The fourth edition of the India-Africa Forum Summit has been cancelled due to the Ebola crisis in the Democratic Republic of Congo and Uganda. The summit, which fosters diplomatic interactions between India and countries of the African continent, was set to be held in Delhi after more than a decade. The move comes days after the World Health Organization (WHO) declared the latest Ebola outbreak a public health emergency of international concern. Ebola is a rare but deadly disease caused by a virus.
The cases have been confined to the African continent so far, but Indian experts say the latest outbreak could be challenging because it involves a rare species of Ebola for which there is no vaccine; also, the epicentre is in an area affected by conflict. Having faced the scourge of coronavirus with its impact on the economy, not to forget the human toll, India just cannot afford to let down its guard. There is a large population of African students in India, who visit home at least once a year. A number of African patients come here for medical treatment. Besides, Indian tourist traffic to Africa is experiencing a massive boom, with South Africa alone targeting over 100,000 visitors from India and a growing number exploring East African safari destinations. Popular hotspots like Kenya, Tanzania and Egypt are offering accessible e-visas or visa-on-arrival.
Of course, India’s preparedness to deal with emerging pandemics has improved substantially after the Covid-19 outbreak. The country has robust airport screening systems and disease surveillance mechanisms compared to earlier years. However, any outbreak anywhere in the world is a reminder that infectious diseases do not respect borders. India’s large population and crowded healthcare settings could pose challenges if an imported case goes undetected. Travellers coming from affected countries need close monitoring, which, among doctors, airport authorities and surveillance teams, is extremely important. Even a single imported infection must be managed quickly to avoid secondary transmission.
Ebola does not spread through the air like Covid-19, which limits the chances of large-scale community transmission. The virus mainly spreads through direct contact with infected bodily fluids, contaminated surfaces or unsafe burial practices. That is why healthcare workers and family caregivers are at a higher risk if proper protective measures are not followed.
The news about the outbreak comes amidst a controversy over the unusual alacrity with which the WHO declared a Public Health Emergency of International Concern over the Ebola outbreak in Central Africa, not even waiting for the advice of an emergency committee of expert panellists, as is conventional. WHO has nevertheless been feted for swift action by global health experts, given that there are several unknowns arising from the current strain responsible for the outbreak – the uncommon Bundibugyo strain. This strain has caused fewer outbreaks in the past and the efficacy of usually effective counter-measures, such as vaccines (highly effective against the common Zaire strain) and other therapies, are untested with Bundibugyo.
The new Ebola outbreak was first reported in the Eastern Congo and Uganda. It is said to be smaller and confined to a limited cross-border region between the two nations, but there are still concerns that, because of the ongoing conflict and displacement in the region, cases might go undetected, leading to a spread and impairing access to care. According to WHO, as of 16 May, eight laboratory-confirmed cases, 246 suspected cases and 80 suspected deaths have been reported in the DRC’s Ituri province. Two lab-confirmed cases (including one death) with no apparent link to each other have been reported in Kampala, Uganda. WHO has listed a clutch of factors – high positivity rate of the initial samples (eight positives among 13 samples); the confirmation of cases in Kampala; increasing trends in syndromic reporting of suspected cases; and clusters of deaths across Ituri province – that point towards a potentially much larger outbreak than what is being detected.
At any rate, WHO has rightly taken a risk-averse pathway when dealing with a condition that has a 50 per cent fatality rate. By issuing the highest level of global alert early on, WHO has solicited the cooperation of the world in handling the crisis. Outbreak control activities at this stage must unfailingly include effective patient and contact tracing, intensive support for every patient, safe and dignified burials, vaccinations, if they work, and social mobilisation to spread information about the disease among the public. The government should not be found wanting on any front.