Emergencies

Emergencies

Ebola – DRC+
Public Health Emergency of International Concern (PHEIC)

Disease Outbreak News (DONs)
Ebola virus disease – Democratic Republic of the Congo
22 August 2019
The Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces in the Democratic Republic of the Congo continued this week with similar transmission intensity (Figure 1). While the last few weeks of the outbreak have been characterized by the geographic expansion of cases to new health zones, we continue to see high case numbers, sustained local transmission, and inter-health zone movement of cases both into and out of the hotspot areas of Beni, Mandima, and Butembo. In the past 21 days from 31 July through 20 August 2019, 69 health areas within 19 health zones reported new cases (Table 1, Figure 2). During this period, a total of 216 confirmed cases were reported, with the majority coming from the health zones of Beni (31%, n=66), Mandima (18%, n=38), and Butembo (8%, n=18). High risks of transmission are also associated with an emerging cluster in the city of Mambasa, which has reported 14 cases in the past 21 days. The response continues to address these hotspots through early case detection and thorough investigation, strong contact identification and follow up, and engagement with the local communities.

Two new health zones reported cases in the past week: Mwenga Health Zone in South Kivu and Pinga Health Zone in North Kivu. In Mwenga, four confirmed cases were reported after two individuals (mother and child) had contact with a confirmed case in Beni before travelling south. The father of the child was subsequently confirmed positive as was a co-patient in a community health facility where the first case initially sought care…

On 19 August 2019, a “ville morte” protest took place in Beni, Butembo, and Oicha in response to recent attacks by armed groups on civilians. This resulted in a temporary suspension of Ebola response activities. Operations resumed on 20 August 2019 with increased caution, and further demonstrations are anticipated. The suspension of Ebola response activities often results in an increase of case numbers and spread of cases to new areas in the subsequent weeks….

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Update on Ebola drug trial: two strong performers identified
12 August 2019
WHO Departmental news
Geneva
The co-sponsors of the Ebola therapeutics trial in the Democratic Republic of the Congo (DRC) have announced advances that will bring patients a better chance of survival. Two out of the four drugs being tested are more effective in treating Ebola. Moving forward, these are the only drugs that future patients will be treated with. Details of the changes are available in this WHO/NIAID/INRB release.

This WHO initiative is the first-ever multi-drug randomized control trial aimed at evaluating the safety and efficacy of four drugs used for treatment of Ebola patients. Initially developed as a multi-outbreak, multi-country study, PALM (“Together save lives”) was launched in November 2018. It is part of the emergency response in DRC, in collaboration with a broad alliance of partners, including the DRC’s National Institute for Biomedical Research (INRB), Ministry of Health, National Institute of Allergy and Infectious Diseases (NIAID), which is part of the United States’ National Institutes of Health, Alliance for International Medical Action (ALIMA), Médecins Sans Frontières (MSF), the International Medical Corps (IMC), and other organizations.

In addition to researching the best treatments for Ebola, other efforts by team members and partners in the field are also critical in impacting survival rates.  Teams of epidemiologists and community members work with communities to identify cases and provide care as quickly as possible. The teams ensure contacts are vaccinated against the disease and that their health is monitored for three weeks. Active case finding, contact tracing, and community acceptance of these teams are vital to ending the outbreak.

WHO is committed to continuing to work closely with the ministries of health of DRC and neighboring countries, and other international partners to ensure the outbreak response remains robust and well-coordinated.  We will continue to conduct rigorous research and incorporate findings into the Ebola outbreak response through a variety of prevention and control strategies.

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World Bank and WHO Statement on Partnership & Deployment of Financing to WHO for Ebola Response in DRC
22 August 2019 News release
The World Bank and the World Health Organization (WHO), along with the Government and other key partners, are working in close partnership on the Ebola Crisis Response in the Democratic Republic of the Congo (DRC). Central to this partnership is the assessment of the financing needs, and deployment of resources, with the goal to put an end to the current deadly outbreak.

The World Bank is today announcing that US$50 million in funding is to be released to WHO for its lifesaving operational work on the frontlines of the outbreak. The WHO is announcing that this US$50 million in funds will close the financing gap for its emergency health response in DRC through to the end of September 2019, and is calling on other partners to mirror this generous support in order to fund the response through to December.

The funding comprises US$30 million from the Pandemic Emergency Financing Facility (PEF) and US$20 million from the World Bank. The US$50 million in grant funding is part of the larger financial package of approximately US$300 million that the World Bank announced last month to support the fourth Strategic Response Plan for the DRC Ebola outbreak.

“WHO is very grateful for the World Bank’s support, which fills a critical gap in our immediate needs for Ebola response efforts in DRC, and will enable the heroic workers on the frontlines of this fight to continue their lifesaving work,” said Dr. Tedros Adhanom Ghebreyesus, Director-General, World Health Organization. “We keenly await further funding from other partners to sustain the response through to the end of the year.”

The DRC government, working in collaboration with the World Bank, WHO, and other key partners, has finalized the Fourth Strategic Response Plan (SRP4), which outlines the total resources needed for the DRC Ebola Crisis Response from July to December 2019. The financing announced today is part of the World Bank’s previously announced financial package of up to US$300 million and covers over half of SRP4’s needs, with the remainder requiring additional funding from other donors and partners.

“The World Bank is working closely with WHO, the Government of DRC, and all partners to do everything we can to put an end to the latest Ebola outbreak,” saidAnnette Dixon, Vice President, Human Development at the World Bank.“The partnership between our organizations and the Government is critical for responding to the emergency as well as rebuilding systems for delivery of basic services and to restoring the trust of communities.”

The Government of DRC requested US$30 million from the PEF Cash Window to be paid directly to WHO. The PEF Steering Body approved the request bringing the PEF’s total contribution to fighting Ebola in DRC to US$61.4 million. The PEF is a financing mechanism housed at the World Bank; its Steering Body is co-chaired by the World Bank and WHO, and comprises donor country members from Japan, Germany and Australia. The quick and flexible financing it provides saves lives, by enabling governments and international responders to concentrate on fighting Ebola—not fundraising.

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POLIO
Public Health Emergency of International Concern (PHEIC)

Polio this week as of 22 August 2019
:: Nigeria marked three years since the last case of wild poliovirus (WPV) was detected within its borders. Because Nigeria is the last polio-endemic country in Africa, this milestone opens the door for the potential WPV-free certification of the entire WHO AFRO region after the Africa Regional Certification Commission (ARCC) evaluation as early as mid-2020. While this is an important programmatic milestone, the region has not yet been certified polio-free and it will be critical for polio programme to maintain momentum.

Summary of new viruses this week:
:: Afghanistan —one wild poliovirus type 1 (WPV1) case;
:: Pakistan — one WPV1-positive environmental sample;
:: Angola — one cVDPV2 case;
:: Ghana — one cVDPVE2 case.

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Editor’s Note:
WHO has posted a refreshed emergencies page which presents an updated listing of Grade 3,2,1 emergencies as below.
WHO Grade 3 Emergencies [to 24 Aug 2019]

Democratic Republic of the Congo
:: Ebola virus disease – Democratic Republic of the Congo Disease Outbreak News (DONs)
22 August 2019
:: Update on Ebola drug trial: two strong performers identified 12 August 2019
[See DRC Ebola+ above for detail]

Nigeria
:: Three years without a case of wild polio virus, Government of Nigeria warns against complacency 21 August 2019
:: Nigeria introduces Meningitis A Conjugate Vaccine into Routine EPI Schedule 12 August 2019

Syrian Arab Republic
:: Syrian Arabic Republic: tackling NCDs in emergencies through primary health care
5 August 2019

Yemen
:: Second round of oral cholera vaccine reaches nearly 400 000 people in Aden, Taiz and Al Dhale’e 21 August 2019

Cyclone Idai – No new digest announcements identified
Mozambique floods – No new digest announcements identified
Somalia – No new digest announcements identified
South Sudan – No new digest announcements identified

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WHO Grade 2 Emergencies [to 24 Aug 2019]

Afghanistan
:: Afghan women eradicating polio #womenhumanitarians 19 August 2019

Malawi floods
:: WHO and MOH brief Malawian journalists about the Ebola Virus Disease outbreak situation in the African Region

Cameroon – No new digest announcements identified
Central African Republic – No new digest announcements identified
Ethiopia – No new digest announcements identified
HIV in Pakistan – No new digest announcements identified
Iran floods 2019 – No new digest announcements identified
Iraq – No new digest announcements identified
Libya – No new digest announcements identified
MERS-CoV – No new digest announcements identified
Myanmar – No new digest announcements identified
Measles in Europe – No new digest announcements identified
Niger – No new digest announcements identified
occupied Palestinian territory – No new digest announcements identified
Sudan – No new digest announcements identified
Ukraine – No new digest announcements identified
Zimbabwe – No new digest announcements identified

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WHO Grade 1 Emergencies [to 24 Aug 2019]

Angola – No new digest announcements identified
Chad – No new digest announcements identified
Djibouti – No new digest announcements identified
Indonesia – Sulawesi earthquake 2018 – No new digest announcements identified
Kenya – No new digest announcements identified
Mali – No new digest announcements identified
Namibia – viral hepatitis – No new digest announcements identified
Tanzania – No new digest announcements identified

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UN OCHA – L3 Emergencies
The UN and its humanitarian partners are currently responding to three ‘L3’ emergencies. This is the global humanitarian system’s classification for the response to the most severe, large-scale humanitarian crises. 
Syrian Arab Republic
:: Syrian Arab Republic: Recent Developments in Northwestern Syria Situation Report No. 10 – as of 23 August 2019

Yemen
:: Yemen: Flash Floods Flash Update No. 2 As of 19 August 2019

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UN OCHA – Corporate Emergencies
When the USG/ERC declares a Corporate Emergency Response, all OCHA offices, branches and sections provide their full support to response activities both at HQ and in the field.
Editor’s Note:
Ebola in the DRC has bene added as a OCHA “Corporate Emergency” this week:
CYCLONE IDAI and Kenneth – No new digest announcements identified
EBOLA OUTBREAK IN THE DRC – No new digest announcements identified

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