The World Health Organisation declared DR Congo’s Ebola outbreak an international health emergency, sounding a rarely used global alarm as the virus threatens to spread to a major city and neighbouring countries.
Despite a highly effective vaccine and a swift international response after it was declared 11 months ago, the outbreak proved tenacious in an unstable region beset by violence, becoming Congo’s worst ever, with almost 1,700 dead.
A vast campaign of vigilance and vaccination, with almost 75 million screenings, kept the highly infectious virus almost entirely confined to two provinces in north-eastern Congo. The emergency committee of international health experts that advises WHO three times declined to declare an emergency.
This month a pastor died after travelling to Goma, a city of two million and a gateway to other countries in the region. On Wednesday, the WHO reported a fisherwoman died after four vomiting incidents at a market in Uganda, where 590 people are sought for vaccination.
“The committee is concerned a year into the outbreak there are worrying signs of possible extension of the epidemic,” the committee’s report said.
The committee was under pressure from experts who felt the scale of the outbreak and the risks meant it had to have emergency status – only the fifth such disease outbreak since the WHO introduced the designations in 2005.
“It shows no sign of coming under control,” said Peter Piot, a member of the team which discovered Ebola and now director of the London School of Hygiene and Tropical Medicine.
“I hope today’s decision serves as a wake-up call to drive high-level political action, improved co-ordination and greater funding to support DRC in efforts to stop this devastating epidemic,” he said.
NO BORDER CLOSURES
Previous international emergencies, under a system introduced after the 2004 Asian SARS epidemic, were the 2013-2016 West African Ebola epidemic that killed over 11,300 people, the 2009 flu pandemic, polio in 2014 and the Zika virus that caused a spate of birth defects across Latin America.
WHO committee chairman, Robert Steffen, tempered the outbreak’s designation as an emergency saying it remained a regional, rather than a global threat and stressed no country should react to Ebola by closing borders or restricting trade.
WHO warned nearby countries Rwanda, South Sudan, Burundi and Uganda are most at risk, while Central African Republic (CAR), Angola, Tanzania, Republic of Congo and Zambia are second tier.
Earlier this week the WHO said hundreds of millions of dollars were needed immediately to prevent the outbreak billowing out of control and costing more lives and money.
WHO chief Tedros Adhanom Ghebreyesus, who convened the emergency committee after viewing the Goma case as a “potential game changer”, said the international emergency designation did not suggest some countries were withholding funds.
One priority was to accelerate production of vaccine, which is in short supply. It is produced by Merck and still unlicensed, meaning it can only be used in a clinical trial overseen by Congo’s health ministry.
WHO has begun using smaller doses to ration supplies and the committee recommends taking “all measures to increase supplies”, including contracting supply to other manufacturers and transferring Merck’s technology.
