Doctors Without Borders/Médecins Sans Frontières (MSF) emergency operations coordinator Dr. Natalie Roberts describes the challenges of responding to the measles epidemic currently affecting the Katanga region in southeastern Democratic Republic of Congo (DRC). Measles, a highly contagious viral disease, is one of the leading causes of death among young children worldwide.
What is the situation in Katanga?
A measles epidemic was declared in March 2018 in the provinces of Haut-Katanga, Haut-Lomami, Lualaba, and Tanganyika, which together previously formed the province of Katanga. The epidemic spread over the course of the year and, by December, every health zone across the four provinces had declared either suspected or confirmed cases. Moreover there are enormous pre-existing health needs throughout the Katanga region—an area the size of Spain—where people are scattered across remote villages.
Since 2011, Katanga has had a large-scale measles epidemic every two or three years. The Ministry of Health faces the same constraints that we do: a lack of supplies in the health zones because of the difficulties of transportation, a lack of electricity for vaccine refrigerators, and difficulties in reaching communities. Routine vaccination coverage is therefore inadequate in many locations, and epidemics are recurrent. MSF has regularly carried out emergency measles vaccination campaigns in the region. Although our goal is to respond early in the epidemic, we still often fail to meet this objective due to the challenges we face. We are constantly trying to find new or different solutions to this recurrent problem.
How does MSF respond to a measles epidemic on this scale?
Measles epidemics take hold in areas where not enough people have been vaccinated. To protect a population, 90 to 95 percent of people—and ideally 100 percent—must be vaccinated.
By vaccinating populations as soon as measles cases are reported, we aim to prevent children in the area from contracting measles and to stop the spread of the disease. To have the greatest impact through mass vaccination, we need to target areas where the epidemic has just begun, as we are now doing in Lualaba province. But sometimes it’s already too late and this isn’t possible.
In areas which have already experienced a major epidemic over several months, a mass vaccination campaign is not necessarily the most appropriate response. Even detecting the epidemic early enough is difficult, as the only validated laboratory in the country is in the capital, Kinshasa.
