Early-August 2019 reports on the Ebola outbreak in eastern Democratic Republic of Congo (DRC) were chilling. Amid increased violence in the affected region, the World Health Organization (WHO) reported interruptions in efforts to contain the outbreak. These interruptions coupled with concerns about high rates of population movement from outbreak-affected areas to other parts of the Democratic Republic of Congo and neighboring countries, increase the risk of geographical spread.
The situation in the DRC—a terrifying scenario for communities at risk, healthcare workers, and international aid organizations alike—illustrates why conflict settings are major flashpoints for epidemics and pandemics. In areas of violence and insecurity, rumors and miscommunication are rampant, people mistrust authority and are afraid to seek treatment, healthcare workers cannot access patients and become more vulnerable to disease themselves, and badly needed aid from outside the country or region is more difficult to bring.
Although DRC has had great success in containing outbreaks of Ebola within its borders, the outbreak that began in the east of the country in 2018 has now become the second-deadliest Ebola outbreak the world has ever seen.
The GHS Index highlights the risks posed by social unrest and political insecurity, as well as the importance of factoring in government effectiveness as part of epidemic and pandemic preparedness in countries around the world. On key indicators related to political and security risk, an alarming 55% of countries score in the bottom and middle tiers. Only approximately 15% of countries score in the highest tier for public confidence in government, and only 23% of countries score in the top tier for political system and government effectiveness.