New Plan For Ebola Outbreak Response To Ensure Safety Of Respondents

There has been a dramatic increase in security incidents around the epicentre of the Ebola epidemic in the Democratic Republic of the Congo (DRC), but a sharp decrease in hospital transmissions, increased vaccinations, and new measures to safeguard response teams, are positive signs, WHO officials told reporters today in a briefing.

“We are seeing a dramatic increase over the past months of security incidents in the area of North Kivu, which is the epicentre of the Ebola outbreak,” said Matshidiso Moeti, WHO Regional Director for Africa, explaining the particular features of this Ebola outbreak.

Dr Matshidiso Moeti, WHO Regional Director for Africa, and Dr Michael Ryan, Executive Director of WHO Health Emergencies Programme, at Tuesday’s press briefing on the Ebola outbreak in DRC.

In his closing remarks earlier today at the World Health Assembly, WHO Director-General Dr Tedros Adhanom Ghebreyesus said that there had been six attacks in just the past week, leading to one additional death.

“Since we remembered Dr Richard’s death last Monday, six attacks on Ebola responders were documented in DRC, including an attack on an infection prevention team on Saturday, in which one responder died,” Dr Tedros said, referring to the commemoration of WHO staffer Richard Valery Mouzoko Kiboung, killed on 19 April just before the opening of the World Health Assembly on 20 May.

Since the beginning of 2019, there have been at least 174 attacks against healthcare facilities and workers, Moeti told journalists at the afternoon press briefing. A total of five responders have perished and 51 have been injured. She said the DRC government authority is weak in the North Kivu region, which is the epicenter of the epidemic, and commented on the presence of many belligerents and armed groups for which, “it is not clear under whose leadership they are operating.”

“Security is really what is making the response so challenging and so unpredictable,” Moeti said, explaining that lack of security constrains access to vaccines and treatment, in turn driving the increase in transmission and fatalities. “When the response can’t reach people, they don’t get the chance to be vaccinated, or to receive life-saving treatments, and they do fall ill,” she said, calling for stepped-up security measures by United Nations actors and the DRC government.

Despite the challenges, hospital transmissions of Ebola have sharply decreased, said Michael Ryan, Executive Director of the WHO Health Emergencies Programme, at the briefing. Six or seven weeks ago, up to 35 percent of Ebola cases were hospital transmission cases, last week it declined to only 5 percent of new cases.

Ryan said there had so far been 1920 confirmed cases, and a toll of 1218 deaths. He mentioned an increased pace of vaccinations, including through innovative “pop-up” vaccination clinics and teams, allowing people to come from their homes to localized centres.

Ryan said that responders were also trying to work more directly with local communities through 21 local Ebola committees chaired and managed by the communities themselves. He said that in fact, a vast majority of families are accepting public health interventions to contain infection, such as safe and decent burials. But opposition by even a few individuals can stimulate new cases.

Over US$60 Million Gap in Financing Challenges Response

In order to really build upon these tools and sustain progress, Ryan said the WHO needs donors to come through with commitments of more support. So far the response operation has received only a little more than US$37 million out of the US$98 million needed to sustain the response.

While acknowledging donors such as the United Kingdom; Germany; South Korea; Australia; Gavi, the Vaccine Alliance; and the Bill and Melinda Gates Foundation, Ryan said that the missing US$64 million threatens the entire Ebola response.

Even so, the Ebola operational financing is secure through the end of June, he said, remarking that US$50 million have been borrowed from the contingency fund, to which he said Japan and Germany have substantially funded.

New UN Structure to Make Health Response Operations Safer, More Efficient

Meanwhile, a new UN structure for coordinating the Ebola response is also being put in place with the aim of removing that task from health agencies and NGOs, and creating a more favourable security environment, WHO officials said.

Last week, David Gressly, Deputy Special Representative for Operations and the Rule of Law in the DRC’s UN Stabilization Mission (MONUSCO), was appointed as the UN’s Emergency Ebola Response Coordinator in the Ebola-affected areas of the DRC.

Gressly is expected to arrive tomorrow in DRC and to start working on negotiations with the key actors in the area to improve the security environment, according to Moeti.

Staff and colleagues need to be protected and “we are hopeful that the new structure will bring much-needed stability, safety, and clarity, and will enable the response to proceed,” she said.

Image Credits: WHO/L.Mackenzie, Catherine Saez.

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