The second-largest Ebola outbreak continues to rage in North Kivu and Ituri provinces, Democratic Republic of Congo (DRC). These provinces have long been affected by conflict and insecurity and distrust is one of the most significant obstacles in tackling the spread of the epidemic. In recent months there have been several attacks on health workers and treatment centers. Remarkably, research is also being conducted in this challenging context: the first multi-drug Ebola trial (WHO 2018) is underway and many social science research studies are being delivered (Sonar Global 2019). As with approaches to delivering outbreak response, research efforts need robust engagement with local communities and with the realities of local contexts to be successful.
On 17-18 March, the African coaLition for Epidemic Research, Response and Training (ALERRT) co-hosted a community engagement workshop in Dakar, together with the Nuffield Council on Bioethics, the Institute for Health Research, Epidemiological Surveillance and Training (IRESSEF), and the Wellcome Centre for Ethics and Humanities (WEH). The workshop aimed to draw out effective practices for community engagement related to research and to consider good practice guidelines for future emergencies. It united experts from organisations involved in policy, research, and survivors, with extensive experience in community engagement. Whilst the context of the workshop considered experience of affected communities in the West Africa Ebola epidemic and the current epidemic in DRC, the conclusions that emerged are relevant well beyond the scope of Ebola.
A key conclusion was that trust and mutual respect should be at the core of relationships between researchers and affected communities. In order for community engagement to be effective during outbreaks, these elements are intrinsic to the research that takes place, arising from the acknowledgment of the experiences of those who are affected and their histories linked with those experiences. Furthermore, community engagement should be ingrained from the start of research activities during outbreaks.
Read the full report from the Dakar meeting here.
Following this meeting and in response to the escalation of conflict related to the Ebola epidemic in DRC, a group of 19 international experts co-signed a letter to The Guardian, calling for increased efforts in community engagement during outbreaks, including the current Ebola epidemic in the Democratic Republic of Congo. This letter calls on parties involved in outbreak responses, including national governments, to promote community engagement efforts in research and outbreak response.
PREPARE strongly supports these recommendations.