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Updated On: Monday, 22 July 2019

WHO under pressure over Ebola response

The Ebola crisis that has raged for 10 months in the Democratic Republic of Congo and spread last week to Uganda is not a “public health emergency of international concern” (PHEIC), the World Health Organization’s advisory committee has declared, in a decision that baffled some critics.

The International Health Regulations (IHR) Emergency Committee met Friday in Geneva following the deaths from Ebola of a five-year-old boy and his grandmother in Uganda – the first confirmed cases of the virus in the East African country.

“Declaring this a PHEIC would have raised the levels of international political support which has been lacking to date, enhanced diplomatic, public health, security and logistic efforts as well as released more financial resources to support the incredibly brave and committed teams working in North Kivu, DRC,”

Jeremy Farrar, director Wellcome

Preben Aavitsland, acting chair of the committee, told a news conference at the UN agency’s Swiss headquarters: “This is not a global emergency, it is an emergency in the Democratic Republic of Congo, a severe emergency.” WHO director-general Tedros Adhanom Ghebreyesus said he accepted the committee’s decision but the outbreak remained “very much an emergency” for the families affected. Marianne Comparet, director of the UK-based International Society for Neglected Tropical Diseases, told SciDev.Net that, should the disease spread further, declaring a PHEIC would be “hugely beneficial in galvanising attention and resources as well as coordinating the response to this outbreak.”

What makes a PHEIC?

A PHEIC is defined by the IHR as “an extraordinary event which is determined to constitute a public health risk to other states through the international spread of disease and to potentially require a coordinated international response”. According to the WHO, the definition implies a situation is “serious, sudden, unusual or unexpected”, “carries implications for public health beyond the affected state’s national border”, and “may require immediate international action”. Jeremy Farrar, director of UK-based medical research charity Wellcome, said he respected the IHR’s decision but felt a PHEIC “would have been justified”. “A step up in the response with full international support is critical if we’re to bring the epidemic to an end and ensure protection for the communities at risk.” “The international community can assist with supporting health systems with things such as improved diagnostics, increasing vaccine stockpiles, and an excellent and growing body of research on Ebola,” she said, adding: “Both countries affected shouldn't have to deal with this on their own." The outcome of the last epidemic shows the urgency of preventative action. In 2014-2016, 11,000 people died in what became the world’s worst Ebola outbreak on record.
Gayle Smith, president and CEO of the ONE Campaign, a non-profit organisation which advocates to end extreme poverty and preventable disease, told SciDev.Net: “Although there have been extraordinary responses from NGOs, and the WHO is very focused on it, it’s striking that we’re missing the same urgency we saw with the 2014/5 Ebola outbreak in West Africa. Back then, the world collectively realised the scale of the situation and came together, this time it almost feels like it’s optional.”

Vaccine rollout

Since last year, authorities in DRC have been vaccinating people with the experimental vaccine rVSV-ZEBOV. The WHO said Uganda had also vaccinated nearly 4,700 health workers in 165 health facilities. Uganda’s health ministry and the WHO announced the five-year-old as the first confirmed case of Ebola in the country last Tuesday (11 June). A Congolese woman and her five-year-old grandson from Uganda both died from the virus, Uganda’s health ministry confirmed in a situation update Thursday, adding that the boy’s three-year-old brother had also tested positive and was being treated in hospital.
Ugandan health minister Jane Ruth Aceng said authorities were “well prepared” for the new outbreak and had moved quickly to detect and isolate cases. Uganda’s health ministry and the WHO said anyone thought to have been in contact with an infected person would be offered a vaccine. In a joint statement they said the investigational vaccine “has so far been effective in protecting people from developing the disease, and has helped those who do develop the disease to have a better chance of survival”.

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