The World Health Organization on Wednesday decided not to declare the ongoing Ebola outbreak in the war-torn northeastern region of the Democratic Republic of Congo an international health emergency.

This Ebola outbreak, the seventh largest in history, with 216 cases and 139 dead since July, has seen a sharp uptick in cases in the last few days after response efforts were limited by rebel violence, political instability and community resistance. The WHO’s emergency response chief, Peter Salama, previously told HuffPost that this has been the “most difficult context” for dealing with an Ebola outbreak ― ever.

The WHO’s emergency committee decided that the outbreak was very concerning for the region, but not of wider international concern, committee Chairman Dr. Robert Steffen said Wednesday in Geneva. While the WHO currently deems the risk of wider international spread as low, it says the risk of its spreading nationally and regionally is very high. The committee also did not want a potential emergency declaration to impact travel and trade, which they believe would hinder the emergency response.

“We do have some optimism that this outbreak, just like the one in May, will be brought under control in a reasonable amount of time,” Steffen said.

A WHO declaration of a so-called public health emergency of international concern (PHEIC) would have aimed to draw the world’s attention and hopefully elicit a greater international response to a health crisis with global implications. Since 2007, when the barometer was established, the WHO has only declared a PHEIC four times: for swine flu in 2009, polio and Ebola in 2014, and Zika in 2016.

The WHO also decided not to declare a PHEIC over the last Ebola outbreak, which ultimately killed 33 people in the DRC’s Équateur province earlier this year, due to the quick response and deployment of an experimental vaccine. However, that outbreak was not taking place in a war zone.