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Delayed containment of Ebola could cost DRC and Uganda billions

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The Bundibugyo Ebola outbreak in the Democratic Republic of the Congo (DRC) and Uganda presents an urgent public health and development challenge for the Great Lakes region. Although smaller so far than the 2014-2016 West Africa Ebola epidemic, history shows how quickly localised outbreaks can escalate when containment is delayed, and health systems are strained.

The immediate policy priority is containment. Failure to control transmission would not only increase mortality but also impose high economic costs through reduced productivity, heightened fiscal burdens and disruptions to trade, investment and development.

As of 7 July, the DRC had reported 1 759 confirmed cases and 600 confirmed Ebolarelated deaths, while Uganda reported 20 confirmed cases and two deaths.

Mortality figures should be interpreted cautiously due to possible under-reporting in remote areas.

No confirmed cases have been reported in neighbouring Rwanda or Burundi. Both countries have, nevertheless, heightened surveillance and preparedness given the extended connections with eastern DRC, especially through the Goma-Rubavu border crossing.

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Ebola outbreaks can disrupt healthcare services and weaken health systems’ capacity. As resources are redirected towards emergency responses, the handling of other communicable diseases may suffer, leading to higher overall incidence and mortality rates. This can reverse hard-won gains and strain already struggling health systems, underscoring the importance of swift containment.

In June, the Institute for Security Studies African Futures and Innovation (AFI) programme modelled the impact of a ‘Containment’ scenario against the ‘Current
Path’ (business-as-usual) forecast. The International Futures modelling platform’s ‘other communicable diseases’ category includes Ebola and was used to model the associated effect.

AFI analysis indicates that on the Current Path, fatalities could reach 3,360 in the DRC and 520 in Uganda by the end of 2026, compared to 490 in DRC and 30 in
Uganda under the Containment forecast. (Actual Ebola deaths are already higher than the Containment forecast, indicating the gravity of the situation.) The outcome may worsen in 2027, rising to about 4,340 additional deaths in the DRC and 750 in Uganda.

These figures are well below the 2014-2016 West Africa Ebola epidemic, which resulted in about 11,325 deaths, but they underscore the risks of delayed
intervention.

Containing the outbreak will require a significant increase in public health expenditure to enable better disease surveillance, laboratory testing, treatment
facilities, community outreach and emergency response systems. These interventions would not only limit transmission but restore public confidence and maintain economic activity.

AFI’s Containment scenario indicates that government health expenditure in 2026 would need to rise to at least US$1.82 billion in the DRC and US$1.17 billion in Uganda. This represents an increase of over US$540 million above the Current Path forecast in the DRC and US$170 million in Uganda. Taken together, at least US$710 million in additional health financing would be required to effectively contain the outbreak.

The benefits of early intervention would be substantial in terms of lives saved. Rapid containment is also significantly less costly than responding to a larger, more entrenched epidemic later.

The estimated financing requirement is broadly consistent with the US$518 million emergency appeal the United Nations and humanitarian partners launched on 5 June. Several governments and development partners have already pledged support, but crisis financing is often reactive and temporary.

The current outbreak highlights the need for more systematic investment in epidemic preparedness, surveillance systems, laboratory infrastructure, community
health workers and rapid-response capacity.

However, additional health spending should not come at the expense of other development priorities. African governments are often forced to divert resources
from education, social protection, food security and infrastructure during crises. This risks undermining long-term development outcomes and shifting the burden of the emergency onto vulnerable populations.

The challenge is not only to mobilise emergency financing, but to secure additional, flexible resources that allow governments to respond without compromising broader development objectives.

Ebola can also discourage market participation due to uncertainty and fear of infection. Border restrictions, reduced travel and disruptions to transport networks constrain trade, services and agricultural activity. These effects are particularly significant in the Great Lakes region, where communities rely on cross-border economic and social ties. If containment is further delayed, the region could face rising communicable disease fatalities alongside slower economic growth.

Often, economic activity does not disappear entirely but shifts into informal, unmonitored channels as households try to preserve their incomes and livelihoods.

As informality increases, governments collect less revenue from customs duties, corporate taxes and other domestic sources.

AFI modelling shows that in 2026, the DRC and Uganda could lose around US$70 million and US$60 million in government revenue, respectively, due to reduced formal economic activity, increased informality and the fiscal strain of financing the outbreak response. Both governments are already under pressure to finance emergency health interventions while sustaining critical development spending.

Four key policy implications emerge from these findings.

First, early containment would be far less costly than the burden of uncontrolled escalation. Rapid intervention saves lives, reduces economic disruption and lowers long-term fiscal costs. Second, emergency health financing must be mobilised quickly and should be additional to existing development resources.

Third, responses should protect livelihoods and formal economic activity wherever possible, particularly in border communities relying on trade and mobility.

Finally, the outbreak reinforces the importance of investing in resilient health systems before crises occur. Strong surveillance networks, laboratory systems, community health workers and cross-border preparedness mechanisms are the most effective safeguards against future epidemics.

The African Development Bank and other development partners can mobilise rapidresponse financing, support health-system resilience and strengthen regional preparedness. Epidemic preparedness must be recognised not just as a health priority, but as a development, fiscal stability and regional resilience imperative.

Marvellous Ngundu is a Research Consultant, Blessing Chipanda is a Senior Research Consultant, and Jakkie Cilliers is Head of African Futures and Innovation at the Institute for Security Studies (ISS) Pretoria.

(This article was first published by ISS Today, a Premium Times syndication partner. We have their permission to republish).

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Health

FCTA trains health workers in basic life support, plans Code Blue teams in hospitals

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The Federal Capital Territory Administration (FCTA) has commenced Basic Life Support (BLS) training for health workers in seven public hospitals, as part of efforts to strengthen emergency response and reduce preventable deaths in the territory.

This was disclosed in a statement issued on Saturday.

The four-day American Heart Association (AHA)- certified training is being held at the Conference Hall of Asokoro District Hospital, Abuja, following the National Council on Health’s approval to implement the National BLS Training Programme nationwide.

Health workers from Asokoro, Maitama, Wuse, Gwarinpa, Kuje, Kubwa and Nyanya hospitals are participating in the training.

The programme is designed to equip health workers with the skills required to respond quickly to medical emergencies and provide basic life-saving care while patients await further medical intervention.

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FCTA plans Code Blue, teams

The Mandate Secretary, Health Services and Environment Secretariat (HSES), Dolapo Fasawe, while declaring the training open, said the programme would strengthen emergency services in FCT hospitals and help reduce avoidable deaths.

Ms Fasawe said the FCTA was also working towards establishing Code Blue teams across hospitals in the territory to ensure that patients requiring urgent attention receive prompt care.

“Our goal is to record success stories from ‘no pulse to resuscitation consistently’. When people know that they can receive timely and proper emergency care in our hospitals, it will also build their confidence and trust in government hospitals to respond swiftly and manage their loved ones,” she said.

She said the training would also help health workers remain up to date with global practices in emergency care.

According to her, participants would be expected to share the knowledge they acquire with their colleagues and the public to support the National Community cardiopulmonary resuscitation (CPR) Initiative.

Ms Fasawe added that the training would be extended to other hospitals in the FCT, with the necessary basic equipment and other requirements provided to strengthen emergency response and patient care.

Training to include bleeding control
The training coordinator, Rosemary Nwokorie, a consultant anaesthetist, said the exercise was being conducted in batches.

She said the first batch was scheduled for 21 and 22 August, while the second batch would be held on 4 and 5 September.

The training also includes a Stop the Bleeding course, which teaches participants how to control severe bleeding in trauma patients before definitive medical care is provided.

Onyedika Okoye, a trauma surgeon at the Trauma Centre, National Hospital, Abuja, leads the team of instructors.

READ ALSO: Stakeholders seek more health workers to boost routine immunisation in three northern states

Participants will undergo an assessment at the end of the training, with certificates to be awarded to those who meet the required standard.

‘Timely intervention can mean the difference between life and death’

The Medical Director of Asokoro District Hospital, Oluseyi Ashaolu, described the training as necessary and timely, saying it would help health workers keep pace with developments in emergency care.

Mr Ashaolu said the knowledge and skills acquired would help curb avoidable deaths, particularly in situations where immediate and appropriate intervention could determine whether a patient survives.

The FCTA said the programme was part of its broader efforts to improve emergency care and ensure that health workers are adequately prepared to respond when patients require immediate attention.


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PT Health Watch: Sex during pregnancy is usually safe, but some risks remain

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Pregnancy often comes with questions about what women can and cannot safely do, particularly when it comes to sexual activity.

For some couples, pregnancy may create fears that sex could harm the baby or trigger complications. Others may assume that once a woman becomes pregnant, all forms of sexual activity should stop.

But medical guidance suggests that pregnancy itself is not a reason to stop having sex.

The American College of Obstetricians and Gynaecologists (ACOG) says most sexual activity is safe for women with healthy pregnancies, noting that the amniotic sac and strong muscles of the uterus protect the developing baby.

However, that reassurance does not apply to every pregnancy. Certain complications can make sexual activity unsafe or require a woman to avoid it on the advice of her healthcare provider.

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To provide more insight into sexual activity during pregnancy and the precautions women should take, PREMIUM TIMES spoke with Halimat Jimoh, a nurse and midwife, who explained the circumstances that can make sex unsafe, the risks of STIs and why some precautions are necessary even during oral sex.

When sex may not be advisable

Ms Jimoh explained that in an uncomplicated pregnancy, the developing baby is protected inside the uterus by the uterus, amniotic fluid and cervix.

However, she said certain pregnancy complications can change the advice given to a woman.

These may include unexplained vaginal bleeding, placenta previa or other placental problems, leaking of amniotic fluid, some cervical conditions and concerns about preterm labour.

She said this means pregnancy should not be viewed as a blanket reason to stop having sex. Rather, a woman’s individual pregnancy and any complications she may have should determine what is considered safe.

“Pregnancy itself is not a reason to stop having sex; it is certain pregnancy complications or medical concerns that may make avoiding sex necessary,” she explained.

Oral sex is generally safe, but not risk-free

While vaginal intercourse is often the focus of discussions about sex during pregnancy, oral sex is another form of sexual activity that couples may have questions about.

Ms Jimoh said oral sex is generally considered safe during an uncomplicated pregnancy, but certain precautions are necessary.

One of them is that a partner should not blow air directly into the vagina.

Although extremely rare, forcing air into the vagina has been associated with air embolism, a potentially life-threatening condition in which an air bubble enters a blood vessel and interferes with blood flow.

More importantly, oral sex does not eliminate the risk of sexually transmitted infections.

The National Health Service (NHS) states that infections, including herpes, gonorrhoea, syphilis, chlamydia, HIV and hepatitis, can be transmitted through oral sex. The risk can increase when either partner has sores or cuts around the mouth, genitals or anus.

This means that the absence of vaginal penetration does not automatically make oral sex risk-free.

And for pregnant women, an STI acquired through sexual contact can have implications beyond the mother.

Pregnancy does not protect women from STIs

According to Ms Jimoh, pregnancy does not protect a woman from contracting an STI.

An infection acquired during pregnancy can affect the mother and, depending on the infection, may also affect the developing baby.

Syphilis is one example.

The World Health Organisation (WHO) estimates that about eight million adults aged 15 to 49 acquired syphilis in 2022.

The organisation says untreated, late-treated or inadequately treated syphilis during pregnancy can result in adverse birth outcomes in an estimated 50 to 80 per cent of cases, depending on the stage of the infection.

The infection can pass from a pregnant woman to her baby through the placenta and may result in stillbirth, neonatal death, premature birth, low birth weight or congenital syphilis.

WHO also stresses that early testing and treatment during pregnancy can prevent these outcomes.

Ms Jimoh said pregnant women should therefore not wait until after delivery before seeking care for a suspected STI.

“Many STIs can be treated or effectively managed, and early testing, diagnosis and appropriate treatment during pregnancy can help protect both the mother and baby,” she said.

Herpes requires particular attention

Among the infections requiring particular attention during pregnancy is genital herpes, particularly because of the risk of transmission to the baby around the time of delivery.

Ms Jimoh explained that genital herpes can be transmitted from a mother to her baby during childbirth.

The risk is particularly concerning when a woman develops genital herpes for the first time towards the end of pregnancy, as she may not yet have developed sufficient antibodies to help protect the baby.

The Centres for Disease Control and Prevention (CDC) estimates that the risk of transmitting herpes to a newborn is between 30 and 50 per cent when a woman acquires genital herpes near the time of delivery.

This compares with a risk of less than one per cent among women with recurrent herpes or those who acquired the infection during the first half of pregnancy.

The CDC recommends that pregnant women with genital herpes inform their healthcare providers. Antiviral medication may be prescribed towards the end of pregnancy to reduce the likelihood of an outbreak around delivery, while a caesarean delivery may be recommended when genital lesions or symptoms are present at the onset of labour.

READ ALSO: Pregnant woman allegedly dies at Ondo fake medical facility

But herpes is not always accompanied by visible symptoms.

Ms Jimoh noted that the infection can sometimes be transmitted even when there are no obvious sores or other symptoms.

She, therefore, advised pregnant women and their partners not to dismiss unexplained sores, blisters or lesions around the mouth or genitals.

This is particularly relevant to oral sex because oral herpes, commonly associated with cold sores, can be transmitted through oral sexual contact.

When should sexual activity be avoided?

The presence of sores is not the only reason a pregnant woman may need to pause sexual activity.

According to Ms Jimoh, women experiencing unexplained vaginal bleeding, leaking of amniotic fluid, known or suspected STI exposure, unexplained sores or lesions, unusual discharge, pain or fever should seek medical advice.

Women who have already been advised to avoid sex because of a pregnancy complication should also not assume that oral sex is automatically safe.

Instead, Ms Jimoh said they should ask their healthcare provider which forms of sexual activity are appropriate for their specific condition.

Vaginal bleeding during pregnancy, in particular, should not simply be dismissed as a normal consequence of sex.

For pregnant women, regular antenatal care, early testing where necessary and prompt medical attention when unusual symptoms occur can help identify and manage potential risks early.
The message, Ms Jimoh stressed, is therefore not that pregnant women must stop being sexually active, but that they should understand their individual circumstances and seek professional advice whenever complications, warning signs or concerns about infection arise.


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