The World Health Organization said Friday that the Ebola outbreak in the Democratic Republic of Congo does not qualify as an international public health emergency, despite confirmed cases also in neighbouring Uganda.
The UN health agency convened its expert committee for the third time Friday to assess the outbreak, which has killed more than 1,400 people.
At a press briefing following the meeting, Dr. Preben Aavitsland, the acting chair of the committee, announced that the outbreak is “a health emergency in the Democratic Republic of the Congo” but that the situation does not yet meet the criteria for being declared a global emergency.
The WHO panel has used the label “public health emergency of international concern” only four times previously.
Those included the H1N1, or swine flu, pandemic of 2009, the spread of poliovirus in 2014, the Ebola epidemic that devastated parts of West Africa from 2014 to 2016 and the surge of the Zika virus in 2016.
The current Ebola crisis, which began in eastern DRC last August, is the worst on record since the 2014-2016 outbreak that killed more than 11,300 people in Liberia, Guinea and Sierra Leone.
Epidemic crosses porous border
The WHO panel had already held off making the emergency call at previous meetings in October and April, despite several experts arguing that the outbreak met the criteria to be designated an international emergency long ago.
The pressure mountedthis week with confirmation that the virus had reached western Uganda, where it has claimed two lives so far.
A Congolese woman — who is married to a Ugandan — as well as her mother, three children and their nanny had travelled to DRC to care for her ill father, who later died of Ebola.
The WHO said 12 members of the family who attended the burial in Congo were placed in isolation in the DRC, but six “escaped and crossed over to Uganda” on June 9.
The next day, a five-year-old boy was admitted to hospital in Bwera, a border town, vomiting blood before he died. Tests confirmed he had Ebola and the family was placed in an isolation ward.
His three-year-old brother was also confirmed to have Ebola, as was their grandmother, who died late Wednesday.
Speaking from western Uganda’s Kasese district, a senior Red Cross official told AFP that “the biggest challenge” was ensuring robust monitoring along the porous border with DRC.
“People are continuing to come in to the country and not passing through the areas where screening is taking place, because screening has been instituted along certain points of entry but not all the points,” said Josephine Okwera, the director of health and social services for the Ugandan Red Cross.
The mere fact that cases have crossed a border does not automatically compel WHO to make the emergency declaration, especially as the epidemic is still confined to one contiguous region.
But invoking the emergency provisions would have entailed additional measures to manage the outbreak, including a possible call for “immediate international action”, according to the UN health agency.
Hostility to health workers
Health officials had initially hoped that they could contain the outbreak with help from a new vaccine, which has now been given to more than 130,000 people in DRC.
But chronic violence and militia activity in the affected eastern DRC provinces of Ituri and North Kivu as well as hostility to medical teams among some people in the region have hampered the response.
WHO has also accused political leaders in the affected region of manipulating the Ebola issue to turn people against health workers.
On Thursday, the agency acknowledged it had been unable to track the origins of nearly half of new Ebola cases in Congo, suggesting it doesn’t know where the virus is spreading.
Ebola spreads among humans through close contact with the blood, body fluids, secretions or organs of an infected person.
Chimpanzees, gorillas, monkeys, forest antelope and porcupines can also become infected, and humans who kill and eat these animals can catch the virus through them.