Ebola in DRC: What Is a Public Health Emergency of International Concern?

Following several months of an ongoing Ebola epidemic in the Democratic Republic of the Congo (DRC), the World Health Organization (WHO) has declared the epidemic a “Public Health Emergency of International Concern” (PHEIC). What does this mean?

According to WHO, an emergency of this type is an emergency that has the potential to (or already has) gone beyond the national borders of where it first happened and needs an immediate and coordinated international response. As a result, different WHO members will free up funds, personnel and other resources to address the emergency according to their own national laws and regulations. In this declaration, however, WHO did not recommend a quarantine of the affected zone citing fears of negatively impacting an already fragile region of the world.

This declaration took some time to be agreed upon by WHO member states. When Ebola was detected in Uganda, authorities deemed it an isolated incident because some infected people did not obey quarantine orders. What really got health authorities worried most recently was the appearance of a case of Ebola in Goma, DRC. Goma has a population of about 2 million residents. Immediately across the border from Goma is Gisenyi, Rwanda, a city of about 80,000 residents. If the epidemic takes a foothold in Goma, millions would be at risk, international travel between the two countries would be affected. And, if you look at the satellite image below, you can see Goma Airport.

Goma Satellite Image
Satellite image of Goma, DRC. (via Google Maps)

For about $1,000, you can jump on a plane in Goma and travel to Washington, DC, with a couple of stops in major cities in Africa and Europe along the way. So, while the beginning of the epidemic was in a relative remote area of the world, it is now at the doorstep of a major city with a well-traveled airport. It is now, truly, something of international concern.

While a very promising and successful vaccine has been in trials in DRC for a while now, the challenges for the country and the region continue to pile up. The country is also facing internal civil strife and poverty. Additionally, a big measles epidemic has killed more children than Ebola victims. And so, the challenges to DRC are many, and this declaration from WHO will aim to move resources into place to at least start taking care of the Ebola epidemic.

(This is only the fifth declaration of a PHEIC. The first was in 2009 due to the influenza H1N1 pandemic. The second was the 2014 resurgence of wildtype polio. That same year, the West Africa Ebola epidemic triggered another declaration. In 2016, the Zika epidemic in the Americas was also met with a declaration.)

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Author: René F. Najera, DrPH

I am the editor of the History of Vaccines site, an online project by the College of Physicians of Philadelphia. All opinions expressed on these blog posts are not necessarily those of the College or any of my employers. Check out my professional profile on LinkedIn: https://www.linkedin.com/in/renenajera Feel free to follow me on Twitter: @EpiRen

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