Statement: response and preparedness for the Ebola outbreak in the Democratic Republic of the Congo

Statement by Josie Golding, Epidemics Lead, at the High-Level Event on Response and Preparedness for the Ebola Outbreak in the Democratic Republic of the Congo (DRC), on behalf of Jeremy Farrar, Director.

We pay tribute and thanks to all the individuals and teams working in North Kivu with such dedication and bravery. We all owe them enormous thanks and respect.

This is an incredibly complex and challenging epidemic. We are almost a year in now and are at a precarious point. At any moment, an epidemic in this phase runs the risk of a major expansion in numbers, or geography, or both. There is a very grave risk of a second related or unrelated Ebola epidemic in the Congo or elsewhere.

A long-running epidemic takes a terrible toll on the communities affected. But it is within these communities that the solutions to this epidemic lie and we must do all we can to gain their trust and engagement.

We welcome the appointment of the UN Emergency Ebola Response Coordinator to bring this epidemic to an end. A change in the response is needed. Community engagement, ownership and trust is critical. This includes working with the community to speed up diagnosis, triage and provide the best possible clinical care.

There is a pressing need for rapid diagnosis and the use of sequencing to inform the public health response immediately, in real-time, on where the disease is spreading to and to understand the true scale of the epidemic. There is an urgent need to make maximum use of the Merck vaccine in a ring vaccination strategy that only the Merck vaccine can provide.

But it is probable that the Merck vaccine will run out before this epidemic comes to an end – and if so, this would have devastating consequences.

We strongly believe there is an urgent need to deploy and assess a second Ebola vaccine, that developed by Johnson and Johnson (J&J), in primary prevention, following the recommendations of the SAGE Committee and the WHO.

We regret the recent announcement against the use of the J&J vaccine and ask for this to be reconsidered. The lives of the people in North Kivu, across DRC and the region, depend on it.

The response in DRC remains overstretched and underfunded, with only a small number of countries providing funding. Others need to show support for the response with funding, as well as at the highest political levels, including through the UN, the African Union, G20 and other forums. Countries should not wait for Ebola to spread across borders or appear on their doorstep before acting.

Wellcome has provided over $5m to support the response work, from social science through to clinical care, to therapeutics, diagnostics and vaccination. We are willing to commit further funds as led by the best science needed to bring this epidemic under control.

While the focus must be now on North Kivu, we call for greater strategic consideration and scenario planning for a much longer and an even more complex epidemic - as this one is looking likely to be.

Beyond that, we must remember the critical importance of universal health coverage, surveillance, and public health systems to provide essential health care and have the surge capacity to prevent, identify and deal with epidemics. We must include in such planning the capacity to address the causes and drivers of these and other epidemics

But today, to end this Ebola epidemic, the focus must be on working with the communities affected to understand how to provide effective infection control, rapid diagnosis and triage, and the best possible clinical care and the deployment of both the Merck and J&J vaccines.

And we look forward to working with all partners, beyond Ebola, to consider how we best prevent such epidemics from happening in the future.

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