DRC Ebola outbreak still not a PHEIC, committee says, while calling for “redoubled efforts”

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Expressing concern over recent increases in areas, and continued risk of cross border spread, and unprecedented challenges posed by ongoing violence in the affected area, committee chair notes the outbreak still has not entered other countries, “now, over many months”

The WHO emergency committee convened to evaluate whether the ongoing spread of Ebola in the Democratic Republic of the Congo “nearly unanimously” recommended not to declare the outbreak a Public Health Emergency of International Concern — a PHEIC — the committee’s chair announced today.

The primary reason for the decision, committee chair Prof. Robert Steffen indicated, was that “by definition,” an outbreak remaining within a country’s borders “is not of international concern.” He added that declaring a PHEIC would not necessarily add to the strength of the current response, but could potentially “complicate matters.”

The decision is similar to that reached by the committee in its previous, Oct. 17 meeting, when the committee expressed concerns that declaring a PHEIC could lead to trade and travel bans that would hinder responses. The committee concluded then that while the challenges presented by ongoing armed conflict and civil strife in the affected area, near borders, and limited local resources were “extraordinary,” and while the risks of regional spread were “very high,” the risks of global spread remained low. Today, Prof. Steffen noted that the outbreak still had not crossed neighboring borders, “now, over many months.”

At the same time, Prof. Steffen, as well as WHO Director General Tedros Adhanom Ghebreyesus, and WHO advisor Dr. Mike Ryan acknowledged that recent steep rises in case numbers, as well as continuing obstacles to control efforts have extended projections of how long the outbreak will continue. While saying “excellent work is being done on the ground by WHO and many partners,” Prof. Steffen called for a “redoubling” of current efforts, greater engagement with community leaders including traditional healers, and increased, immediate, and continuing financial support from international donors.

Declaring a PHEIC also can spur international interest in the response, leading, as it did following the belated declaration that the 2013-2016 West Africa Ebola crisis was a PHEIC, to infusions of critically needed funding from abroad. But, Prof. Steffen said, “a PHEIC should not just be a money making decision.”

In addition, Dr. Ryan noted, the existence now of a vaccine has changed expectations around the disease. Data examined by the committee shows the vaccine has demonstrated “remarkable efficacy,” in preventing infections and deaths, Prof. Steffen said.

About 90 percent of those offered the vaccine have accepted it, Dr. Ryan said, noting that rate exceeds measles vaccination uptake. In addition, about 93 percent of those offered assistance of safe burials of the dead to prevent the spread of the virus have accepted it.

The greatest gaps, he said, are among those who have not been reached because of conflict and violence in the region.

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