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WHO chief laments violence in DRC as Ebola cases near 1,000

Tedros Adhanom Ghebreyesus 
Tedros Adhanom Ghebreyesus
Photo of Robert Redfield 
Robert Redfield

As the outbreak nears 1,000 cases, WHO’s top official warned today that ongoing violence in the Democratic Republic of the Congo is threating to reverse gains made against Ebola, saying “security remains our No. 1 concern.”

WHO Director-General Tedros Adhanom Ghebreyesus, PhD, MSc, spoke hours after an incident in which a transit center in Biena that was being used in the response was severely damaged following a death in the community.

Tedros said there were no reports yet of health workers or patients being injured in the incident. Earlier this week, the WHO chief and CDC Director Robert Redfield, MD, visited a treatment center in Butembo hours after armed men had opened fire on it, killing a policeman and wounding three workers.

It was just one of several attacks in the last 2 weeks, Tedros said. Violence and political instability has been an issue for months.

“They left bullet holes in the windows of the center, but they did not dampen the spirit of the health workers who work there. When I arrived at the center 5 hours later, it was already reopened,” Tedros recounted. “It was such a humbling experience for me. ... How can people after they were attacked and after helping their wounded colleagues actually continue their work and their service to the people? It gave me confidence that our staff will finish this job. I have witnessed that their dedication is unparalleled.”

Tedros said the attacks are being carried out by armed militia groups, including Mai-Mai rebels and the Allied Democratic Forces.

“The attacks on Ebola treatment centers are not attacks by the community but on the community,” he said. “These attacks could reverse the gains we have made. We are working to find a balance between protecting patients and staff from attacks by armed groups and building community trust and ownership. It’s not a an either-or situation. We must do both to end the outbreak.”

The outbreak, which began last summer, is the second largest Ebola outbreak in history. There have been 927 confirmed or probable cases and 584 deaths, according to the DRC health ministry. More than 87,000 people have received Merck’s experimental Ebola vaccine, including 27,000 health care workers in the DRC and 5,000 in surrounding countries, Tedros said. He said more than 90% of people who are eligible to be vaccinated — which now includes pregnant women — have accepted vaccination, and more than 90% have accepted follow-up visits.

“We have averted a much larger outbreak,” he said.

In a first, more than 400 people have been treated with novel therapeutics for Ebola infection under a pioneering randomized control trial that began in November, Tedros said. There are no data yet showing how effective the treatments have been, but the WHO director-general said: “We’re happy that people are surviving.”

He said more than 58,000 contacts of patients have been registered and more than 4,200 are currently being monitored for signs of illness. Tedros said there are half as many cases per week now than in January, when they recorded 50 per week. He said the outbreak has been contained in 11 of 28 communities that have had cases.

Transmission has been stopped in the town of Beni, which had seen many infections, and cases are now concentrated in Butembo and Katwa, with 38 of last 74 cases coming in Katwa alone, Tedros said. He said cases in other towns are being linked to these two places.

As an example of how some communities have become more responsive, Tedros noted that residents of Butembo and Katwa are increasingly open to allowing qualified burial teams to bury the bodies of Ebola victims to prevent further transmission, “although there is still resistance to some extent,” he said.

WHO has thus far been reluctant to declare a Public Health Emergency of International Concern, highlighting that the outbreak has not crossed the border and is not a threat to the international community. Tedros said funding for the response is about $60 million short of the $148 million that will be needed over the next 6 months but indicated he would not convene an emergency committee to get the needed money.

“That’s not the purpose of the emergency committee. It’s meant to assist if the outbreak constitutes a global threat,” Tedros said. “We do this assessment almost daily. I will not hesitate to convene the committee again if needed.”

He asked WHO partners for the additional funds and said “the global community must stay the course with us and end this outbreak.” – by Gerard Gallagher

Disclosure: Tedros is the director-general of WHO.

Tedros Adhanom Ghebreyesus 
Tedros Adhanom Ghebreyesus
Photo of Robert Redfield 
Robert Redfield

As the outbreak nears 1,000 cases, WHO’s top official warned today that ongoing violence in the Democratic Republic of the Congo is threating to reverse gains made against Ebola, saying “security remains our No. 1 concern.”

WHO Director-General Tedros Adhanom Ghebreyesus, PhD, MSc, spoke hours after an incident in which a transit center in Biena that was being used in the response was severely damaged following a death in the community.

Tedros said there were no reports yet of health workers or patients being injured in the incident. Earlier this week, the WHO chief and CDC Director Robert Redfield, MD, visited a treatment center in Butembo hours after armed men had opened fire on it, killing a policeman and wounding three workers.

It was just one of several attacks in the last 2 weeks, Tedros said. Violence and political instability has been an issue for months.

“They left bullet holes in the windows of the center, but they did not dampen the spirit of the health workers who work there. When I arrived at the center 5 hours later, it was already reopened,” Tedros recounted. “It was such a humbling experience for me. ... How can people after they were attacked and after helping their wounded colleagues actually continue their work and their service to the people? It gave me confidence that our staff will finish this job. I have witnessed that their dedication is unparalleled.”

Tedros said the attacks are being carried out by armed militia groups, including Mai-Mai rebels and the Allied Democratic Forces.

“The attacks on Ebola treatment centers are not attacks by the community but on the community,” he said. “These attacks could reverse the gains we have made. We are working to find a balance between protecting patients and staff from attacks by armed groups and building community trust and ownership. It’s not a an either-or situation. We must do both to end the outbreak.”

The outbreak, which began last summer, is the second largest Ebola outbreak in history. There have been 927 confirmed or probable cases and 584 deaths, according to the DRC health ministry. More than 87,000 people have received Merck’s experimental Ebola vaccine, including 27,000 health care workers in the DRC and 5,000 in surrounding countries, Tedros said. He said more than 90% of people who are eligible to be vaccinated — which now includes pregnant women — have accepted vaccination, and more than 90% have accepted follow-up visits.

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“We have averted a much larger outbreak,” he said.

In a first, more than 400 people have been treated with novel therapeutics for Ebola infection under a pioneering randomized control trial that began in November, Tedros said. There are no data yet showing how effective the treatments have been, but the WHO director-general said: “We’re happy that people are surviving.”

He said more than 58,000 contacts of patients have been registered and more than 4,200 are currently being monitored for signs of illness. Tedros said there are half as many cases per week now than in January, when they recorded 50 per week. He said the outbreak has been contained in 11 of 28 communities that have had cases.

Transmission has been stopped in the town of Beni, which had seen many infections, and cases are now concentrated in Butembo and Katwa, with 38 of last 74 cases coming in Katwa alone, Tedros said. He said cases in other towns are being linked to these two places.

As an example of how some communities have become more responsive, Tedros noted that residents of Butembo and Katwa are increasingly open to allowing qualified burial teams to bury the bodies of Ebola victims to prevent further transmission, “although there is still resistance to some extent,” he said.

WHO has thus far been reluctant to declare a Public Health Emergency of International Concern, highlighting that the outbreak has not crossed the border and is not a threat to the international community. Tedros said funding for the response is about $60 million short of the $148 million that will be needed over the next 6 months but indicated he would not convene an emergency committee to get the needed money.

“That’s not the purpose of the emergency committee. It’s meant to assist if the outbreak constitutes a global threat,” Tedros said. “We do this assessment almost daily. I will not hesitate to convene the committee again if needed.”

He asked WHO partners for the additional funds and said “the global community must stay the course with us and end this outbreak.” – by Gerard Gallagher

Disclosure: Tedros is the director-general of WHO.

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