Goats and Soda : NPR

Dr. Jean Cassia has a warning to the world: “We are playing with fire.”

Cassia He is the general manager of the Centers for Disease Control and Prevention. He talks about MPOX, a virus that causes painful blisters and can be fatal.

For most of the world, MPOX – previously known as MonkeyPox – looks like a virus a few years ago. There was global outbreak in 2022 and 2023, but the virus was no longer a widely circulated in Europe and the United States

However, the large areas in Africa are in the midst of a great outbreak. The Democratic Center is located in the Democratic Republic of the Congo, where more than 2000 suspected cases were reported every week for several months, according to Africa CDC.

There seems to be encouraging news at the end of January, when the number of new cases suddenly decreased. But MPOX tracking devices do not celebrate.

“This decrease in terms of cases is not the reality,” says Cassia. Instead, he says, this is a sign that the ability to monitor new cases and their account have been interrupted. This is attributed to two things: “The combination of insecurity [and] Lack of funding. “

The insecurity that is in the eastern Democratic Republic of the Congo – a hot point in the outbreak of MPOX – where the rebel forces took control of the main areas. Violence has interrupted MPOX control and reports preparation.

The lack of financing is the result of the surprise Freezing in US foreign aid It was established after President Trump took office on January 20, along with a decision Fire or place on vacation Most 10,000 people working at the United States Agency for International Development. Almost all the agency’s work, including the critical parts of the MPOX response voltage. Trump also ordered the United States to leave the World Health Organization Stop communicating with officialsThose who played an important role in containing MPOX.

“It is similar to watching the train wreckage in an actual time – and the inability to do something about it,” says a health worker previously from the US response team. The worker spoke on the condition that his identity is not disclosed for fear of revenge on the federal government.

Expectations before Trump’s inauguration

The global community gathered after both Africa CDC and from The outbreak of MPOX in Africa announced a state of public health emergency in August 2024.

More than a billion dollars have been pledged to control efforts by countries throughout Africa, Europe, as well as Japan and the United States, according to AFRICA CDC. President Biden promised 500 million dollars in addition to a million doses of MPOX vaccine.

Hope was to stop this virus and prevented it from spreading to other parts of the world. However, the Democratic Republic of the Congo can be a difficult place to fight an infectious disease. It is a huge country with poor road networks and a hot period in fascism in the east, which is torn by war, where the crowded camps for the displaced are common. MPOX virus is spread through sexual contact as well as close contact, even through bed sheets.

The United States plays a major role in public health in the Democratic Republic of the Congo. Last year, the United States presented Almost 70 % From all humanitarian aid Go to the country, and send 965,000,000 dollars to the Democratic Republic of the Congo, according to the United Nations Office for the Coordination of Humanitarian Affairs. When it comes to MPOX response, American funds supported a wide range of efforts made by training laboratory technicians to provide diagnostic tests to provide gloves and dresses for health workers to work with veterinarians to monitor diseases in animal groups.

Then, in late January, the campaign was cut off to crush the virus.

A turning point – for the worst

On January 27, the M23 group – a rebel group that the United Nations says it was supported by Rwanda – in a city, a city in the Eastern Democratic Republic of the Congo, which was the center of efforts to respond to the disease. The intense fighting of the city for several days and early United Nations estimated indicating that a few thousand people were killed.

“From day to day, everything has just collapsed,” says Paulin Nocuso, head of the UNICEF field operations in the Democratic Republic of the Congo. UNICEF is the Humanitarian Agency that the United Nations is managed and managed.

NKWOSSEU, who was traveling when violence erupted, says violence did not stop the MPOX response efforts. The outbreak of the disease is much worse. This is because the vast majority of MPOX patients in isolation escaped to find a shelter of fighting.

“After the outbreak of the fighting, we were able to locate only 15 [mpox patients]. “Therefore, the rest of the community may live with a great danger of pollution. This is a very high risk in general,” says NKWOSSEU.

Africa CDC reports that at least 400 MPOX patients escaped.

NKWOSSEU adds that the risk of spreading the virus is particularly large because fighting means that many people have lost access to clean water or electricity.

NKWOSSEU says, even if relief workers can locate all MPOX patients who have escaped, it is unclear where they will be isolated now and make sure they do not spread the disease to others. “Six of the seven MPOX treatment centers were looted and completely destroyed, including two with the support of UNICEF,” he says. “All supplies, treatment, medications, mattresses, and tents – everything was looted.”

Dr. Mike Ryan, director of the World Health Organization, says violence was a major setback. “All the investment we have made during the last number of months to create MPOX monitoring, MPOX control, MPOX’s vaccination – all that stops, waiting and it is impossible to continue,” he says.

“Blind Air”

At the same time that the security situation in the eastern Democratic Republic of the Congo deteriorated, President Trump froze all US foreign assistance. While the judge spent that the money should start to flow again and that the administration issued exemptions for some “life rescue activities” – including the campaign against MPOX – the relief world faced a great revolution, with sudden work orders and the ends.

Public health experts say there are at least two areas where the effects of freezing aid are already feeling on MPOX response.

First, the vast majority of MPOX vaccines pledged by the United States stuck in a warehouse. While vaccines were donated by the US Department of Health and Humanitarian Services, the United States Agency for International Development facilitated the transfer to the Democratic Republic of the Congo. Thus, the work orders stopped the operation, according to an individual who was working on the operation and spoke, provided that his identity was not disclosed because they were not allowed to speak publicly.

In order to continue to donate the vaccine in the Democratic Republic of the Congo, this person says, HHS needs to launch vaccines – which involve the Trump administration confirms the donation – and the leadership of the American Agency for International Development must agree that the money is dispersed to the partners who will help pay the payment after that For the operational costs associated with the transfer of the vaccine.

Second, the United States funded the safe transport of MPOX samples suspected of clinics to laboratories for testing – but no longer.

“We are increasing the laboratory capacity, but the transfer of samples has become a nightmare,” he says. Dr. Nagashi NgongoCDC, which is based in the Democratic Republic of the Congo.

Ngongo says his team documented a sharp decrease in the test rate – a part of suspected cases where there is a test to confirm the diagnosis – even in parts of the country where violence has not been disrupted by MPOX response efforts.

“The United States, in particular, was putting a lot of funding and effort to enhance this monitoring. Without this piece, you are blind. He asked not to reveal his identity for fear of revenge,” says one of the individual who worked on the United States.

There was a concession that the US government gives MPOX to continue despite freezing in external aid. NPR obtained an internal memorandum sent to the United States Agency for International Development from Mark Lloyd, who was performing the duties of the assistant official of the US International Development Agency Office. On February 13, he wrote that the rapid emergency response is continuing to diseases such as MPOX. “This includes the disclosure of detection, prevention and containment efforts … such as the following activities: risk information for the affected population, active monitoring, infection prevention and control, test support, management, treatment, and supply of medical measures.”

However, such activities have proven difficult. The payments did not resume the response of MPOX, and there are currently nor any American employees on the American Democratic Development Agency mission in the capital of the Democratic Republic of the Congo and Trump’s order to the officials of the Disease Control Center not to communicate with those who are still present.

The White House did not respond to the suspension requests, and the American Centers for Disease Control and Prevention refused to request the interview. The press line of the US Agency for International Development has rang busy. NPR sent a request to comment on the Ministry of Foreign Affairs – Foreign Minister Marco Rubio on behalf of the US Agency for International Development; Questions covered vaccine donations, suspected MPOX samples, and the effect of unrest in the United States, aid on MPOX. The request has not been answered in time for our publication date.

Public health experts only warn of MPOX, but a full range of health threats faced by the Democratic Republic of the Congo now, from measles to cholera to widespread malnutrition.

Cassia says that the deterioration of health situations “an entry point to a new pace.”

Anne Remoen, a professor of epidemics at the University of Public Health at the University of California, Los Angel, says in the Democratic Republic of the Congo for decades.

Without our support, there will be “catastrophic setbacks” of health in the Democratic Republic of the Congo and because diseases do not respect the borders, they are concerned that these setbacks can be perceived elsewhere in the world as well.