WHO to decide if Ebola in DRC is of 'international concern'

The World Health Organisation will announce on Wednesday whether the Ebola outbreak in the Democratic Republic of Congo is to be considered a "public health emergency of international concern”. This follows the first confirmed case of Ebola in the densely populated city of Goma.

The head of the World Health Organisation called it a “game changer” as Goma is a gateway to the Great Lakes region and the rest of the world.

Teodros Adhanom Ghebreyesus, the WHO director general, announced that the International Health Regulations Emergency Committee will meet on Wednesday 17 July to assess whether the Ebola outbreak in DRC should be declared a "public health emergency of international concern”.

Goma is home to 1 million people and located on the border with Rwanda. The provincial capital of the North Kivu province is also a major traffic hub with international flights and daily ones connecting to the capital Kinshasa.

"It's the door of this region to the rest of the world," said Dr. Harouna Djingarey, infectious disease program manager for the WHO's regional office in eastern Congo.

"From Goma you can fly to everywhere in the world. If we don't have the control over the contacts, some high-risk contacts may fly, take a plane and go somewhere."

The International Health Regulations Emergency Committee has been convened three times in the past to decide whether or not the epidemic warrants being declared a global emergency; it has declined every time to do so.

“We really want to see the world step up and take this threat seriously. We need financial support to do the job properly. We are going to need 250 to 300 million dollars to achieve a strategic plan for the next six months,” says Dr Margaret Harris, the communication manager for the World Health Organisation's Ebola response in the Democratic Republic of Congo.

Harris told RFI there was a general consensus among the participants, at the 4th high level meeting on Ebola outbreak in DRC, that they should do more than just “fixing Ebola and then go” but also help towards strengthening the health system and ensure improvements are provided where needed.

Ebola prevention campaigns
She believes that the six months and efforts spent in having an Ebola treatment centre already “up and running” in Goma helped to quickly detect the virus and isolate the patient tested positive.

“Our partner, Mèdecins Sans Frontières, had set up [the treatment centre], trained the staff and they were ready even though there was no patients. That's difficult: to be ready when there doesn't seem to be much happening. And when somebody arrived with a potential case, everything swung into action,” Harris explained.

The preparedness programme proved to be successful in Goma. It consists, among other things, of improving the level of hygiene at community level and vaccinating around 3,000 health workers.

The campaign aims to reach everyone, not only health workers, and is provided in various local languages including Swahili, which is widely spoken in the region.

“We've worked with cleaners who said that nobody ever taught them this in 40 years. You have to keep ensuring that people have the equipment to prevent themselves from being infected and that they continually keep the place clean and free from things like body fluids or other elements that can transmit the virus,” Harris said.

The case in Goma
The man who was tested positive for the Ebola virus is a 46-year-old pastor who died while being transferred from Goma to Butembo.

The patient arrived in Goma on Sunday 14 July after a 2-day bus trip from Butembo, one of the towns hardest hit by Ebola in DR Congo.

The pastor started showing the first symptoms of Ebola on July 9th but managed to go through three health checkpoints on his way to Goma without being detected.

He sought medical treatment upon his arrival in Goma. The health workers immediately alerted the Ebola response team who came to test him and moved him in an ambulance to the Ebola treatment centre.

WHO said that 60 people who have been in contact with the preacher have been identified. 30 were already vaccinated by Monday and 30 are to be vaccinated on Tuesday 16 July.

According to the ministry, the pastor preached at seven churches and regularly touched worshippers including the sick.

Rwanda said it would step up border monitoring and urged its citizens to avoid "unnecessary" travel to the eastern DRC.

Rwanda's Health minister Diane Gashumba, who visited towns along Rwanda's western frontier on Monday, said the government "would not close the border" but would monitor of those coming in and out of DR Congo.

Deadly virus, unstable region
1,668 people died since the Ebola outbreak began in eastern DRC in August 2018 and the virus has already spread to neighbouring Uganda.

The areas of Ituri and North Kivu provinces affected by Ebola are characterised by poor infrastructure, political instability and ongoing conflict involving scores of armed militia groups and community mistrust of national authorities and outsiders.

“Together with the government, we can and will end this outbreak,”said WHO's Dr. Tedros. “But we need to see an end to the attacks and other disruptions to the response.”

Since January, there have been 198 attacks against the health response that have resulted in seven deaths and left 58 healthcare workers and patients injured.

On Monday the health ministry said two Ebola awareness workers had been killed in Beni.

Speaking at Monday's high-level meeting in Geneva on the Ebola outbreak in DRC, the country's minister for Humanitarian action, Biando Sango, acknowledged that it has been difficult for his government to get ahead of the Ebola outbreak because “the response is being carried out in a very complex environment.”

“An Ebola outbreak is a global health security threat and because it poses a serious threat to the health of the whole human race, I think the world will take this seriously,” concluded Dr. Harris.