By Jennifer Rigby and Emma Farge
LONDON/NAIROBI, July 2 (Reuters) – Malaria and other diseases may be as deadly as the Ebola outbreak in the Democratic Republic of Congo, health officials have warned, as the outbreak strains the healthcare system and spooks patients into staying away from clinics.
Half-a-dozen medics and local and international health officials told Reuters they are taking steps to limit deaths, but face longstanding healthcare gaps and delivery issues in a region plagued by conflict, as well as patient fear.
“As has been the case in nearly every Ebola epidemic, it is likely that more people will die of malaria during this outbreak than of Ebola,” said Bill Steiger, chief executive of the non-profit Malaria No More.
MALARIA RISKS
Malaria is a particular threat because it is widespread in Congo, including to varying degrees in the eastern provinces where the Ebola Bundibugyo outbreak is hitting hardest. There were around 35 million cases and 68,000 deaths in Congo in 2024, the second-highest in the world after Nigeria, according to the World Health Organization.
There are also longstanding gaps: two planned distribution campaigns for insecticide-treated bed nets had to be cancelled last year for security reasons in the provinces of Ituri and North Kivu, both areas at the center of the Ebola epidemic, an official from the Global Fund to Fight AIDS, Tuberculosis and Malaria told Reuters.
That means many people are likely unprotected this year as older nets have worn out, said Susie Nasr, the Global Fund’s head of malaria. Congo’s national malaria programme did not respond to requests for comment.
Nasr said there were already early signs of a rise in malaria cases in the Ebola outbreak areas, although that may be because of medics treating all suspected cases as confirmed while they avoid testing to limit their exposure to bodily fluids – highly infectious if the patient ultimately has Ebola. The diseases share similar symptoms, like fever, during their early stages.
CONCERN OVER MISSING CASES
However, Nasr and others said work was underway to prevent a worst-case scenario. Buffer stocks of antimalarial drugs were being transferred to the outbreak areas by the Congolese government, the Global Fund and the Gates Foundation, she said.
Teams are also considering mass drug administration of antimalarials – going door-to-door in affected areas to hand out drugs to rapidly reduce the malaria burden.
Still, medics working on the ground said they were worried about missing cases in the community.
Dr Aimé Mbonda, emergency health coordinator for the International Federation of Red Cross and Red Crescent Societies in Bunia, Congo, estimated that roughly half of those experiencing symptoms may be unlikely to seek care, having watched community members with fever attend healthcare facilities and never return.
“Because people are waiting, we are now receiving more complicated cases, and deaths. This is a big challenge,” he said, adding that his team had met people who were frightened to admit to having symptoms.
Nasr said the Global Fund and others were still working out how much money would be needed to prevent a malaria surge. There is already a massive shortfall for the Ebola response between the $1.4 billion Africa CDC says is needed, and the $120 million currently delivered.
“Does the global health community realise malaria is probably a bigger risk than Ebola over the longer term? Yes,” said Steiger. “Are they responding? They are. Is it enough or quick enough? Maybe not.”
(Reporting by Jennifer Rigby and Emma Farge; additional reporting by Olivia Le Poidevin; Editing by Aidan Lewis)
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