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Data: DRC Ministry of Health; Chart: Andrew Witherspoon, Harry Stevens/Axios

The World Health Organization — still reeling over the loss of one of its doctors killed in a violent attack in the Democratic Republic of the Congo a week ago — and other experts indicate that the Ebola outbreak will likely continue spreading until the region can be made secure enough to implement the necessary steps.

Why it matters: The deadly contagious virus can only be halted by tracking down people who may have been in contact with infected patients and taking steps to quarantine and vaccinate them, experts say. But the violence wracking that region — causing DRC doctors and nurses to threaten strike and WHO to stop some of its activities — puts those efforts at risk.

"This is a saddening and horrifying situation," says Julie Fischer, a program director in the Center for Global Health Science and Security at Georgetown University.

  • She tells Axios that medical personnel have the know-how plus new tools like an apparently effective vaccine, but these have to be implemented via on-the-ground efforts in the communities and that's not possible when it becomes too unsafe.
  • "This is a combination of a very contagious disease with very contagious violence," Fischer says.

The backdrop: This region has faced violence on a regular basis due to armed groups in the area, but also faces impoverishment and neglect.

  • These groups include the Allied Democratic Forces (with possible linkages to the Islamic State) and local Mai Mai militias, says Stephen Morrison, SVP at the Center for Strategic and International Studies. "These require different approaches," he adds.
  • Fischer says there's a strong distrust of the government and of foreign organizations because that area, which contains millions of displaced people, doesn't receive regular services for their basic needs, like health care and clean water.
  • "A good number of people believe Ebola is fabricated by outside sources to profit off the DRC," Fischer says.
  • DRC Ministry of Health spokesperson Jessica Ilunga tells Axios that most of the general population is aware of Ebola, but "there is always a small part of the population who just does not want to believe in Ebola, no matter what they see or even experience."

What's happening: The violence appears to have pivoted toward targeting health care workers, including the attack last Friday that killed WHO epidemiologist Richard Mouzoko Kiboung and injured 2 health care workers. DRC announced its security forces arrested some of the suspects for that attack.

  • WHO issued a statement today noting that a recent "notable escalation of security incidents" forced them to halt their activities in some of the hot spots of the outbreak.
  • These attacks "have affected the response. Some of the increase in case numbers has been due to response teams’ decreased access to affected areas because of insecurity, which  means response measures could not be put in place to prevent new infections," WHO spokesperson Tarik Jasarevic tells Axios.

Meanwhile, DRC doctors and nurses held a march on Wednesday to protest their unsafe conditions, AP reported, and are threatening to strike indefinitely if the situation isn't made better.

"It is understandable that health workers are concerned for their safety ... WHO is only all too aware of security after losing a colleague to a violent attack last Friday. We stand with them in their call for protection and are working alongside local authorities to increase safety for all, from health workers to patients."
"Fundamentally, as the health workers themselves have highlighted, the support and engagement of the community are key to supporting the response and health workers in particular."
— Tarik Jasarevic

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