Ebola fighters need to widen use of vaccination in their campaign against the deadly epidemic in DR Congo, the head of Doctors Without Borders (MSF) said Thursday.
Joanne Liu, the international president of the medical charity known by its French acronym MSF, told AFP that health officials needed a "reality check" in their response to the outbreak.
A day after the World Health Organization declared Ebola a "public health emergency of international concern" -- a designation reserved for the gravest epidemics -- Liu called for broader immunisation.
So far, doctors have used a so-called ring vaccination strategy, which focuses on protecting a circle of people who have been in contact with Ebola patients.
That is a "great, cost-effective way of doing things when you have real contact tracing of people but we are not in that scenario," Liu said in an interview.
"We are not able to follow up everybody," she noted.
Liu referred to the difficulties of tracing contacts in North Kivu and Ituri provinces of eastern DRC, which are plagued by chronic insecurity and poor transport.
Instead of a targeted vaccination approach, "we should have a geographical approach, meaning that if someone is infected coming from (a) village, we would not only vaccinate the contacts and the contacts of contacts, we would vaccinate the whole village," she said.
- 'Opacity?' -
New figures released by the health ministry on Thursday said that 1,698 people have died since the outbreak was declared last August 1.
As WHO made the global emergency call on Wednesday, it acknowledged a "shortage of supply of rVSV-ZEBOV vaccine" despite "commendable efforts" by manufacturer Merck to double supplies by 2020.
Liu said there "has been a lot of opacity" regarding available stocks of the vaccine, which is being used for the first time and has proven effective.
"What is the supply the world has right now?" she asked.
"We are told it is between 250,000 to 500,000 doses. So great, if we have that, but then where are they? When will they be available? We need much more transparency and clarity about the status of vaccine supply today."
WHO has called for the use of a second, less tested vaccine, made by the healthcare firm Johnson&Johnson, suggesting it be given to people facing lower infection risk.
DRC's health ministry has rejected the J&J vaccine, citing problems introducing a new product in communities where mistrust of Ebola responders runs high.
Liu said she appreciated that building confidence around a new vaccine was "complex", but that "we need to deploy everything we got" until the outbreak is under control.
The Merck vaccine has been widely deployed, but in regulatory terms is still unlicensed. The J&J vaccine, meanwhile, is in the investigational stage.
- 'Spacemen' -
The MSF chief also stressed that improving the response will require fostering an environment where people feel comfortable seeking care.
Ebola patients, she said, are "stripped of their rights," when they are removed from their homes only to be looked after by "people wearing a space suit," with a better than 50 percent chance of dying far from family.
"Could we think of having a decentralised approach to treat patients, and not putting them somewhere with only spacemen around away from their loved ones?" she said.