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Five Lessons Learned During Latest Ebola Outbreak in DRC

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By MSF

Four people died in the most recent Ebola outbreak that occurred in a remote, forested area of the Democratic Republic of Congo (DRC).

This small outbreak (five laboratory-confirmed and three probable cases) was quickly curtailed. The international humanitarian organisation Doctors Without Borders (MSF) shares lessons learned from this first occurrence of the deadly virus since the end of the large-scale Ebola outbreak that devastated West Africa in 2014-2015.

Train frontline health teams

The scale of this outbreak was minimised, thanks in no small part to a nurse named Dieumerci. With a name that literally translates to ‘Thank God’ in French, Dieumerci works at a Ministry of Health centre in northeast DRC, where the first Ebola cases started emerging.

He detected the risk of Ebola in a seriously ill man at the hospital, and rang the alarm. This man turned out to be the second confirmed case during the recent outbreak. Unlike in West Africa prior to the last major outbreak, Ebola is known in the DRC: the Ebola River, where the virus was first discovered, runs 100 kilometres away from where Dieumerci works.

That doesn’t mean that it is common disease in the area, but still, Dieumerci recognised the symptoms. His quick actions should not be taken for granted. Healthcare workers play a crucial role not only for patients, but also for general epidemiological surveillance. However, in many developing countries human resources within the health sector remain starkly inadequate.

On that fateful day where the Ebola patient came to the health centre, Dieumerci could have easily been on a sick leave, or visiting family somewhere else in the country. One cannot rely on a single individual to play the crucial role of on-the-ground surveillance.

What is needed are proper surveillance systems in resource-poor countries, which were clearly lacking in West Africa at the time of the epidemic. So all in all: thank you Dieumerci. We should all hope that during the next outbreak – be it Ebola or any other infectious disease – there will be another Dieumerci to ring the alarm bell for everyone’s sake.

Finally, a forgotten disease is taken seriously

The word “Ebola” doesn’t ring the same after 2014-2015’s devastating epidemic. At least 11,300 people were killed, and over 28,000 were infected. As a result, Dieumerci’s alarm bell sent shock waves across the world. Congolese authorities immediately activated their outbreak response team and had strong support from WHO and other organisations.

Henry Gray, MSF’s project coordinator during this recent outbreak, has worked on seven haemorrhagic fever interventions in DRC, Uganda and West Africa, to name a few. “The pressure we felt was very different from previous comparable outbreaks: it was clearly at the top of the agenda,” he says. “When it comes to Ebola, we have all learned that it’s better to be safe than sorry in order not to repeat the disaster of 2014-2015.

“However, it is sad to still see that other outbreaks in countries do not trigger the same mobilisation, even in regards to the main killer diseases like cholera or measles.

“Once the Ebola outbreak was over, we were able to re-assign some of the MSF staff towards a serious cholera outbreak on the other side of the country. Our teams went on to treat 1,100 cholera patients. “Considering the dire health needs in many parts of the country, additional support is always welcome”.

Old tricks are timeless – back to basics

The promise of new drugs or vaccines should not overshadow the necessity of putting in place the basic pillars of outbreak control.

It all starts with good surveillance, followed by the five pillars of outbreak control:

    Safely isolating and treating the sick.

    Actively looking for potential new cases and surveilling those who have been in contact with them.

    Burying the dead safely.

    Engaging and mobilising the affected communities.

    Offering psychological support.

In West Africa, the havoc wrecked by Ebola on the entire health system created more indirect than direct victims of the virus: children became prone to infectious diseases because they weren’t vaccinated; Childbirth complications led to the deaths of mothers and/or children because there were no healthcare workers to care for them; untreated cases of malaria became fatal…

International health actors need to do more to support local health facilities that often have much smaller means and equipment: training staff, ensuring there is basic protection equipment available, and that their pharmacies are stocked with first aid supplies and basic medicines. Our experience in DRC has shown that training frontline workers, even when done ad-hoc, can bring sustained effects to improve their performance in surveillance.

Location, location, location

Like the majority of haemorrhagic fever outbreaks prior to West Africa, the recent one occurred in a very remote, forested area.

Here, the virus was already known to exist within an animal reservoir (assumed to be fruit bats) that is occasionally transmitted to apes, monkeys or men. Some people are very mobile in the region, but can only go as far and as fast as their available transportation; which is pretty much nothing beyond walking and the occasional motorbike.

Dieumerci’s village is 45 kilometres from Likati, the closest town. It is home to 18,000 people, with a majestic cathedral and large, but under equipped, hospital serving as remnants of a time when a railroad was still linking plantations across the country. Today that railroad has been eaten by the encroaching jungle. By contrast, in Guéckédou, Guinea – where the West Africa outbreak started – people can jump on a motorbike and be in the heart of the capital Conakry and its 2.5 million people within two days.

These contrasting examples show how isolation from major cities can keep the spread of deadly disease under control.

Medical innovations are not the magic bullet

At the time of the latest outbreak, MSF was willing to use Ebola treatments which were still in development. However this window closed as the outbreak stopped before the process to allow the use of the experimental treatments was complete. However, this event acted as a ‘booster’ – speeding up the process of preparing medical protocols so that new drugs (still in the experimental phase) can be used in ways that are as safe and ethical as possible.

The rVsV-ZEBOV vaccine (the most advanced investigational vaccine candidate for an Ebola outbreak today) is in development, and needs to be implemented through a study protocol. This, and a vaccine strategy – including informed consent under good clinical practice – were mandatory requirements needed from us to access them.

Soon enough, a study protocol was developed and approved by the MSF Ethics Review Board a few months ago. It was ready for implementation should an outbreak occur. Additionally, a dedicated MSF research team was ready to be deployed. Unfortunately, our negotiations at the DRC Ministry of Health level only took place when the outbreak had already been declared.

It took some time for us to explain what we were planning to do, and how this would differ from a vaccination campaign. But, we managed to obtain authorisation from all the regulatory bodies to start activities in case of a future outbreak.

It is likely that the next outbreak (and trust us, there will be a next outbreak) will happen in a similar setting. We can continue to learn how to best tackle it, and ensure that the West Africa Ebola outbreak remains an isolated tragedy.

Since 1990 MSF has responded to over a dozen outbreaks in sub-Saharan Africa. During the devastating Ebola outbreak that struck mainly Liberia, Guinea, and Sierra Leone in 2014-2015, MSF launched one of the largest emergency operations in its 44-year history.

MSF admitted 10,310 patients to its Ebola management centres of which 5,201 were confirmed Ebola cases, representing one-third of all WHO-confirmed cases. During the first five months of the epidemic, MSF handled more than 85 percent of all hospitalized cases in the affected countries.

At the peak of the epidemic, MSF employed nearly 4,300 staff—most of whom were from the affected countries—who ran Ebola management centres, conducted surveillance, contact tracing, and health promotion, and provided psychological support.

Modupe Gbadeyanka is a fast-rising journalist with Business Post Nigeria. Her passion for journalism is amazing. She is willing to learn more with a view to becoming one of the best pen-pushers in Nigeria. Her role models are the duo of CNN's Richard Quest and Christiane Amanpour.

Health

NAFDAC Intensifies Efforts to Block Substandard Products from China, India

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Medication Drugs

By Adedapo Adesanya

The National Agency for Food and Drug Administration and Control (NAFDAC) is increasing efforts to block the entry of substandard and counterfeit products into Nigeria, particularly from China and India, the country’s two largest pharmaceutical trade partners.

This was revealed by Mrs Mojisola Adeyeye, the Director-General of the agency, emphasised that the Clean Report of Inspection and Analysis (CRIA) scheme has significantly strengthened regulatory control over imports from these nations.

The two nation’s account for 60 per cent of Nigeria’s pharmaceutical imports and yet, there is a lot of counterfeit and substandard medicines from these countries.

She said, “Because most of these drugs come from China and India, the CRIA scheme is operational in those two countries,” adding that, “It ensures that only safe and high-quality products are shipped while preventing the export of substandard and counterfeit products.”

She note that NAFDAC has appointed and accredited CRIA agents in China and India to conduct rigorous pre-shipment inspections to tackle the issue.

In addition to appointing CRIA agents in China and India, NAFDAC is collaborating with COTECNA, a global testing, inspection, and certification service provider, to enhance quality control measures.

Mrs Adeyeye urged stakeholders to engage with these CRIA agents before shipping any consignment to Nigeria, saying, “I strongly encourage you to engage with CRIA agents before shipping any consignment–that is, to our stakeholders– from China, India, or Nigeria. You have the flexibility to choose from any of the listed CRIA agents to ensure compliance and safeguard the quality of imported products.”

NAFDAC also introduced an electronic platform, the Port Inspection Data Capture and Risk Management System (PIDCARMS), to enhance document verification and streamline inspection processes.

Mrs Adeyeye noted that CRIA agents will ensure that rejected shipments carrying drugs will not find their way to the country.

She urged stakeholders to visit NAFDAC’s official website for guidelines on product registration, labelling, and shipment requirements to ensure compliance with regulatory standards in order to prevent such lapses and ensure only approved products enter Nigeria.

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AXA’s Mind Health Report Highlights Importance of Workplace Wellness

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AXA's Mind Health Report Omowunmi Mabel Adewusi

Nigeria’s leading insurance company, AXA Mansard Insurance Plc, has announced the release of the AXA Mind Health Report 2025. This comprehensive study underscores the critical importance of mental health in the workplace and among young people.

According to Omowunmi Mabel Adewusi, General Counsel and Human Resource Director of AXA Mansard, the Mind Health Report is part of AXA’s ongoing commitment to promoting positive mental well-being and reducing stigma through holistic approaches.

She said, “The state of mind health in the world continues to give cause for concern, with a lot of people currently experiencing a mental health condition. This fifth edition of the report shows a worrying trend among our youth.

“We also observe an interesting trend in the workplace that reveals work impacts employees’ mental health either as a source of support or a source of issues.”

The AXA Mind Health Report 2025 reveals significant insights into the mental health landscape, highlighting the challenges that young adults and employees face.

According to the report, 44% of young adults (18-24) currently suffer from mental health conditions, with excessive use of social media and financial instability being major contributing factors.

Additionally, work-related stress, including excessive workload, tight deadlines, and a lack of work-life balance, remains a significant concern for employees.

Adewusi further emphasized the importance of prioritizing mental health in the workplace, explaining that mental health is a crucial aspect of overall well-being. Organizations must implement policies that support their employees.

“For us at AXA, this realization is at the heart of our We Care Programme, which affords our employees benefits such as flexible working hours, access to professional counselling services, monthly health workshops, a supportive work environment, menstrual, extended paternity, and caregiver leave benefits.

“The findings of the AXA Mind Health Report 2025 highlight the urgent need for proactive measures to address mental health issues in the workplace and among the youth. We are calling on business leaders, government agencies, and other stakeholders to foster a wellness culture that promotes positive mental health and supports individuals in reaching their full potential.”

The 2025 study, conducted in collaboration with IPSOS, aims to identify mental health and wellness issues in global society to build solutions to mitigate them. A total of 17,000 respondents from 16 countries participated in the survey.

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Oyo Raises Entry Grade Level for University Graduate Nurses to 10

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graduate nurses ibadan

By Modupe Gbadeyanka

The entry grade level for nurses in the Oyo State civil service with university degree has been reviewed, the Provost of the Oyo State College of Nursing Sciences, Ibadan, Dr Gbonjubola Owolabi, has revealed.

The review was done by the state government through the Oyo State Civil Service Commission.

Recall that the National Council of Establishment (NCE) at its 43rd meeting in 2022 approved the placement of university graduate nurses on grade level 10.

At a meeting with 21 Nursing Tutors on Wednesday in Ibadan, Dr Owolabi said the state government has moved the category of nurses from grade 8, charging nursing tutors of the institution to be diligent in their duties and imbibe integrity and quality.

“The institution is out to train nursing and health practitioners and churn out quality manpower who can function effectively in community, primary, secondary, tertiary, and industrial health settings.

“I urge you to key into this vision, even as the present administration will not deprive you of your rights,” the provost stated.

Dr Owolabi, who said that the Oyo State government placed priority on integrity and quality, disclosed that “the institution has received necessary accreditations from the regulatory bodies for some courses.”

She lauded Governor Seyi Makinde for approving the promotion of the 21 tutors, saying such a gesture should be reciprocated with dedication to service.

In her vote of thanks, one of the lecturers, Mrs Abiola Elizabeth, lauded the management of the institution, saying the approval from the civil service had further accentuated the priority placed on the health sector by Oyo State government.

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