NEW YORK CITY – The Ebola outbreak in the Democratic Republic of Congo appears to be finally “on the decline”, World Health Organization Director General Tedros Adhanom Ghebreyesus told reporters Wednesday.

Dr Tedros spoke after a meeting at UN Headquarters with new DRC Minister of Health Etembi Longodo and Alex Azar, US Secretary of Health and Human Services, which coincided with the launch of a new US $66 million regional Ebola preparedness plan for the second half of 2019.

Trends show that the incidence of new cases has been gradually decreasing since mid July. There were 29 new cases of Ebola reported between 18-24 September, down from a spike of 57 new cases between 11-17 September, according to the latest WHO data. Those numbers contrast sharply with the average of 85 new cases a week seen over the month of July.

Despite the encouraging news, the WHO Director General refrained for setting a date for when the outbreak might finally end, saying “it’s not over until it’s over”.  He noted that chronic civil unrest, insecurity, and other factors continue to create continuing uncertainty.

A mysterious case of febrile illness reported in Tanzania earlier this month highlighted the need for continued vigilance among neighboring countries. However, the nine countries bordering the DRC have ramped up efforts to prepare for and contain any potential outbreak spillover, officials said.

With the launch of the regional Ebola preparedness plan, the fourth in a series, “we have a new agreement among the [9] countries, which are all very engaged,” as well as access to more funding from the World Bank and other donors, noted Longodo. Longodo replaced former Minister of Health Oly Ilunga who resigned in July, and was recently detained by DRC police for alleged misuse of Ebola funds.

The decision to deploy a second Ebola vaccine, a two-dose vaccine developed by Johnson & Johnson, should also boost containment efforts, officials said.  While a Merck vaccine, which has proven to be highly effective, will continue to be used for health workers and people who have come into direct contact with Ebola victims, the newer Johnson & Johnson vaccine will be deployed in populations without contact with Ebola, with an eye to creating belts of geographic protection against further disease expansion outside of the disease epicenter, Longodo said.

The vaccine deployment comes after a long period of contentious debate between DRC government officials, NGOs and WHO and other actors over the acceptability of using the second vaccine, which has been successfully tested among healthy volunteers, but not yet deployed in the field.  Advocates had said that the second vaccine would provide an important additional layer of protection to the broader population, and it is also effective against other strains of Ebola, which recur periodically in the DRC and surrounding areas. Deployment of the second vaccine was recommended by a WHO group of experts in May.

HHS Secretary Azar reaffirmed the US’s commitment to supporting the Ebola response, asserting that the outbreak “is one of the top global health priorities of President Trump, and will remain so until the outbreak is over.”

He emphasized that it is the DRC government that must remain in charge of response activities, with WHO and the international community supporting those efforts.

The latest WHO outbreak news further underlines that reports of a decrease in new cases should be interpreted with caution, as some cases may have gone unreported due to security challenges in certain health zones.

In particular, there has been a recent uptick in disturbances in the area of DRC’s Lwemba, in the Mandima Health Zone as well as in the Mambasa Health Zone. The recent major security incident in Lwemba has halted response activities there for the past nine days. This has limited contact tracing efforts, with 169 and 162 contacts lost to follow up in Lwemba and Mambasa, respectively.

A WHO team of social scientists, community engagement, risk communication, and health promotion experts has been established under the umbrella of the Strategic Response Plan 4 (SRP4) to work together with DRC’s “Commission Communication de Risque et Engagement Communautaire (CREC)” on further strengthening community support for Ebola response in those areas.

This story was updated on 27 September, 2019.

Elaine Ruth Fletcher contributed reporting to this story

Image Credits: WHO.