The meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (IHR) (2005) regarding Ebola virus disease (EVD) in the Democratic Republic of the Congo took place on Friday, 12th April, 2019, from 13:00 to 17:20 Geneva time (CET).

Key Findings:

It was the view of the Committee the ongoing Ebola outbreak in North Kivu and Ituri provinces of the Democratic Republic of the Congo does not constitute a Public Health Emergency of International Concern (PHEIC). However, the Committee wished to express their deep concern about the recent increase in transmission in specific areas, and therefore the potential risk of spread to neighbouring countries.

The Committee also wishes to commend the efforts of responders from the government of the Democratic Republic of Congo, the World Health Organization and partners to contain the outbreak in a complex and difficult setting.

Additionally, the Committee has provided the following public health advice:

The committee advises to redouble efforts to detect cases as early as possible, identify and follow up all contacts, ensure the highest level of coverage vaccination of all contacts and contacts of contacts.

Sustained efforts must be made to prevent nosocomial transmission and to shorten time between onset of disease and access to high standards of care and therapeutics at Ebola treatment units.

Special emphasis should be placed on addressing the rise in case numbers in the remaining epicentres, notably Butembo, Katwa, Vuhovi, and Mandima.

The Committee advises WHO and all partners to identify, target, and scale up community dialogue and participation, engagement of traditional healers, and other community engagement tactics to strengthen and broaden community acceptance.

The Committee also noted the need to follow the recommendations of SAGE with regards to the vaccination strategy provided at its latest meeting.

The safety of responders should be prioritized, while avoiding the securitization of the response.

Because there is a very high risk of regional spread, neighbouring countries should continue to accelerate current preparedness and surveillance efforts, including vaccination of health care workers and front-line workers in surrounding countries.

Cross-border collaboration should continue to be strengthened, including timely sharing of data and alerts, cross-border community engagement and awareness raising. In addition, work should be done to better map population movements and understand social networks bridging national boundaries.

The Committee maintains its previous advice that it is particularly important that no international travel or trade restrictions should be applied. Exit screening, including at airports, ports, and land crossings, is of great importance; however, entry screening, particularly in distant airports, is not considered to be of any public health or cost-benefit value.

The committee strongly emphasized the critical need to strengthen currents efforts in both preparedness and response. This will require substantial, immediate and sustained additional financial support.

While there is no added benefit to declaring a PHEIC at this stage, there was concern about current levels of transmission requiring close attention to the evolving situation. The committee advised the WHO Director General to continue to monitor the situation closely and reconvene the Emergency Committee as needed.

Proceedings of the meeting

Members and advisors of the Emergency Committee met by teleconference. Presentations were made by representatives of the Ministry of Health of the Democratic Republic of the Congo on the epidemiological situation, the response strategies, and recent adaptations, including a shift in strategy to improve engagement of the community in the response.

A representative of the Office of the Deputy Special Representative of the Secretary-General (MONUSCO) reported on the work of MONUSCO, including its logistics and security activities to support the response.

The WHO Secretariat gave an update on the current situation and provided detail of the response to the current Ebola outbreak and preparedness activities in neighbouring countries.

The Committee’s role was to provide to the Director-General its views and perspectives on:

Whether the event constitutes a Public Health Emergency of International Concern (PHEIC)

If the event constitutes a PHEIC, what Temporary Recommendations should be made.

Based on the above advice, the reports made by the affected State Party, and the currently available information, the Director-General accepted the Committee’s assessment and on 12 April 2019 did not declare the Ebola outbreak in the Democratic Republic of the Congo a Public Health Emergency of International Concern. In light of the advice of the Emergency Committee, WHO advises against the application of any travel or trade restrictions. The Director-General thanked the Committee Members and Advisors for their advice.