Despite a week with record cases, the World Health Organization's (WHO's) emergency committee today agreed for a second time that the ongoing Ebola outbreak in the Democratic Republic of the Congo (DRC)—history's second largest—does not constitute a Public Health Emergency of International Concern (PHEIC).
"Although we have great concern about rising numbers in some regions, the outbreak has not spread internationally over many months," said Robert Steffen, PhD, the head of the committee, during press conference. "There is no added benefit to [a] PHEIC, as excellent work is being done on the ground by WHO and its partner organizations."
Agency taking recent surge seriously
Throughout the press conference Steffen, WHO Director-General Tedros Adhanom Ghebreyesus, PhD, and assistant director-general Mike Ryan, MD, emphasized that recommending against a PHEIC was not a sign of complacency or a failure on the part of the WHO to take the outbreak's latest spike in cases seriously.
Today, the WHO's Ebola dashboard shows 14 new cases, raising the outbreak total to 1,220 cases since August. That follows record-breaking days of 18 cases on Apr 10 and 20 cases yesterday.
"Together we will increase our efforts even more," Tedros said. "Working with communities to understand their concerns and needs, we will also step up support to neighboring countries."
The lack of PHEIC designation also does not diminish the need to close a funding gap of $104 million, Tedros said.
"The gap slows surveillance activities, which leads to more cases," he said. "I urge donors to step forward; stopping this outbreak is our collective responsibility."
WHO defends successes, progress
In a question-and-answer session that at times put the WHO on the defensive, Ryan was quick to point out the successes seen in the outbreak.
"Most people in the community are accepting our interventions, we have over a 90% vaccination rate, and we know the outbreak would be much larger were it not for the vaccine," Ryan said.
He also explained that the record-breaking week still ongoing in the DRC was partly because WHO responders were allowed more access to communities and transmission chains in hot spots, such as Katwa, which means they were able to identify and reach more patients.
But Ryan was firm in refusing to give an estimate as to how long the outbreak will continue. "One thing I do is not make: predictions with this virus," he said.
Tedros echoed Ryan, stating the WHO has never tried to contain an Ebola outbreak in such a "complex" environment.
The WHO emergency panel first decided not to declare the outbreak a PHEIC in October 2018.
MSF, Ron Klain respond to WHO
Doctors Without Border (MSF), which has been critical of the WHO's response, said today that the organization was still failing to control the outbreak.
"Whatever the official status of this outbreak is, it is clear that the outbreak is not under control and therefore we need a better collective effort. The virus has not spread to neighboring countries so far, but the possibility exists," said Gwenola Seroux, emergency manager at MSF in a press statement.
Ron Klain, the United States Ebola response coordinator during the West African outbreak, took to Twitter to criticize the WHO.
"The response is failing to get the disease under control," Klain said. "This is particularly worrisome given that — unlike the Ebola response in 2014-15 — this effort has the benefit of a highly effective vaccine that can prevent the disease's spread."
Klain called for the US government to step up its response efforts for this crisis, and quickly. The United States has not had feet on the ground in the DRC since September, when Trump administration officials removed personnel amid security concerns.
WHO Ebola dashboard
Apr 12 MSF statement
Ron Klain Twitter feed