剛果（金）暴發(fā)罕見(jiàn)埃博拉毒株，無(wú)疫苗、無(wú)快速檢測(cè)，戰(zhàn)亂與援助削減雙重夾擊，專家警告這可能成為十年來(lái)最嚴(yán)重的疫情。
A new Ebola outbreak could be the worst in a decade
新一輪埃博拉疫情或成為十年來(lái)最嚴(yán)重的一次
Medics know how to respond.
醫(yī)護(hù)人員知道如何應(yīng)對(duì)。
But aid cuts, war and the lack of a vaccine make it difficult
但援助削減、戰(zhàn)爭(zhēng)以及缺乏疫苗使這一切困難重重
“SINCE APRIL, we’ve seen people dying,” says Sylvie Kabuo-Kinyoma, who sells vegetables in Mongbwalu, a gold-mining town in Ituri, a province in eastern Democratic Republic of Congo.
“從四月開(kāi)始，我們就看到不斷有人死去，”在剛果民主共和國(guó)東部伊圖里省金礦小鎮(zhèn)蒙布瓦盧賣(mài)蔬菜的西爾維·卡布奧-基尼奧馬說(shuō)。
At first she thought the deaths were due to witchcraft.
起初她以為這些死亡是巫術(shù)所致。
But then a nurse spotted a patient with a severe fever who was bleeding from their nose—a sign of Ebola, a virus with a fatality rate of up to 50% that spreads through direct contact with bodily fluids.
但后來(lái)一名護(hù)士發(fā)現(xiàn)一名高燒患者鼻子出血——這是埃博拉病毒的征兆，該病毒致死率高達(dá)50%，通過(guò)直接接觸體液傳播。
“We’re afraid,” says Ms Kabuo-Kinyoma.
“我們很害怕，”卡布奧-基尼奧馬女士說(shuō)。
“I don’t want to lose my children.”
“我不想失去我的孩子。”
On May 17th the World Health Organisation (WHO) said the outbreak was a “public health emergency of international concern”, only the ninth such declaration since 2005.
5月17日，世界衛(wèi)生組織宣布此次疫情構(gòu)成“國(guó)際關(guān)注的突發(fā)公共衛(wèi)生事件”，這是自2005年以來(lái)第九次此類聲明。
Though it has not been declared a pandemic, it is shaping up to be the worst Ebola epidemic since at least 2018, when more than 2,000 people died in eastern Congo.
盡管尚未被宣布為大流行病，但這至少正在成為自2018年以來(lái)最嚴(yán)重的埃博拉疫情，當(dāng)年剛果東部有2000多人死亡。
Some experts worry that it could be as bad as in 2014-16, when an epidemic in west Africa killed 11,000.
一些專家擔(dān)心情況可能惡化至2014-2016年西非疫情的水平，那次疫情導(dǎo)致11000人死亡。
That is because of a fatal blend of bad luck, a country at war and a world cutting health aid.
原因是不幸的致命組合：厄運(yùn)、一個(gè)處于戰(zhàn)爭(zhēng)中的國(guó)家，以及全球削減衛(wèi)生援助。
As of May 19th there have been more than 500 suspected cases and 130 deaths in Congo.
截至5月19日，剛果已有超過(guò)500例疑似病例和130例死亡。
There are almost certainly more, according to modelling by the MRC Centre for Global Infectious Disease Analysis, an institute at Imperial College in London.
根據(jù)倫敦帝國(guó)理工學(xué)院MRC全球傳染病分析中心的模型，實(shí)際數(shù)字幾乎肯定更高。
The virus has already been circulating for several weeks (Congolese authorities first detected it on April 24th).
該病毒已傳播數(shù)周（剛果當(dāng)局于4月24日首次發(fā)現(xiàn)）。
Two Congolese nationals have been diagnosed with it in Kampala, the capital of neighbouring Uganda.
鄰國(guó)烏干達(dá)首都坎帕拉有兩名剛果國(guó)民被確診。
An American doctor working in the area was also found to have the disease and has been evacuated to Germany.
在該地區(qū)工作的一名美國(guó)醫(yī)生也被發(fā)現(xiàn)感染，已被轉(zhuǎn)運(yùn)至德國(guó)。
There have also been cases in Goma, the capital of North Kivu, a Congolese province to the south of Ituri (see map).
剛果伊圖里以南的北基伍省首府戈馬也出現(xiàn)了病例（見(jiàn)圖表）。
Rwanda has reportedly closed some border crossings with Congo.
據(jù)報(bào)道，盧旺達(dá)已關(guān)閉部分與剛果的邊境口岸。
Public-health experts worry the disease could spread to Burundi and South Sudan.
公共衛(wèi)生專家擔(dān)心疫情可能蔓延至布隆迪和南蘇丹。
Since the west African disaster, governments and international bodies have vastly improved how they respond to the spread of the virus.
自西非災(zāi)難以來(lái)，各國(guó)政府和國(guó)際機(jī)構(gòu)大大改進(jìn)了應(yīng)對(duì)病毒傳播的方式。
Vaccines against the most common strain, known as Zaire, have allowed medics to isolate infected populations.
針對(duì)最常見(jiàn)的扎伊爾毒株的疫苗使醫(yī)護(hù)人員能夠隔離感染人群。
Genetic sequencing of this strain has enabled rapid diagnostic testing.
對(duì)該毒株的基因測(cè)序也使得快速診斷檢測(cè)成為可能。
Local health workers, backed by international NGOs and African governments, have got better at educating people about Ebola, earning their trust and isolating those with symptoms.
在國(guó)際非政府組織和非洲各國(guó)政府的支持下，當(dāng)?shù)匦l(wèi)生工作者在向民眾宣傳埃博拉知識(shí)、贏得信任以及隔離有癥狀者方面也更加得心應(yīng)手。
Yet none of that is likely to be much help with this outbreak, the 17th recorded in Congo since 1976.
然而，這些應(yīng)對(duì)措施對(duì)此次疫情很可能幫助不大，這是剛果自1976年以來(lái)記錄的第17次埃博拉疫情。
Bundibugyo, the strain that is causing it, is a bit less fatal than Zaire.
此次致病的本迪布焦毒株致死率略低于扎伊爾毒株。
But it is less common, and there is no licensed vaccine or rapid diagnostic testing for it.
但它較為罕見(jiàn)，且沒(méi)有獲批的疫苗或快速檢測(cè)方法。
Samples taken in Ituri must be flown to Kinshasa, the capital of Congo, some 2,000km away.
在伊圖里采集的樣本必須空運(yùn)至約2000公里外的剛果首都金沙薩。
It can take several days to receive an official result.
官方結(jié)果可能需要數(shù)天才能出來(lái)。
“This feels like we’re back to square one,” says Bob Kitchen of the International Rescue Committee (IRC), a humanitarian NGO, likening the situation to the start of the epidemic in 2014, before vaccines against any strain were available.
“這感覺(jué)像是回到了原點(diǎn)，”人道主義非政府組織國(guó)際救援委員會(huì)的鮑勃·基欽說(shuō)，他將當(dāng)前情況比作2014年疫情暴發(fā)之初——那時(shí)還沒(méi)有任何針對(duì)任何毒株的疫苗。
The kaleidoscope of conflicts in eastern Congo further complicates the picture.
剛果東部錯(cuò)綜復(fù)雜的沖突使局勢(shì)更加棘手。
More than 100 militias are active across Ituri and the Kivus.
超過(guò)100個(gè)民兵組織活躍在伊圖里和南北基伍。
In the last major Ebola outbreak in Congo in 2018 some of these groups burned down clinics run by Médecins Sans Frontières (MSF), another NGO.
在2018年剛果上一次重大埃博拉疫情期間，其中一些武裝團(tuán)體燒毀了無(wú)國(guó)界醫(yī)生組織運(yùn)營(yíng)的診所。
“We are taking safeguarding very seriously,” says Alan Gonzalez of MSF.
“我們非常重視安全防護(hù)，”無(wú)國(guó)界醫(yī)生組織的艾倫·岡薩雷斯說(shuō)。
Armed groups, along with some of the worst roads in Africa, make it hard for medics to get to remote areas.
武裝團(tuán)體，加上非洲最糟糕的路況之一，使得醫(yī)護(hù)人員難以抵達(dá)偏遠(yuǎn)地區(qū)。
The state presence in Ituri is incredibly weak, as it is in much of Congo.
國(guó)家在伊圖里的存在感極其薄弱，這也是剛果大部分地區(qū)的常態(tài)。
“We are very worried because, so far, the provincial authorities have taken no action,” says Machozi Mwanamolo, a university professor in Bunia, a city in Ituri province.
“我們非常擔(dān)心，因?yàn)榈侥壳盀橹?，省?jí)當(dāng)局沒(méi)有采取任何行動(dòng)，”伊圖里省布尼亞市的一位大學(xué)教授馬喬齊·姆瓦納莫洛說(shuō)。
He laments that people from Mongbwalu have been “allowed to move about freely when they should be restricted to prevent the spread of the virus”.
他痛心地說(shuō)，來(lái)自蒙布瓦盧的人“被允許自由活動(dòng)，而本應(yīng)限制他們的流動(dòng)以防止病毒傳播”。
He is wearing face masks and making ginger tea with lemon and garlic “to boost our antibodies”.
他戴著口罩，并用生姜、檸檬和大蒜泡茶，“以增強(qiáng)我們的抗體”。
Academics, normally a polite and formal bunch, have stopped shaking hands.
平時(shí)禮貌而正式的學(xué)者們已經(jīng)停止了握手。
Farther south in the Kivus, the situation is even trickier.
再往南至基伍地區(qū)，局勢(shì)更加棘手。
In the past two years M23, an armed group backed by Rwanda that is at war with the Congolese government, has taken control in much of the two provinces, causing many aid workers to leave.
過(guò)去兩年中，由盧旺達(dá)支持、與剛果政府交戰(zhàn)的M23叛軍已控制了這兩個(gè)省的大部分地區(qū)，導(dǎo)致許多救援人員離開(kāi)。
It has replaced officials across the local bureaucracy, including in the health ministry.
該組織已替換了當(dāng)?shù)馗骷?jí)官僚機(jī)構(gòu)中的官員，包括衛(wèi)生部。
When your correspondent visited a government-run clinic near Goma at the end of April, it was struggling to contain a measles epidemic.
當(dāng)本刊記者四月底訪問(wèn)戈馬附近一家政府運(yùn)營(yíng)的診所時(shí)，該診所正在努力應(yīng)對(duì)麻疹疫情。
M23 has also declined to reopen the airport in Goma, forcing NGO workers to make some journeys to parts of North Kivu via Rwanda and Uganda.
M23還拒絕重新開(kāi)放戈馬機(jī)場(chǎng)，迫使救援人員經(jīng)盧旺達(dá)和烏干達(dá)前往北基伍部分地區(qū)。
Humanitarians complain of supplies being held up by M23 officials demanding payment.
人道主義工作者抱怨物資被M23官員扣留，后者要求付費(fèi)。
Then there are the aid cuts.
其次是援助削減。
Before 2025 American funding helped pay for surveillance (typically in the form of community health workers) and preparedness (for instance education schemes and protective gear).
在2025年之前，美國(guó)的資金用于支持監(jiān)測(cè)（通常是社區(qū)衛(wèi)生工作者形式）和準(zhǔn)備工作（例如教育計(jì)劃和防護(hù)設(shè)備）。
But over the past year these programmes have been slashed; IRC, for example, went from working in five areas in Ituri to just two after March 2025.
但過(guò)去一年中，這些項(xiàng)目被大幅削減。例如，國(guó)際救援委員會(huì)在伊圖里的工作區(qū)域從2025年3月后的五個(gè)減少到僅兩個(gè)。
On May 18th the State Department promised $13m to help with the response, a fraction of what America spent to combat the epidemic in 2014-16.
5月18日，美國(guó)國(guó)務(wù)院承諾提供1300萬(wàn)美元用于應(yīng)對(duì)疫情，這只是美國(guó)在2014-2016年抗擊疫情期間支出的一小部分。
Other Western governments, including Britain and Germany, have also dramatically reduced aid spending.
包括英國(guó)和德國(guó)在內(nèi)的其他西方國(guó)家政府也大幅削減了援助支出。
Much will depend on whether the WHO, international NGOs and African organisations can fill the gap.
很大程度上取決于世衛(wèi)組織、國(guó)際非政府組織和非洲各機(jī)構(gòu)能否填補(bǔ)這一缺口。
Jean Kaseya, the head of Africa CDC, the continent’s main public-health body, implicitly criticised as inadequate America’s decision to restrict travel to non-Americans who had recently been to Congo, Uganda or South Sudan.
非洲主要公共衛(wèi)生機(jī)構(gòu)非洲疾控中心的主任讓·卡塞亞含蓄地批評(píng)美國(guó)決定限制近期去過(guò)剛果、烏干達(dá)或南蘇丹的非美國(guó)公民入境，認(rèn)為這一措施不夠充分。
“Global health security cannot be achieved through borders alone,” he said.
“全球衛(wèi)生安全無(wú)法僅通過(guò)邊境管控來(lái)實(shí)現(xiàn)，”他說(shuō)。
“It is achieved through partnership, trust, science and rapid investment in preparedness and response capacity.”
“它需要通過(guò)伙伴關(guān)系、信任、科學(xué)以及對(duì)防范和應(yīng)對(duì)能力的快速投資來(lái)實(shí)現(xiàn)。”
Responding to Ebola was incredibly difficult even with more of that around.
即便在資源更充足的情況下，應(yīng)對(duì)埃博拉也極其困難。
In the 2018 outbreak it took two years, around 300,000 doses of vaccine and a well-funded aid response to end the epidemic.
在2018年的疫情中，結(jié)束疫情用了兩年時(shí)間、約30萬(wàn)劑疫苗以及資金充足的援助響應(yīng)。
Without vaccines, the support of local Congolese for public-health measures is even more important, just as there is less money to fund schemes that build trust.
在沒(méi)有疫苗的情況下，剛果當(dāng)?shù)孛癖妼?duì)公共衛(wèi)生措施的支持變得更加重要，而恰恰此時(shí)用于建立信任的資金卻更少了。
That sort of education matters, says Foibe Mbusi, a market seller from Bunia: “There’s a segment of the population, even female vendors like us, who don’t believe Ebola exists.”
來(lái)自布尼亞的市場(chǎng)商販福伊貝·姆布西說(shuō)，這種宣傳教育至關(guān)重要：“有一部分人，甚至包括像我們這樣的女性商販，根本不相信埃博拉存在?！?/h1>