WHO sounds Ebola alarm as risks intensify

A Congolese health worker administers ebola vaccine to a child at the Himbi Health Centre in Goma, Democratic Republic of Congo, July 17, 2019. REUTERS/Olivia Acland

By Tom Miles

GENEVA (Reuters) – The World Health Organization on Wednesday declared Congo’s Ebola outbreak an international health emergency, sounding a rarely used global alarm after the virus threatened to spread to a major city and into neighboring countries.

Despite a highly effective vaccine and a swift international response after it was declared 11 months ago, the outbreak has 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, has kept the highly infectious virus almost entirely confined to two provinces in northeastern Congo. The emergency committee of international health experts that advises WHO had thrice declined to declare an emergency.

But this month a pastor died after traveling to Goma, a city of 2 million and a gateway to other countries in the region. On Wednesday, the WHO reported a fisherwoman had died in Congo after four vomiting incidents at a market in Uganda, where 590 people may be sought for vaccination.

“The committee is concerned that a year into the outbreak, there are worrying signs of possible extension of the epidemic,” the committee’s report said.

The committee had been under pressure from many experts who felt the scale of the outbreak and the risks meant it had to be given the emergency status – only the fifth such disease outbreak since the WHO introduced such designations in 2005.

“It shows no sign of coming under control,” said Peter Piot, a member of the team that discovered Ebola and is now director of the London School of Hygiene & Tropical Medicine.

“I hope that today’s decision serves as a wake-up call to drive high-level political action, improved coordination, and greater funding to support DRC in their efforts to stop this devastating epidemic,” he said.

NO BORDER CLOSURES

The 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.

The WHO committee’s chairman, Robert Steffen, tempered the outbreak’s designation as an emergency by saying it remained a regional, rather than a global threat, and stressed that no country should react to Ebola by closing borders or restricting trade.

The WHO has warned that the nearby countries of Rwanda, South Sudan, Burundi and Uganda are the most at risk, while Central African Republic, Angola, Tanzania, Republic of Congo and Zambia are in a 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 far more lives and money.

But WHO chief Tedros Adhanom Ghebreyesus, who convened the emergency committee after viewing the Goma case as a “potential gamechanger”, said the designation as an international emergency was not meant to suggest that some countries had been withholding funds and would now unlock them.

One priority was to accelerate the production of the vaccine, which is in short supply. It is produced by Merck and still unlicensed, which means it can only be used in a clinical trial overseen by Congo’s health ministry.

WHO has already begun using smaller doses to ration supplies and the committee recommended taking “all measures to increase supplies”, including contracting supply to other manufacturers and transferring Merck’s technology.

(Reporting by Tom Miles, Kate Kelland and Nairobi newsroom; Editing by Gareth Jones, John Stonestreet and Dan Grebler)

Ebola spread concentrated in Congo, not a wider emergency: WHO

FILE PHOTO: Health workers carry a newly admitted confirmed Ebola patient into a treatment centre in Butembo in the eastern Democratic Republic of Congo, March 28, 2019. REUTERS/Baz Ratner

By Stephanie Nebehay and Kate Kelland

GENEVA/LONDON (Reuters) – An outbreak of Ebola in the Democratic Republic of Congo (DRC) that has killed more than 700 people and is continuing to spread does not constitute an international emergency, the World Health Organization said on Friday.

Declaring the epidemic a “public health emergency of international concern” would have signaled that greater resources and international coordination are needed.

The WHO’s independent Emergency Committee, which analyzed the latest data, said the disease was entrenched in several epicenters in the northeast and was being transmitted in health care settings.

It had not spread across borders to Uganda, Rwanda or South Sudan, but neighboring countries should shore up their preparedness, the experts said.

“It was an almost unanimous vote that this would not constitute a PHEIC (public health emergency of international concern) because we are moderately optimistic that this outbreak can be brought into control – not immediately, but still within a foreseeable time,” panel chairman Professor Robert Steffen told a news conference.

Dozens of new cases reported this week have been mainly in the epicenters of Butembe, Katwe and Vuhovi, said Mike Ryan, head of the WHO’s health emergencies program.

“It’s quite a focused amplification of disease in a very specific geographic area,” Ryan said.

“But the disease there has risen because of lack of access to that community, we’ve fallen behind in starting vaccination rings,” he said, referring to attacks on health centers by armed groups in February that cut-off hotspot areas.

“Vaccine is proving to be a highly effective way of stopping this virus but if we can’t vaccinate people we cannot protect them,” he added, noting that nearly 100,000 people have been vaccinated.

Experts have declared four emergencies in the past decade: the H1N1 virus that caused an influenza pandemic (2009), a major Ebola outbreak in West Africa (2014), polio (2014) and Zika virus (2016).

Some experts expressed concern that the Emergency Committee was too narrowly interpreting WHO guidelines.

“This is a deeply concerning event, due to the pathogen itself, the total number of cases, the increase in cases just this week, and the difficulty of coordinating the response due to conflict – that needs to receive the appropriate level of attention,” health experts Rebecca Katz and Alexandra Phelan of Georgetown University in Washington D.C. said in a statement.

The Ebola outbreak – by far the biggest Congo has seen, and the world’s second largest in history – was declared by national authorities in August. It is concentrated in Congo’s North Kivu and Ituri provinces.

It has already infected at least 1,206 people, of whom 764 have died – giving a death rate of 63 percent.

They include 20 new cases reported by the health ministry on Thursday, another one-day record after 18 on Wednesday. Two workers at the Butembo airport tested positive, it said.

(Reporting by Stephanie Nebehay and Kate Kelland Additional reporting by Aaron Ross in Dakar; Editing by Hugh Lawson and Frances Kerry)