DRC health minister resigns over Ebola response

The outspoken minister of health of the Democratic Republic of the Congo (DRC) resigned today, protesting his president’s takeover of the country’s Ebola response. He also asserted that unnamed parties hid information about plans to deploy an experimental vaccine in the DRC, which has battled an Ebola outbreak since August 2018.

Oly Ilunga Kalenga wrote to DRC President Félix Tshisekedi that, “as a result of your decision to oversee the response to the Ebola epidemic, and because I anticipate that this decision will inevitably lead to a predictable outcry, I submit to you my resignation as Health Minister.”

Kalenga, 59, who has held the job since January 2017, wrote that Tshisekedi’s decision to remove him from heading the country’s Ebola response was made without his knowledge on 18 July. At the time, Kalenga was supervising the Ebola response in the city of Goma, DRC, where a first Ebola case was diagnosed on 14 July.

He said his ministry had communicated daily on the situation in the ongoing outbreak “to reassure and show the world that the country is managing this epidemic, thus preserving its reputation and preventing negative socioeconomic effects on the impacted regions.”

Tshisekedi’s administration announced on Saturday that direct supervision of the Ebola response was being placed with a team of experts under the direction of Jean Jacques Muyembe Tamfum, director-general of the DRC’s National Institute for Biomedical Research (NIBR) and a microbiologist at the University of Kinshasa’s medical school. Tamfum has studied Ebola and responded to outbreaks for more than 40 years.

One expert outside the country welcomed the change in leadership, which came days after the World Health Organization (WHO) declared the DRC outbreak a Public Health Emergency of International Concern. “There is no sign of this epidemic slowing down. We therefore welcome the DRC President’s bold decision to change strategy and bring the Ebola response under his direct supervision,” Peter Piot, director of the London School of Hygiene & Tropical Medicine, said in a statement. Since August 2018, the DRC has recorded more than 2500 cases of Ebola and, among them, more than 1700 deaths.

In his resignation letter, Kalenga also attacked efforts to launch trials of an experimental vaccine made by Johnson & Johnson (J&J) in the country. A Merck & Co. vaccine is already in use there. “The [Merck] vaccine currently used in the context of this epidemic is the only one that has shown efficacy,” Kalenga wrote, and it does so within 10 days. “It is fantastical to think that the new vaccine being recommended (with two doses administered 56 days apart) … could have a determinative effect on the epidemic that’s now underway,” Kalenga wrote. He charged that those proposing the use of the J&J vaccine “have shown a clear lack of ethics by intentionally hiding important information from the health authorities.”

Kalenga could not immediately be reached to detail the basis of his charges.

The London School of Hygiene and Tropical Medicine is one of several organizations that have been pushing to deploy the J&J vaccine, and in an interview with Science , Piot called Kalenga’s charges “outrageous.”

The groups backing the use of the J&J vaccine in the DRC—a coalition that includes the Wellcome Trust, Doctors Without Borders, the Coalition for Epidemic Preparedness Innovations (CEPI), WHO, J&J, and NIBR—are not intentionally hiding information, Piot says. He says he briefed Kalenga during a meeting in Kinshasa in March, hosted by the University of Kinshasa and NIBR, at which participants discussed the possible deployment of the J&J vaccine.

The convener of the coalition, CEPI, headquartered in Oslo, noted in a statement that details of the protocols under which the experimental J&J vaccine would be deployed have been submitted to ethics and regulatory bodies in the DRC. CEPI also noted that data from already conducted preclinical and clinical safety studies have been reported to the U.S. Food and Drug Administration and the European Medicines Agency. “Our goal was to be transparent and to make tools available for public health authorities. We would only ever proceed with a vaccine protocol if the Ministry of Health was supportive and it had gone through appropriate ethical and regulatory review,” says Richard Hatchett, CEPI’s CEO.

Piot calls Kalenga’s charges “the political gesture of a minister who loses his job in a pretty brutal political environment.”

Ministers such as Kalenga who were appointed under the administration of former DRC President Joseph Kabila have been in political peril since he left office in January, observers say.

*Update, 23 July, 8:15 a.m.: This story has been changed to more accurately translate certain phrases from Minister of Health Oly Ilunga Kalenga’s resignation letter.