Dynamics of conflict during the Ebola outbreak in the Democratic Republic of the Congo 2018–2019

Abstract

Background: The 2018-2019 Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in the Democratic Republic of the Congo (DRC) is the largest ever recorded in the DRC. It has been declared a Public Health Emergency of International Concern. The outbreak emerged in a region of chronic conflict and insecurity, and directed attacks against health care workers may have interfered with disease response activities. Our study characterizes and quantifies the broader conflict dynamics over the course of the outbreak by pairing epidemiological and all available spatial conflict data. Methods: We build a set of conflict variables by mapping the spatial locations of all conflict events and their associated deaths in each of the affected health zones in North Kivu and Ituri, eastern DRC, before and during the outbreak. Using these data, we compare patterns of conflict before and during the outbreak in affected health zones and those not affected. We then test whether conflict is correlated with increased EVD transmission at the health zone level. Findings: The incidence of conflict events per capita is~600 times more likely in Ituri and North Kivu than for the rest of the DRC. We identified 15 time periods of substantial uninterrupted transmission across 11 health zones and a total of 120 bi-weeks. We do not find significant short-term associations between the bi-week reproduction numbers and the number of conflicts. However, we do find that the incidence of conflict per capita was correlated with the incidence of EVD per capita at the health zone level for the entire outbreak (Pearson's r = 0.33, 95% CI 0.05-0.57). In the two provinces, the monthly number of conflict events also increased by a factor of 2.7 in Ebolaaffected health zones (p value < 0.05) compared to 2.0 where no transmission was reported and 1.3 in the rest of the DRC, in the period between February 2019 and July 2019.

Narratives and Counternarratives on Data Sharing in Africa

“…The authors found that African researchers are significantly under-represented in the global health community, even when the data originates from Africa. A common threat is parachute-research, in which non-African researchers benefit from data sharing and open data, are afforded the opportunity to narrate African stories (in some cases also contributing to deficit narratives), and publish scientific work using African generated data available through open access initiativesall while ignoring the contributions of African communities and scholars [66,74,82,127]. Recent work within the medical sciences published on the Ebola outbreak in the Democratic Republic of the Congo can be cited as a prime example in this regard.…”

Conflictos y conservación

“…a las personas por la degradación de servicios ecosistémicos, por ejemplo, mediante cambios en la hidrología, la gestión del agua, y la agricultura de regadío (Recuadro 1) 52 . También es posible que las relaciones a gran escala entre brotes de enfermedades zoonóticas y conflictos armados, como se documentó para el Ébola en la República Democrática del Congo en 2018-2019 53 , puedan verse influenciadas por el deterioro ambiental concomitante con ambos.…”

Conflits et conservation

“…Les impacts de la guerre sur les écosystèmes incluent également les coûts indirects imposés aux populations par la dégradation des services écosystémiques, comme par exemple au travers de changements dans l'hydrologie et la gestion de l'eau ou l'agriculture irriguée associées (Encadré 1) 52 . Il est également possible que des relations à grande échelle entre épidémies de zoonoses et conflits armés puissent être influencées par la détérioration de l'environnement liée à ces deux aspects, comme cela a été documenté pour le virus Ébola en République démocratique du Congo, en 2018-2019 53 .…”