Some experts said that’s the wrong choice.
Despite the rapidly mounting Ebola cases in the Democratic Republic of Congo, experts at the World Health Organization on Friday decided not to declare a global health emergency.
Because the outbreak, which has been ongoing since August, hasn’t spread beyond the DRC, “We considered there would be no added benefit by declaring [an emergency], particularly as excellent work is being done on the ground by WHO and many partner organizations,” said Robert Steffen, chair of the WHO committee that deliberated over the emergency declaration.
A PHEIC, or “public health emergency of international concern,” is an official designation the WHO can give to an outbreak in order to sound the international alarm. It can galvanize attention and trigger the release of resources — money and personnel — to help stop a disease from spreading globally.
Today’s decision marks the second time the WHO determined that the situation in the central African country doesn’t warrant the emergency designation. In October, the health agency’s expert panel offered similar reasoning when it decided against the PHEIC. Then, WHO noted that not a single Ebola case has been exported beyond the borders of the DRC, and that an international response was already well underway. The panel was confident the DRC had plenty of experience responding to the virus.
But this year, the outbreak has continued to spiral. It’s the first known Ebola outbreak to happen in an active war zone (located in DRC’s northeastern provinces, North Kivu and Ituri). And flare-ups in violence have frequently interrupted the efforts of Ebola responders, leading to more cases. That’s why some health experts think the WHO is acting too timidly and that an emergency declaration is overdue.
Why some say it’s time to call DRC Ebola a global health emergency
In the past week alone, there were 74 new cases — the most of any week since the outbreak was identified in August. And to date, at least 740 people have died out of more than 1,100 cases. That makes the DRC’s outbreak the second-largest known Ebola outbreak in history, following only the 2014-2016 epidemic in West Africa.
And while Ebola hasn’t yet spread across international borders, cases were recently identified at an airport in the DRC.
“The Ebola outbreak in DRC is serious,” Tom Frieden, the former director of the Centers for Disease Control and Prevention, told Vox. “Cases are increasing, and there’s decreasing ability to stop spread because of insecurity. It’s hard to see how you can make a strong argument about this not being a PHEIC.”
Tom Inglesby, director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health, was also surprised by the negative decision. “We’ve reached a new moment of seriousness in this outbreak and WHO has not gotten the resources it needs to respond to this outbreak in full capacity,” he said.
And it’s not just that this is the worst week in terms of new cases since the outbreak started, Inglesby continued. “It’s what’s behind the numbers. We have a high percentage of people who are appearing with Ebola after thy’ve died. We have a lot of people who have Ebola but are invisible to the response community. That’s why those numbers are going up.”
Why global health emergencies are rare
But there are reasons WHO experts might opt against triggering the PHEIC alarm, even in serious outbreaks.
PHEIC — pronounced “fake” — is defined as “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response.”
Despite all the dangerous outbreaks in response years, the WHO has only declared a public health emergency four times since the International Health Regulations, which govern global health emergency responses, were enacted in 2007.
The first time was in 2009, with the outbreak of the H1N1 swine flu pandemic. The second time was in May 2014, when polio seemed to surge again, threatening the eradication effort. The third time, in August 2014, came as the Ebola outbreak in West Africa was growing out of control. And the fourth: In February 2016, the Zika outbreak across South and Central America was declared a PHEIC.
And that’s because these decisions are not taken lightly. First, the PHEIC is a political tool used to focus the world’s attention on a health crisis. Using this declaration too often would weaken its significance. Second, one of the key considerations in declaring a PHEIC is whether the disease threat is dire enough for countries to be forced into enacting travel and trade restrictions. These can be devastating to local economies.
Health emergency declarations are often associated with economic losses, even when the WHO only warns people to limit or delay travel to affected regions (instead of outright travel restrictions).
Because of the 2014-2016 Ebola crisis in West Africa, the World Bank Group estimated that the West African countries at the center of the outbreak — Guinea, Liberia, and Sierra Leone — lost out on about $1.6 billion in economic growth in 2015. Similarly, the South American countries hit by swine flu suffered economic losses ranging from 0.5 to 1.5 percent of their GDPs.
If this outbreak continues to spiral, however, the WHO risks reputational damage for not declaring an emergency sooner.
“I don’t think we should wait for the appearance of an international case to trigger an emergency declaration,” said Inglesby. “I imagined this meeting would end in a [PHEIC] declaration, and I hope we reconsider this in the days ahead.”
from Vox - All http://bit.ly/2P5Ieuk
Breaking News: The WHO just decided the latest Ebola outbreak is not a global emergency - News Paper
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