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Author Yap Boum, professor at the Faculty of Medicine of the University of Science and Technology of Mbarara
The World Health Organization (WHO) has declared the Ebola outbreak in the Democratic Republic of Congo (DRC) public health emergency of international concern. The decision was taken on the basis of the International Health Regulations adopted in 2005. This requires the WHO to declare an emergency when a public health event, such as an outbreak, becomes extraordinary because that it constitutes a risk for other countries and when a coordinated international intervention is necessary. Required fields.
The WHO emergency committee – tasked with making this decision – has met four times since the declaration of the outbreak in the North Kivu region of the DRC, on August 1, 2018. During the last meeting in June, the committee decided that the outbreak should not be a public health emergency of international concern.
A month later, the committee changed their minds. His reasons were that the number of cases had increased from 2071 to 2522. Even though the death rate had remained at 67%, three new cases were detected in Uganda. In addition, a case of Ebola was diagnosed in Goma, a town of nearly 2 million inhabitants, which is a very active entry point for the DRC. The city is located on the Rwandan border.
The expected impact of the decision is that more funds will be collected for the field intervention teams as international support intensifies. This will also give the DRC Ministry of Health more flexibility in ensuring that response teams reach the most remote areas. More resources are needed to ensure that teams can engage communities. This is partly to ensure the logistics needed to access them, especially in the most remote places.
The decision is important and should have a critical effect on the response. It will provide a second wind to tackle the new phase of the epidemic, hoping it will be halted.
But the decision is not a quick fix. The epidemic of a deadly disease in a conflict zone – and now in a big city – can not be solved by a technical solution, such as increased funding.
What works, what does not work
The Ebola response has not been enough to stop the spread of the epidemic. This is despite the significant efforts of the Ebola teams, their community involvement, surveillance, vaccination and communication.
The number of cases and deaths has not decreased. This suggests that people still avoid going to Ebola treatment centers for treatment. This is despite the fact that new therapies are now available through a randomized clinical trial.
More than 100,000 people were vaccinated. The vaccine did not stop the spread of the disease, although it helped control it. The introduction of a second vaccine as part of a clinical trial would support the response, particularly in neighboring regions of North Kivu, where no cases have been reported.
The increase in attacks against staff in the region has also slowed efforts to eliminate the epidemic. Dr. Richard Mouzoko, an epidemiologist working for the WHO, was killed in April and clinics were set on fire. The attacks highlight the complexity of responding to an already complex epidemic in a conflict zone.
Violence also hampers community mobilization, an essential element of any response to Ebola.
The DRC also struggled to secure the funds needed to effectively manage the response.
The announcement of a public health emergency of international importance is a call to action by the international community. But additional funds will not be enough. the problem of unrest in North Kivu must be resolved, as it remains one of the main catalysts of this epidemic. Resolving the epidemic requires a peaceful environment, in which the community trusts the Ebola response team and thus reinforces its commitment. Without increased awareness and commitment from the community, it is difficult to see the end of the Ebola epidemic in the DRC.
https: //theconversation.com/why-declaring-ebola-in-public-health-emergenc …
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