The World Health Organization declared the Ebola outbreak in the Democratic Republic of the Congo a global health emergency on Wednesday, a move that is likely to escalate international attention on a crisis that has flared for a year despite aggressive efforts to stamp it out.
The declaration, which critics have contended is long overdue, could increase the amount of funding and assistance other countries are willing to provide to the response effort.
Director-General Tedros Adhanom Ghebreyesus declared the public health emergency of international concern — known as a PHEIC — as his organization and its partners scramble to contain what they’ve described as the most challenging outbreak ever and struggled to raise the funding needed to finance the operation. He did so on the recommendation of a panel of outside experts.
The emergency committee had recommended against the declaration of a PHEIC for the outbreak on three previous occasions.
“This is still a regional emergency and by no means a global threat,” said the head of the emergency committee, Robert Steffen.
Tedros, as the director-general is known, reconvened the group after health officials discovered Sunday that a man infected with Ebola had traveled to Goma, a city of 2 million south of the outbreak zone. Goma is located near DRC’s border with Rwanda and it is a regional transportation hub. The man, a pastor, has since died.
Though there is no indication yet whether the man infected anyone in Goma, the presence of a case there raises serious concerns. It had long been feared that the disease might take root in Goma, and that the city would serve as a launching pad to send cases both to regional neighbors and potentially further afield.
To date the outbreak has spread broadly within North Kivu and Ituri, two northeastern provinces on DRC’s border with Uganda, South Sudan, and Rwanda. But so far only four cases are known to have crossed the border into Uganda. Three members of a family traveling from the funeral of an Ebola victim became ill and went to hospital for care; they were quickly isolated. All three died in early June, but they appear not to have infected anyone in Uganda.
On Wednesday, Uganda’s health minister announced an infected woman from DRC crossed into Uganda to sell fish; she later returned to DRC, where she died. Authorities are looking for people who were in contact with her while she was in Uganda so they can be vaccinated.
Aug. 1 marks the first anniversary of the declaration that an outbreak was underway in the DRC. Since then, more than 2,500 cases have been reported and the death toll is approaching 1,700 people.
In that time, nearly 164,000 people have been vaccinated with an experimental Ebola vaccine being developed by Merck. While the WHO credits the vaccine for preventing a larger disaster, the outbreak response has struggled to find a way to bring this outbreak to an end.
The outbreak is occurring in a part of DRC that has been a conflict zone for decades. A United Nation peacekeeping force operates in the area and has had to provide security for outbreak responders who have come under attack from people in the region, some of whom believe Ebola was brought to the region by the outsiders.
Seven people working on the response have been killed, teams trying to conduct safe burials to prevent transmission have been attacked, and Ebola treatment centers have been fire bombed. The violence and the distrust has sharply impeded the outbreak responders’ ability to bring the outbreak under control and it’s not clear at this point what will swing the trajectory toward a conclusion of the outbreak.
This marks only the fifth time the WHO has declared a public health emergency of international concern. The previous PHEICs were the 2009 H1N1 flu pandemic, the 2014-2016 Ebola outbreak in West Africa, and the Zika outbreak in Latin America in 2016. Setbacks in the polio eradication effort in 2014 led WHO to declare the spread of wild poliovirus a public health emergency; that PHEIC remains in place today.