WHO declares Ebola epidemic a global emergency

The World Health Organisation (WHO) today declared the current outbreak of the killer Ebola epidemic ravaging parts of West Africa an international health emergency and appealed for coordinated global efforts to help afflicted countries.

The WHO's emergency committee said it was its unanimously of the view that the conditions for a Public Health Emergency of International Concern (PHEIC) be met.

The decision that comes after a two-day emergency session behind closed doors in Geneva means global travel restrictions may be put in place to halt its spread as the overall death toll nears 1,000.

''The Ebola outbreak in West Africa constitutes an 'extraordinary event' and a public health risk to other states; the possible consequences of further international spread are particularly serious in view of the virulence of the virus, the intensive community and health facility transmission patterns, and the weak health systems in the currently affected and most at-risk countries.

''A coordinated international response is deemed essential to stop and reverse the international spread of Ebola,'' the WHO's emergency committee said after a meeting.

WHO noted that the outbreak of the current Ebola virus disease (EVD) that began in Guinea in December 2013, has now spread to Guinea, Liberia, Nigeria, and Sierra Leone. As of 4 August 2014, countries have reported 1,711 cases, including 1,070 confirmed, 436 probable and 205 suspected. Of these, countries have so far reported 932 deaths.

This is currently the largest EVD outbreak ever recorded. In response to the outbreak, a number of unaffected countries have made a range of travel related advice or recommendations.

With no effective medicines, and not even an effective response mechanism, to treat the disease, WHO's hands are tied. However, the agency is convening a meeting of ethicists early next week to discuss the sensitive and difficult issue of using experimental drugs on hundreds of affected Africans.

The United States government is also forming a group to consider the issues, said Dr Anthony S Fauci, director of the National Institute of Allergy and Infectious Diseases.

The US Food and Drug Administration helped clear the way on Thursday for a second experimental drug to be tried by people in Africa stricken with the Ebola virus.

The drug, being developed by Tekmira Pharmaceuticals of British Columbia, was in the initial phase of human testing, which is on healthy volunteers, when the FDA last month halted the trial because side effects were observed.

Tekmira said while the FDA was saying the drug, called TKM-Ebola, should not be given to healthy volunteers, it was now allowing its use to treat patients actually infected with the virus.

The first doses of the extremely scarce supplies of another experimental drug to fight the Ebola outbreak have, meanwhile, gone to two white American aid workers even as hundreds of Africans continued to die from the outbreak of the killer disease.

The experimental medicine, made by Mapp Biopharmaceutical of San Diego, appeared to be helping two American aid workers who had been stricken by the disease. Mapp and federal agencies are looking to provide that drug, called ZMapp, to the EVD-affected  in Africa.

But supplies of both ZMapp and TKM-Ebola are limited. And there are various other obstacles, such as regulatory issues, to be surmounted before the drugs can be used in Africa.

The WHO committee noted that for the affected countries, their health systems are fragile with significant deficits in human, financial and material resources, resulting in compromised ability to mount an adequate Ebola outbreak control response; inexperience in dealing with Ebola outbreaks; misperceptions of the disease, including how the disease is transmitted, are common and continue to be a major challenge in some communities.

This is compounded by high mobility of populations and several instances of cross-border movement of travellers with infection. Several generations of transmission have occurred in the three capital cities of Conakry (Guinea), Monrovia (Liberia) and Freetown (Sierra Leone) and a high number of infections have been identified among health-care workers, highlighting inadequate infection control practices in many facilities.

The director-general of WHO has asked heads of states of Ebola-affected countries to declare a national emergency and personally address the nation to provide information on the situation, the steps being taken to address the outbreak and the critical role of the community in ensuring its rapid control.

Besides, WHO has asked health authorities in individual states to:

• Provide immediate access to emergency financing to initiate and sustain response operations;
• Ensure all necessary measures are taken to mobilise and remunerate the necessary health care workforce;
• Coordinate and implement emergency response measures;
• Activate national emergency management mechanisms and establish emergency operation centre to coordinate support across all partners;
• Ensure large-scale and sustained effort to fully engage the community - through local, religious and traditional leaders and healers;
• Establish a strong supply pipeline to ensure that sufficient medical commodities, especially personal protective equipment (PPE), are made available to all who need them;
• Seek material and psychosocial support for reducing the movement of people, including use of quarantine wherever necessary;
• Ensure timely payment to health care workers and provide adequate safety and protection as also incentives like hazard pay, appropriate education and training on proper use of PPEs.

The WHO move comes as US health authorities yesterday admitted that Ebola's spread beyond west Africa was ''inevitable'', and after medical charity Doctors Without Borders (MSF) warning that the deadly virus was now ''out of control'' with more than 60 outbreak hotspots.

WHO director Dr Margaret Chan, appealed for greater international aid for the countries worst hit by the outbreak, which she described as the most serious in four decades, echoing an earlier claim by MSF that the ''epidemic is unprecedented in terms of geographical distribution, people infected and deaths''.

A state of emergency has been put in effect across overwhelmed West African nations, including Libera, Guinea and Sierra Leone.

Soldiers in Liberia's Grand Cape Mount province - one of the worst-affected areas - set up road blocks to limit travel to the capital Monrovia, as bodies reportedly lay unburied in the city's streets.

Ebola causes severe fever and, in the worst cases, unstoppable bleeding. It is transmitted through contact with bodily fluids, and people who live with or care for patients are most at risk.

First discovered in 1976 and named after a river in what is now the Democratic Republic of Congo, Ebola has killed around two-thirds of those infected, with two outbreaks registering fatality rates approaching 90 per cent. The latest outbreak has a fatality rate of around 55 per cent.

(See: What is Ebola virus disease?)