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Will Ebola cross-border spread spur recognition of an international public health emergency?

Antigone Barton
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An Ebola-infected child's death in Uganda, and the confirmation of the virus in at least two of his family members who had together traveled from the Democratic Republic of Congo after attending the funeral of a relative who died in the outbreak there, brings reality to fears expressed since the beginning of the current outbreak and exponentially multiplies its challenges. The World Health Organization will convene its emergency committee again this week -- for the third time since the current outbreak began --  to decide if this outbreak yet meets the criteria to be declared a Public Health Emergency of International Concern -- a PHEIC. Whether the committee reaches that conclusion or not, by definition, the reality of two countries grappling with multiple infectious disease challenges and stretched health response resources responding now to an intractable and still uncontrolled outbreak, even as WHO notes a  $28 million shortfall in internationally provided funding needed to respond to public health emergencies in the region, is an emergency, and is of international concern. The resources needed to overcome gaps in infrastructure, communication, diagnostic technology and capacities demand infusions of funding, expertise and personnel. Even then, observation as well as subsequent data from the 2013-2016 Ebola crisis in West Africa have shown us, the toll of an Ebola outbreak goes beyond those infected with the virus, claiming the health and lives of people in need of primary and preventive health care, as well as treatment for other diseases. Earlier this week, Democratic Republic of Congo health officials noted a 700% increase  -- compared to this time last year --  in suspected cases of measles, a disease they had set their sights on eliminating by 2020. The confirmation of the virus in Uganda could still, with proper and prompt international responses, also allow a glimpse of what proactive and preventive action can accomplish. Uganda already, according to its health ministry, has vaccinated more than 4,000 frontline health providers against Ebola. Uganda also was among the countries where pilot activities in 2013 supported the development of the Global Health Security Agenda to build international resources and capacities to prevent, detect and respond to outbreaks where they originate. The preparedness, as well as the vulnerability of other neighboring countries, including South Sudan, where outbreaks of other infectious diseases, wide spread poverty and political instability already stretch limited health resources, remain to be tested. Stay tuned -- The World Health Organization Emergency Committee will announce its findings on whether the cross border spread of Ebola constitutes a PHEIC Friday afternoon . . .    

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