On 17 July 2019, the World Health Organisation (WHO) Director General, Dr Tedros Adhanom Ghebreyesus, declared the ongoing Ebola virus disease (EVD) outbreak in the Democratic Republic of Congo (DRC) as a Public Health Emergency of International Concern (PHEIC). A PHEIC is defined in the IHR (2005) as, “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response”1.
As of 18 July 2019, the Ministry of Public Health of the DRC reported 2,532 cases (2,438 confirmed and 94 probable) with 1,705 deaths and 718 cured. In declaring the DRC EVD outbreak a PHEIC, the WHO took into consideration the first confirmed case in Goma, a city of almost two million inhabitants and close to the border with Rwanda, and the gateway to the rest of DRC and the world.
Between 2009 and 2019, there have been five PHEIC declarations.2 Declaration of a PHEIC is a call to action. Therefore, it is time for the African continent and indeed the world to redouble our efforts in solidarity with the DRC to end this outbreak and build a stronger health system.
In view of the PHEIC declaration, Africa Centres for Disease Control and Prevention (Africa CDC) and the WHO Regional Office for Africa would like to reiterate the need for all Member States to adhere to the recommendations made, emphasising the following:
- No country should close its borders or place any restrictions on travel and trade, including general quarantine of travelers from the Ebola-affected countries, currently the DRC. Such measures compromise economies and impede response operations.
- There should be no requirement of certificates of Ebola vaccination for any movement across borders or for issuance of visas, as there is currently no licensed vaccine against Ebola.
- Exit screening is recommended at international airports in affected countries (currently only the DRC).
- Entry screening at international airports or other ports of entry outside countries neighbouring the DRC is not recommended as it is not effective and involves large amounts of resources.
- National authorities should work with airlines, airports and other transport and tourism industries to encourage communication and collaboration, and to ensure that the measures adopted are in line with WHO guidance for travel and transport during outbreaks.
- The full list of IHR recommendations and more information are available at:
Africa CDC and WHO express their gratitude to all AU Member States for the close collaboration with and support to the EVD outbreak response. Currently, no country has implemented travel measures that interfere with international traffic to and from the DRC.
Under the leadership of the government of the DRC, Africa CDC and WHO are committed to continuing to coordinate their efforts together with other partners to increase support and control of this outbreak.
Ever since the current outbreak was declared in August 2018, Africa CDC has supported the efforts of the Government of the DRC in several ways. These include deployment of 41 multi-disciplinary public health experts, training of more than 800 local healthcare workers and community volunteers, contributions to surveillance and investigations, and provision of personal protective equipment and GeneXpert machines to health facilities.
Alongside the Ministry of Public Health of the DRC, WHO is leading the coordination of the public health response. WHO is also providing technical leadership in the areas of surveillance, vaccination and case management. WHO has mobilised and deployed over 700 international experts as part of the surge capacity needed to respond to the outbreak.
Africa CDC and WHO strongly call for member states in Africa and the international community to adhere to the requirements of the International Health Regulations (2005) including ensuring that national capacities to prevent, detect and respond to public health emergencies are strengthened.
Endnotes
- This definition implies a situation that is: serious, sudden, unusual or unexpected; carries implications for public health beyond the affected State’s national border; and may require immediate international action.
- The 2009 H1N1 (or swine flu) pandemic; the 2014 polio declaration; the 2014 outbreak of Ebola in Western Africa; the 2015–16 Zika virus epidemic; and, as of 17 July 2019, and the 2018–19 Kivu Ebola epidemic.