received little attention from the media and international community.
Half of the cases this year have been in provinces of Tshopo, Kasai, Haut-Lomami, Kwilu, and South Ubangi, although the infectious disease is widespread, with every province in the country reporting cases, according to Outbreak News Today.
The outbreak, which began in early 2019, is disproportionately affecting children under 5 years old.
A measles vaccine does exist, and is effective when at least 92% to 95% of the population has been immunized — a concept known as "herd immunity."
While there are several factors behind the current outbreak, a major contributing factor is that too few children are vaccinated against the disease.
The number of measles deaths have topped 4,000 in DR Congo, becoming far deadlier than the current Ebola outbreak.
— UNICEF (@UNICEF) October 9, 2019
We’re racing to vaccinate children and supply clinics with vital medicine. @UNICEFDRC#VaccinesWorkhttps://t.co/NfFtsZkWOm
"In the DRC, as in many underfunded health systems, many families cannot routinely access timely preventive services. This can be because they live too far from clinics, or because clinics are in bad shape," Matthew Ferrari, an associate professor of biology at Pennsylvania State University, wrote in an article for The Conversation.
In addition, years of internal conflict in the country have led to an estimated 4.5 million people being displaced from their homes, which has further limited their access to health services.
Ferrari also says there is a “deep mistrust of government institutions and solutions from the global north in areas that have experienced decades of both colonial and internal oppression.”
Together, these factors prevent some people from seeking or accessing care.
In a July speech focused on combating Ebola in the DRC, the World Health Organization Director-General Tedros Adhanom Ghebreyesus spoke of the country’s weak health system, saying the WHO is committed to strengthening it.
"Unless we address its root causes – the weak health system, the insecurity, and the political instability – there will be another outbreak," he warned.
The country’s health system is a contributing factor to people impacted by the measles outbreak not being diagnosed and treated effectively.
"The DRC currently has only one reference laboratory that can run the blood tests necessary to confirm a measles outbreak. Transporting and processing samples can take weeks," Ferrari wrote.
In an op-ed published in The Conversation, Jeremy Rossman and Matthew Badham from the UK’s University of Kent point to a solution proposed by Doctors Without Borders and the Alliance for International Medical Action: instead of the international community delivering targeted aid just to tackle Ebola, resources should be deployed to strengthen local infrastructure.
"This may enable a country to contain an Ebola outbreak while still responding to outbreaks of other infectious and non-infectious diseases, providing better care for local communities," the authors wrote.
This would ultimately create a more resilient health system that could respond to future outbreaks without international support.