The interplay between civil unrest and disease transmission is not well understood. Violence targeting healthcare workers and Ebola treatment centers in the Democratic Republic of the Congo (DRC) has been thwarting the case isolation, treatment, and vaccination efforts. The extent to which conflict impedes public health re- sponse and contributes to incidence has not previously been evaluated. We construct a timeline of conflict events throughout the course of the epidemic and provide an ethnographic appraisal of the local conditions that preceded and followed conflict events. Informed by temporal incidence and conflict data as well as the ethnographic evidence, we developed a model of Ebola trans- mission and control to assess the impact of conflict on the epidemic in the eastern DRC from April 30, 2018, to June 23, 2019. We found that both the rapidity of case isolation and the population-level effectiveness of vaccination varied notably as a result of preceding unrest and subsequent impact of conflict events. Furthermore, con- flict events were found to reverse an otherwise declining phase of the epidemic trajectory. Our model framework can be extended to other infectious diseases in the same and other regions of the world experiencing conflict and violence.
This is the abstract from the paper in PNAS in which the research is published. To read the full paper: The exacerbation of Ebola outbreaks by conflict in the Democratic Republic of the Congo. Chad R. Wells et al.
The research team includes scientists from the Yale School of Public Health, Texas A&M University, the Centre René Labusquière, Department of Tropical Medicine and Clinical International Health, University of Bordeaux, the Department for Infectious and Tropical Diseases, University Hospital Centre of Bordeaux, and the University of Florida.