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| - Efforts to roll back the Democratic Republic of Congo's worst outbreak of Ebola created a "parallel" health system that had negative side effects, according to a report published on Thursday. Around a billion dollars in aid, along with an army of external specialists, flooded into the DRC after the much-feared haemorrhagic fever surfaced in its volatile east two years ago. But the influx fuelled suspicions among local people and drained much-needed skills from the DRC's own health service, according to the report by the Congo Research Group (CRG), a non-profit initiative based at New York University. The epidemic broke out in DRC's North Kivu province in August 2018. It was declared over on June 25 this year after 2,287 lives were lost -- the highest Ebola toll in the DRC's history and the second highest in the world, after the 2013-16 epidemic in West Africa that killed 11,000 people. "This epidemic emerged at the intersection of two histories -- the perception of Ebola as a global health security threat and the privatisation and decline of the Congolese health system," the CRG said. "Both trends led the donor community to create structures parallel to the existing health system and led largely by outsiders. "Viewed with suspicion -- many thought these outsiders had come to profit from the disease -- this parallel system struggled to be accepted, leading to a lack of collaboration with local communities and even violent attacks, feeding into a cycle of militarisation." Eleven Ebola workers and patients were killed, according to UN figures. The report argued that the "parallel" health system to fight Ebola developed "in the same racist logic that has historically denied recognition to Black and African systems of knowledge and practice." It pointed to problems on the ground when a new vaccine was introduced -- a tested but as-then unlicensed formula that eventually became a successful weapon in the campaign. "Initially, the consent process was incredibly opaque, with the consent forms being written in French and then Tanzanian Swahili," a language that would be "unreadable to even literate Congolese," it said. "Despite improvements in the consent process, in our household survey conducted in early 2020, nearly 40 percent of households reported that they did not understand the information that they had been given about the vaccine." The big influx of resources also had an impact on the DRC's under-resourced health service, taking away workers required for the country's many other medical needs, the authors said. Other experts have acknowledged these problems, and on June 25, WHO chief Tedros Adhanom Ghebreyesus himself stressed the need for long-term funding in health. "Ultimately the best defence against any outbreak is investing in a stronger health system as the foundation for universal health coverage," he said. Another Ebola outbreak, the 11th in the DRC's history, is underway in the northwest of the country. It has so far claimed 50 lives. On September 15, the ambassadors of the United States, Britain and Canada, in a statement co-signed by Congolese professor Jean-Jacques Muyembe after a visit to the area, said the latest outbreak was "the chance to strengthen not only the response to Ebola but also the DRC's overall health system." st/bmb/ri/dl
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