The meeting of the Emergency Committee convened by the Director-General of WHO under the International Health Regulations (IHR) (2005) on Ebola Virus Disease (EVD) in the Democratic Republic of the Congo was held on Friday, 12 April 2019 , from 1 pm to 5 pm (CET).
The Committee was of the view that the continuing Ebola outbreak in the provinces of North Kivu and Ituri in the Democratic Republic of the Congo does not constitute a public health emergency of international concern (PHEIC). However, the Committee wished to express its deep concern about the recent increase in transmission in some areas, and therefore the potential risk of spread to neighboring countries.
The Committee also wishes to acknowledge the efforts of those involved in the response – the Government of the Democratic Republic of the Congo, the World Health Organization and partners – to stem the outbreak in a complex and difficult context.
In addition, the Committee has given the following advice for public health:
- The Committee recommends that more efforts be made to identify cases as soon as possible, identify all contacts and ensure follow-up, and ensure maximum immunization coverage of all contacts and contacts.
- Sustained efforts must be made to prevent nosocomial transmission and to shorten the time between onset of illness and access to high-quality care and treatment in Ebola treatment units.
- Special emphasis should be placed on combating the increasing number of cases in the remaining epicenters, including Butembo, Katwa, Vuhovi, and Mandima.
- The Committee advises WHO and all partners to identify, target and expand opportunities for community engagement and dialogue, mobilization of traditional healers, and other community mobilization tactics to strengthen and expand acceptance within the community.
- The Committee also noted the need to follow the SAGE recommendations regarding the immunization strategy presented at the last meeting.
- The security of the actors of the response must be a priority, while avoiding the security of interventions.
- As the risk of regional spread is very high, neighboring countries must continue to accelerate current preparedness and surveillance efforts, including the immunization of health workers and front-line workers in neighboring countries.
- Cross-border collaboration must continue to be strengthened, including timely sharing of data and alerts, cross-border community mobilization and awareness raising. In addition, efforts should focus on improving the mapping of population movements and the understanding of social networks that transcend national boundaries.
- The Committee maintains its previous advice that it is particularly important that no restrictions be placed on international trade or travel. Out-of-territory testing, including at airports, ports and at land crossings, is of great importance; however, entry screening, especially at remote airports, is not considered to be of any public health or cost-benefit interest.
- The Committee strongly emphasized the critical need to strengthen current efforts in both the areas of preparedness and response. These efforts require significant additional financial support, immediate and sustainable.
- Although there is no additional benefit to a PHEIC reporting at this stage, concerns have been expressed about current levels of transmission that require close monitoring of the evolution of the situation. The Committee advised the Director-General of WHO to continue to monitor the situation closely and to reconvene the Emergency Committee as necessary.
Minutes of the meeting
The members and advisers of the Emergency Committee met by teleconference. Representatives from the Ministry of Health of the Democratic Republic of the Congo presented the epidemiological situation, response strategies and recent adaptations, including a change in the strategy to improve community engagement in the response.
A representative of the Office of the Deputy Special Representative of the Secretary-General (MONUSCO) reported on MONUSCO's work, including on logistics and security activities in support of the response.
The WHO Secretariat provided an update on the current situation and provided details on the response to the current outbreak, as well as on preparedness activities in neighboring countries.
The role of the Committee was to advise the Director-General and to present his views on:
- whether the event constitutes a public health emergency of international concern (USPPI);
- and, if so, the temporary recommendations to be issued.
On the basis of this opinion, reports submitted by the affected State Party and information currently available, the Director-General accepted the Committee's evaluation and did not declare on 12 April 2019 that the Ebola outbreak was in the Democratic Republic of the Congo was a public health emergency of international In the light of the opinion of the Emergency Committee, WHO advises against the application of any restrictions on travel or trade. The Director-General thanked the members and advisers of the Committee for their advice.