DRC Ebola Outbreak Remains Public Health Emergency of International Concern
Leaders from the WHO and various impacted countries met to assess the risks of the Ebola outbreak in the Democratic Republic of the Congo and the future of the outbreak response.
A meeting of the International Health Regulations Emergency Committee convened by the World Health Organization (WHO) director-general has concluded that the current Ebola virus disease outbreak in the Democratic Republic of the Congo (DRC) remains a Public Health Emergency of International Concern (PHEIC). The meeting was held via teleconference on October 18, 2019.
Speakers at the meeting included representatives of the Ministry of Health of the DRC, United Republic of Tanzania, Republic of Uganda, the United Nations Ebola Emergency Response Coordinator and the WHO Secretariat.
Although the ring vaccination strategy currently being pursued is reportedly “proving efficient and successful,“ the committee made recommendations for affected countries in order to maintain a commitment to the collaborative response and expand this commitment to rural areas at risk of undetected disease transmission due to their isolation from health services.
During the meeting, concern was also expressed for lack of funding for Ebola preparedness in the 9 nations that neighbor the DRC. According to the statement, of the $66.6 million required for preparedness efforts, only $4.5 million has been pledged.
In spite of concerns, nation states at risk for Ebola exposure were praised for not limiting travel. Maintaining a degree of free movement under current border regulations allows economic activity to continue unabated and allows for Ebola screening at official points of entry between countries, whereas border restrictions “are usually implemented out of fear,” but incentivize “the movement of people and goods” at “informal border crossings that are not monitored, thus increasing the chances of the spread of disease.”
The committee recommended the declaration of the outbreak a PHEIC at meeting in July 2019, in Geneva Switzerland. WHO director-general Tedros Adhanom Ghebreyesus, PhD, accepted the recommendation making it official. At the time, the WHO articulated a “need for intensified and coordinated action,” and pointed to violence as a barrier to treatment efforts following the fatal attacks on 2 health workers who were killed participating in Ebola outbreak response activities.
As of October 19, 3123 cases of Ebola had been confirmed in the DRC, with 2053 deaths.
As it stands, the case fatality rate associated with the outbreak is 66%. The number of impacted areas has diminished over time, with 22 health areas and 10 health zones currently reporting new cases. The epidemic remains concentrated in the Mandima health zone and the Bikato Mine health area. In recent weeks, Ebola cases have been declining, with 15 new confirmed cases reported in North Kivu and Ituri provinces during the last epidemiological week of 7—13 October. This contrasts with the 128 confirmed cases per week during the peak of the outbreak in April 2019.
The WHO Secretariat presented the latest risk assessment information. Risk continues to be “very high at national and regional levels,” but has remained low on a global scale. Hot spots have shifted away from urban areas toward rural, hard-to-reach communities.
The WHO Secretariat also emphasized the import of coordination between 9 neighboring countries, divided into 2 priority levels. Priority 1 countries are Burundi, Rwanda, South Sudan, and Uganda, and priority 2 countries are Angola, Republic of the Congo, Central African Republic, Tanzania, and Zambia. Cross-border coordination plans are already being implemented between the Democratic Republic of the Congo and priority 1 countries.