Ebola Outpacing Control Effects: WHO

Megan Brooks

September 03, 2014

The ongoing Ebola outbreak in West Africa shows no signs of letting up.

On the contrary, it is racing ahead of control efforts, the World Health Organization (WHO) and United Nation's (UN's) senior leadership on Ebola acknowledged today during a press briefing.

"This Ebola epidemic is the largest, most severe and most complex we have ever seen in the nearly 40-year history of this disease, said Margaret Chan, MD, WHO director-general.

"This is an international issue and global threat and that requires global coordination. We can and we will bring the Ebola epidemic under control," Dr. Chan said.

The WHO has launched the Ebola response roadmap to guide and coordinate the growing international response to the outbreak.

"The roadmap aims to stop ongoing Ebola transmission worldwide within 6–9 months, while rapidly managing the consequences of any further international spread. It also recognizes the need to address, in parallel, the outbreak's broader socioeconomic impact," a news release from the WHO explains.

Stigma Hampering Efforts

Keiji Fukuda, MD, WHO assistant director-general for health security, and David Nabarro, MD, senior UN coordinator for the outbreak have just returned from a needs assessment in the affected countries and their observations have shaped the new surge response plan that the UN has committed to in the region.

In town hall meetings, Dr. Fukuda said, he heard the challenges faced by those dealing first-hand with Ebola. One key problem, he said, continues to be a lack of capacity to deal with infected patients. New infections continue to happen in families and communities, and many people are just staying home if they or their loved ones are ill because there aren't enough beds at the hospital or transportation to the hospital. "For them, there is no real benefit to be identified," Dr. Fukuda told the briefing. That has to change, he said.

He also found that people in affected communities are clearly hungry for information. "They want to understand what is going on, how decisions are made, and what they can do protect themselves," Dr. Fukuda said.

Dr. Nabarro said part of the emphasis going forward will be to strengthen communication and messaging about the outbreak. "In particular, to make sure information people have is the correct information about how you do and do not get infected."

Efforts will also focus on getting more health workers and treatment beds, along with food, money, equipment, materials, and vehicles, to the region, Dr. Nabarro said.

In conversations on the ground, Dr. Fukuda said it's also clear that people "feel stigmatized and isolated and are under extreme stress."

Dr. Chan said stigmatization is "uncalled for, but it is already playing out in big way at the country level and beyond and making the coordinated global response much more difficult."

As of this week, there are 3500 probable or confirmed Ebola cases and more than 1900 deaths in Liberia, Sierra Leone, and Guinea, Dr. Chan reported. In Nigeria, the outbreak in Lagos is much smaller and most cases are linked to an air traveler from Liberia, she noted.

Senegal reported its first case of Ebola on August 29. This too was an imported case and to date no other cases have been reported. Senegal has mounted a strong response to do contract tracing, Dr. Chan said.

In the Democratic Republic of the Congo, Dr. Chan said, there is now "clear" epidemiologic and virus sequencing evidence that this is a smaller independent outbreak.

Dr. Nabarro plans to travel back to the region next week.

On September 4 and 5, scientists will convene at WHO headquarters in Geneva to assess the most promising experimental therapies or vaccines that could be fast-tracked, Dr. Chan said.

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