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Expand chart
Data: DRC Ministry of Health; Chart: Andrew Witherspoon, Harry Stevens/Axios

The World Health Organization declined Friday to declare a "Public Health Emergency of International Concern," (PHEIC} its highest alert level, despite a sharp uptick in the number and geographical spread of cases of the Ebola virus in the Democratic Republic of the Congo (DRC).

Why it matters: This is already the second-largest Ebola outbreak on record, with more than 1,000 cases of the hemorrhagic fever so far, and it's the first to occur in a country where there is widespread civil unrest.

The details: The outbreak, which began in August, has killed 751 and sickened 1,186 as of April 9, according to WHO and DRC Ministry of Health data.

  • During the past few weeks, a dramatic increase in the number of cases, and the prevalence of community cases — patients unknown to health workers who often die at home, exposing caretakers to the virus — have raised concerns and prompted a WHO committee meeting to determine if an emergency declaration was warranted.
  • "The emergency committee almost unanimously decided against recommending a public health emergency of international concern," said Robert Steffen, chair of the WHO's Emergency Committee, during a press conference in Geneva.
  • Steffen said an emergency was not warranted because the outbreak has not spread to any other country, though there's nothing preventing its spread.

Between the lines: The WHO has been criticized for moving too slowly to declare a public health emergency during this outbreak while issuing optimistic outlooks about its ability to contain it, despite a steady rise in cases, an anemic international response effort and multiple deadly attacks on Ebola treatment facilities and workers.

  • According to Jennifer Nuzzo, a public health expert at the Johns Hopkins Center for Health Security, an emergency declaration is the best option at the WHO's disposal:
"I am deeply disappointed by today’s decision to not declare a PHEIC. The statement that there would be no added benefits of a PHEIC declaration is misplaced. Potential benefits are not criteria by which these decisions should be made. The decision to declare a PHEIC should be made on technical merits, not political ones."
  • Alexandra Phelan, a health expert at Georgetown University, also criticized the WHO's decision:
"The persistence of community and health care workers’ cases and high risk of regional spread means that significantly greater financial, political, and technical support is urgently needed. A PHEIC declaration is intended to garner this support and provide guidance to the international community. This is not only a missed opportunity but undermines the international law developed to safeguard global health.” 

By the numbers: The WHO's director, Dr. Tedros Adhanom Ghebreyesus, said the WHO needs $104 million until July 31 to close a funding gap in order to continue to fight the disease in the DRC.

  • The WHO says it needs a total of $148 million to carry out its Ebola fight.

But, but but: A lack of an emergency declaration may work against the fundraising effort, Nuzzo says.

  • "The reason that’s been given for not declaring a [Public Health Emergency] has been skepticism that it will result in anything," she says, referring to additional resources from the international community.
  • "While I can understand where that skepticism is coming from ... I also know that not declaring it certainly doesn’t wake up world leaders either."

Go deeper: Ebola outbreak passes 900 cases amid urgent new warnings

Go deeper

Scoop: Border officials project 13,000 child migrants in May

The "El Chaparral" border crossing at Tijuana. Photo: Stringer/Picture Alliance via Getty Images

A Customs and Border Protection staffer told top administration officials Thursday the agency is projecting a peak of 13,000 unaccompanied children crossing the border in May, sources directly familiar with the discussion told Axios.

Why it matters: That projection would exceed the height of the 2019 crisis, which led to the infamous "kids-in-cages" disaster. It also underscores a rapidly escalating crisis for the Biden administration.

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U.S. strikes Iran-backed militia facilities in Syria

President Biden at the Pentagon on Feb. 10. Photo: Alex Brandon - Pool/Getty Images

The United States on Thursday carried out an airstrike against facilities in Syria linked to an Iran-backed militia group, the Pentagon announced.

The state of play: The strike, approved by President Biden, comes "in response to recent attacks against American and Coalition personnel in Iraq, and to ongoing threats to those personnel," Pentagon press secretary John Kirby said in a statement.

Senate parliamentarian rules $15 minimum wage cannot be included in relief package

Photo: Al Drago/Getty Images

The Senate parliamentarian ruled Thursday that the provision to increase the minimum wage to $15/hour cannot be included in the broader $1.9 trillion COVID relief package.

Why it matters: It's now very likely that any increase in the minimum wage will need bipartisan support, as the provision cannot be passed with the simple Senate majority that Democrats are aiming to use for President Biden's rescue bill.