The two most severe outbreaks of Ebola virus disease (EVD) have occurred within the last five years, in Libera, Sierra Leone and Guinea between 2014 and 2016, and the current outbreak raging in eastern Democratic Republic of the Congo (DRC). The outbreaks share some close similarities, but also stark differences in how containment, treatment and most importantly engagement of affected communities has been conducted. This report from RAN will be the first in a series, comparing the response and outcomes from the 2014-16 outbreak with the ongoing DRC outbreak.

The 2014-16 outbreak was the largest outbreak of EVD in history, claiming over 11,000 lives across six countries with one highly publicised fatality in the US, and non-fatal cases in the Europe. This severe epidemic of EVD, with almost one hundred times more cases than the second largest outbreak by its end, tested the response of humanitarian aid efforts to an extent never before seen in an infectious disease epidemic. As Ebola rapidly took hold in densely populated urban areas, the need for effective community engagement practices became apparent. The pressure only grew as the outbreak surpassed the four month mark, set by the previously longest-running incidence from December 2002 to April 2003 in the Republic of the Congo. Longer outbreaks can cause more public anger and allow rumours, disquiet and distrust to spread, further fueling the disease cycle.

We know much from how communities were engaged and responded during the West African epidemic in 2014-16. It is important to gather the same data in real time from organisations on the ground in the DRC as the outbreak continues to tighten its grip on Kivu province. Despite the caseload increasing at a similar weekly rate to that of the 2014-16 outbreak and many on-the-ground aid organisations collecting extensive data (for example, the British Red Cross has collected over 30,000 pieces of community feedback to the outbreak response), there is minimal news reporting on the outbreak and little data is available outside of the DRC. As occurred during the West Africa epidemic, much of the data that is collected is often held within individual aid organisations and not published. The consequence is that these data sources are often repeatedly collected by multiple organisation and are not available to other on-the-ground organisations during the current and future outbreaks. Whilst data from the outbreak response (such as EVD vaccine and treatment clinical trials) will likely eventually be published in academic journals (as occurred following the West African epidemic), the publication process is lengthy and many of the articles that are already coming out of the DRC response are not freely available in open access journals. The consequence is that there is little real-time reporting and information dissemination, which limits the information available to all responding organisations. A freely-accessible system for real-time, interagency data sharing could be invaluable for effectively responding to this and future outbreaks.