Jun 6, 2019

In contrast to others, WHO offers cautious hope on Ebola outbreak

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

The World Health Organization said Thursday there should be cautious hope at signs the numbers of confirmed Ebola cases and the geographical footprint have lessened over the past couple weeks in the Democratic Republic of the Congo.

The other side: This is in sharp contrast to what other experts and organizations have been saying, with the head of the Centers for Disease Control warning at a hearing that he anticipates the deadly virus will spread outside the DRC and multiple international health officials calling for a "reset."

What they're saying:

“The magnitude of this outbreak is getting to the point that one has to anticipate that it will spread outside of DRC.”
— Robert Redfield, CDC director at hearing this week, per Devex
“The Ebola response effort has undoubtedly saved lives and helped prevent the spread of this disease beyond North Kivu and Ituri. We’ve now reached more than 2,000 Ebola cases and the numbers being reported have risen dramatically. We need to reset the response, and place communities at the centre of all of our efforts.”
— Nicole Fassina, Ebola virus disease coordinator, Red Cross statement
“It is clear the current response to tackle Ebola isn’t working. No matter how effective treatment is, if people don’t trust or understand it, they will not use it. Our teams are still meeting people on a daily basis who don’t believe Ebola is real. ... Since the UN has stepped up their leadership ... there’s an opportunity to reset the response."
Corinne N’Daw, director in DRC, Oxfam statement

Yes, but: Michael Ryan, executive director of WHO's health emergencies program, says...

"This outbreak doesn't have a reset button. Unfortunately, we don't get choices like that. ... We get to learn and adapt [instead]."

By the numbers: Total cases since the outbreak started Aug. 1 breached 2,000 this week and Ryan cautioned at Thursday's press briefing that the outbreak still has the ability to pivot to worsening conditions — which could include a "worst case scenario" of lasting up to another 2 years — but he stressed there now are some "hopeful" changes in trajectories...

  • Confirmed cases the past 2 weeks dropped to 88 each week, which is lower than April's average of 126 cases/week.
  • There's a "smaller geographical footprint" as the outbreak has shrunk to 75 health areas in 12 health zones in the DRC.
  • The number of contacts of known infected people who health officials are monitoring daily dropped from roughly 20,000 to 15,000.

Between the lines: Jennifer Nuzzo, senior scholar at Johns Hopkins' Center for Health Security, tells Axios that despite the lower recent numbers, there's "cause for concern" due to the large number of cases who were not known contacts, violence and criminal behavior targeting Ebola Treatment Centers, and fears of an upcoming shortage of the Ebola vaccine.

  • Nuzzo agrees with Redfield that Ebola will likely spread over the border: "I see absolutely no reason to think that this will not happen."
  • She says she's also concerned about a vaccine shortage, and cautions that WHO's recommendations to either dilute the current vaccine or add a second experimental vaccine that has less research behind it may be impractical. "We need a very realistic plan for expanding the vaccine supplies."

Go deeper: Follow Axios' Ebola coverage here.

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