“The risk of Ebola spread in DRC and the region remains very high, and the risk of spread outside the region remains low,” Dr. Tedros Adhanom Ghebreyesus, director-general of WHO, said during a press conference on Wednesday.
“Now is the time for the international community to stand in solidarity with the people of DRC.”
WHO defines a public health emergency of international concern as “an extraordinary event” that constitutes a “public health risk to other States through the international spread of disease” and “to potentially require a coordinated international response.”
The WHO International Health Regulations’ Emergency Committee for Ebola Viral Disease in Congo convened at the organization’s world headquarters in Geneva on Wednesday to discuss whether or not the outbreak constitutes international concern.
“The fight is ongoing for a full year now,” Robert Steffen, chairman of the committee, said during a press conference on Wednesday.
The meeting was the fourth time the committee has convened to review the outbreak. In a deliberation on Friday, it was decided that the outbreak does not constitute a public health emergency of international concern.
“This emergency in Congo has been going on for almost a year and is a very, very serious emergency and has been treated as our highest level of emergency since the beginning — but the difference that’s going on with this committee is, do we need to tell the rest of the world to start taking measures? And if so, what measures are we going to tell them to do?” Dr. Margaret Harris, WHO’s communication lead on the Ebola emergency in DRC, said in a video posted to Twitter ahead of the meeting on Wednesday.
“They make their decision as a consensus,” she said. “They will also lay down what under that public health emergency of international concern other countries need to do. So they will have recommendations for the affected country — that’s Congo. They will have recommendations for the neighboring countries, those most at risk. They will also have recommendations for the rest of the world.”
The committee’s consensus and recommendations then get presented to the WHO Director-General, who chooses whether or not to agree and adopt the committee’s decisions.
With its latest declaration, WHO does not recommend any restrictions on travel or trade, but rather the organization released recommendations for affected countries, which include to continue strengthening community awareness and screenings, among other actions.
Committee members were disappointed by delays in funding which have constrained the response, according to WHO.
The humanitarian group Mercy Corps hopes that WHO’s declaration “will translate into urgent and practical action, including more funding from international donors,” Laura Miller, Mercy Corps’ acting country director for DRC, said in a written statement following WHO’s announcement.
“Every day, women, men and children are dying of the Ebola virus and it is becoming too easy to forget that the ever-climbing case numbers are people,” she said in part. “With the WHO declaration comes the possibility that neighboring countries could react by heavily blocking or reducing border access in a way that restricts trade. This would be devastating for the economy of the region and impact the food security of large numbers of people.”
This Ebola outbreak began last summer. On the first day of August in 2018, the Ministry of Health of the Democratic Republic of Congo declared an outbreak of Ebola virus disease in the country’s North Kivu province.
Now the World Health Organization reports a total of 2,512 Ebola cases and 1,676 deaths involved in the outbreak, as of Monday.
On Monday, the United Nations hosted a high-level meeting to discuss response efforts amid the current outbreak in Congo. The meeting was held after the first case of Ebola was confirmed on Sunday in the city of Goma, the capital of North Kivu province and a major transit hub where some 1 million people reside on the Rwandan border.
That case raised fears that the virus could make its way across the porous border into still-uninfected Rwanda — something health experts have been working desperately to prevent. Health officials and aid organizations have dreaded Ebola’s arrival in Goma for months, and have been working to prepare for the eventuality — which is partly why the case was immediately caught and isolated.
These preparation measures include an emergency response team that has carried out outbreak simulation exercises, WHO teams that screen travelers at every entry and exit point in Goma, and workers who check the city’s health centers every morning for suspected cases, according to WHO officials.
It has been difficult to get ahead of the outbreak as ongoing violence in the area has impacted response efforts. Since January, there have been 198 attacks against health care personnel and patients in Ebola-affected areas, resulting in seven deaths and 58 injuries, according to WHO.
The rare but deadly Ebola virus disease can cause fever, headache, muscle pain, vomiting, diarrhea and unexplained bleeding, among other symptoms. The virus was first identified in 1976 when outbreaks occurred near the Ebola River in the DRC.
Scientists think the virus initially infected humans through close contact with an infected animal, such as a bat, and then the virus spread from person to person.
The virus spreads between humans through direct contact with an infected person’s bodily fluids, including infected blood, feces or vomit, or direct contact with contaminated objects, such as needles and syringes.
Yet hope comes in the form of research advancements. Experimental treatments and vaccines have been used in Congo. To date, at least 585 patients have recovered from the illness, and more than 133,000 vaccines have been administered, which many believe has helped limit the spread of the outbreak.
The rVSV-ZEBOV experimental vaccine, manufactured by Merck, was approved by Congo’s health ministry ethics committee for use in country in May 2018.
In its previous meeting on Friday, the emergency committee recommended all at-risk countries put in place the necessary approvals for using investigational medicines and vaccines as part of their preparedness.