Context

World Health Organization (WHO) has again decided not to declare Africa’s latest Ebola outbreak a global emergency.

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• Many infectious disease experts and public officials had called for WHO to declare a Public Health Emergency of International Concern (PHEIC) when Ebola broke out of the Democratic Republic of Congo (DRC).
• However, WHO has again decided not to declare Africa’s latest Ebola outbreak, which has killed more than 1400 people and just crossed into a new country.
• It was the view of the committee that the outbreak is a health emergency in the Democratic Republic of Congo [DRC] and the region, but it does not meet all [the PHEIC] criteria.
• The committee gathered for the third time after news emerged that the virus had spread from the DRC to neighboring Uganda, so far killing two people there—a 5-year-old boy and his grandmother—who had crossed the border.
• More than 2400 people have been sickened since the outbreak started in August 2018—the largest outbreak of Ebola other than when it ravaged West Africa 5 years ago.
• WHO has declared a PHEIC only four times since the tool was introduced into the agency’s arsenal in 2005: for the 2014 West African Ebola outbreak; Pandemic flu in 2009; Polio in 2014; and the Zika virus in 2016.
• Declaring Africa’s latest Ebola outbreak a PHEIC would have raised the levels of international political support, which has been lacking to date; enhanced diplomatic, public health, security, and logistic efforts as well as released more financial resources to support teams working in DRC.

WHO’s Arguments

• Although declaring a PHEIC would allow WHO to share information about the disease’s spread without the affected countries’ consent and to make temporary recommendations that member states have to follow, those measures are not necessary because countries are already sharing information and following WHO’s advice.
• The overall regional risk posed by the outbreak in DRC remains very high. The overall risk at international level remains low. Declaring a PHEIC could be interpreted as the outbreak being a global emergency.

Ebola Ebola virus disease (EVD), also known as Ebola hemorrhagic fever (EHF) or simply Ebola, is a viral hemorrhagic fever of humans and other primates caused by Ebola viruses. Signs and symptoms typically start between two days and three weeks after contracting the virus with a fever, sore throat, muscular pain, and headaches. Vomiting, diarrhea and rash usually follow, along with decreased function of the liver and kidneys.  At this time, some people begin to bleed both internally and externally. The disease has a high risk of death, killing between 25 and 90 percent of those infected, with an average of about 50 percent. This is often due to low blood pressure from fluid loss, and typically follows six to sixteen days after symptoms appear. The virus spreads through direct contact with body fluids, such as blood from infected humans or other animals.  Spread may also occur from contact with items recently contaminated with bodily fluids. Spread of the disease through the air between primates, including humans, has not been documented in either laboratory or natural conditions. Semen or breast milk of a person after recovery from EVD may carry the virus for several weeks to months. Fruit bats are believed to be the normal carrier in nature, able to spread the virus without being affected by it.