The WHO Finally Sounds Its Loudest Alarm Over Ebola in the Congo

Almost a year after the second-worst Ebola outbreak in history began in the Democratic Republic of Congo, the World Health Organization finally declared the crisis a “public health emergency of international concern” (or PHEIC for short)—a label that it has only used four times before. The decision was made at an emergency meeting yesterday, on the recommendations of a panel of independent experts.

More than 2,500 people have become infected since the outbreak was officially declared on August 1, 2018. Almost 1,700 of those have died, while more than 700 have been cured. A few hundred cases are still being investigated, and new ones arise on an almost daily basis. These numbers make the outbreak worse than all of the Congo’s nine past encounters with Ebola put together, although they are still well below the scale of the West African epidemic of 2014 to 2016, which infected 28,000 people and killed 11,000.

Ebola was first discovered within the Congo’s borders in 1976 by Jean-Jacques Muyembe—then the country’s only virologist and now the director-general of its National Institute for Biomedical Research. The disease has reared its head repeatedly, more so in recent years. But the Congo is arguably the most experienced nation in the world at dealing with Ebola. The eighth outbreak in 2017 was contained in just 42 days. The ninth was over in three months (almost exactly as Muyembe predicted at the time).

But the tenth and current outbreak is different. While the previous ones took place in the Congo’s northern and western regions, this one had the grave misfortune to spark up in the eastern provinces of North Kivu and Ituri. These regions abut Rwanda and Uganda, and are active war zones full of displaced refugees.

The calculus shifted slightly in June, when two children and their grandmother carried the virus into Uganda. All three died, but fortunately, the virus didn’t spread any further. Once again, the WHO ruled against a PHEIC. (Uganda also has a strong track record of controlling Ebola; its robust surveillance network means that most of the outbreaks that have been detected in the past decade have been limited to a handful of cases.)

Then, on July 14, a pastor brought Ebola to Goma, a big city that directly borders Rwanda and has an international airport. (Depending on the source, Goma is home to either 1 or 2 million people.) That event finally swayed the WHO’s emergency committee, although the chairman, Robert Steffen, emphasized that states should not use the PHEIC “as an excuse to impose trade or travel restrictions, which would have a negative impact on the response and on the lives and livelihoods of people in the region.”

The Congo’s Ministry of Health accepted the WHO’s decision, but released a somewhat barbed statement in their daily update. “The Ministry hopes that this decision is not the result of many pressures from different stakeholder groups who wanted to use this statement as an opportunity to raise funds for humanitarian actors despite the potentially harmful and unintended consequences for the affected communities dependent on significant cross-border trade for survival,” the ministry said. “While the Government continues to openly share with partners and donors how it uses the funds received, we hope there will be greater transparency and accountability of humanitarian actors in relation to their use of funds to meet this Ebola outbreak.”

“A public health emergency of international concern is not for fundraising, it’s for preventing the spread of disease,” said Tedros Adhanom Ghebreyesus, the director-general of the WHO, on Twitter. “The WHO is not aware of any donor that has withheld funding because the emergency had not been declared. But if that was the excuse, it can no longer be used.”

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