Question 15650 — overseas

Summary

Mr. Yoann Gillet questions the Minister of Health, Families, Autonomy and People with Disabilities on the recent health alerts concerning the progression of the Ebola epidemic in the Democratic Republic of Congo and on its potential risks of spreading to Mayotte, an overseas department of the French Republic particularly exposed to migratory flows from the African Great Lakes region. In the name of residents of Mayotte and health professionals who work in extremely fragile conditions, the MP intends to confront government assurances with the reality on the ground and the structural vulnerability of this territory. Regarding the epidemic risk, the Democratic Republic of Congo is facing its 17th Ebola epidemic since 1976. The current outbreak is concentrated in a province bordering Uganda and Uganda. South Sudan, subject to intense population movements linked to mining activity. According to the Congolese authorities, the death toll stands at at least 91 dead. Professor Xavier Lescure, infectious disease specialist and head of Epidemic and Biological Operational Coordination, believes that the risk of spread in Mayotte remains “possible”. He also emphasizes that it is necessary to be “vigilant and in anticipation”. Africa CDC estimates to her that this risk, for the East African countries bordering the DRC, is “high”. The MP draws the attention of the Minister to the health and migration situation in Mayotte. As the member of the French community Estelle Youssouffa points out, Mayotte is a land of welcome for thousands of illegal immigrants each year, a significant proportion of whom come from the Comoros, including areas of potential contamination. Thousands of nationals come from these risk areas, transit through the Comoros before arriving in Mayotte without potential carriers of the virus reporting to the authorities or declaring a risk. The island's health system is described by its own representatives as "extremely fragile" and "in a difficult position" in the face of an epidemic of this nature. The slums, which concentrate a share large immigrant population in crowded conditions favorable to viral transmission, constitute a considerable aggravating factor. Furthermore, the MP emphasizes that the strain identified is the Bundibugyo variant, for which there is no vaccine or specific treatment. The fight therefore relies exclusively on the rapid identification of cases and the application of barrier measures, two levers particularly difficult to operate in a territory where a significant part of the population lives illegally and avoids any contact with the health authorities representing the state apparatus. As epidemiologist Mircea Sofonea recalls, the closure of borders, demanded by the representative of Mayotte in the National Assembly, is an option that the WHO does not recommend, on the grounds that illegal arrivals divert people contaminated towards even less traceable routes, further delaying the use of care. Finally, in terms of the State's response capabilities, the risk of a case in Mayotte remains, according to experts, low but not zero. An exceptionally long incubation or an asymptomatic case would be enough to introduce the virus into the territory without immediate detection. However, a single case in a hospital system under chronic strain could trigger a chain of contamination particularly difficult to contain. Reducing this threat to a simple statistical probability, without implementing reinforced surveillance protocols at points of entry and without strengthening the island's health reception capacities, would amount to ignoring the reality of a territory that the State has left on the verge of collapse for too long. He therefore asks him if the Government will implement strong measures to protection of borders, strengthening health surveillance, adapting the epidemic monitoring system to the migratory specificities of the territory and guaranteeing that health personnel and residents of the island have the necessary means to deal with a possible introduction of the virus onto French soil.

Machine translation from French. The official text remains authoritative.

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