By Bruce Aylward, World Health Organization, Special Representative for the Ebola Response
Despite the massive decline in Ebola cases in the past few months, last week’s increase in cases is a stark reminder that Ebola has not gone away yet and will not go away without a tremendous redoubling of our collective efforts. As the case numbers decrease, there will be volatility — numbers will go up and down, but this recent upsurge tells us that the outbreak is nowhere near over and still presents a grave threat.
If we can’t substantially reduce the geographic extent of this outbreak within the next two months, before the rainy season begins in late March or April, we will be in a particularly difficult situation. It is absolutely vital that we are able to keep our teams and resources in place through this period so that these countries can eventually finish the job. Although the international community has been incredibly generous, continued commitment and financial support is essential to continue the kind of epidemiologic detective work that is needed to get to zero cases.
By ‘epidemiologic’ detective work, I mean effectively tracing every person who has had contact with a person who is sick with Ebola and then following those contacts for 21 days so that further spread can be stopped by isolating and treating these people immediately if they become ill. The difficult geography, high human mobility, and lack of community acceptance in some areas still present major barriers to these efforts.
The good news is that we are seeing major improvements in contact tracing across all three of the most-affected countries. All three countries are getting closer and closer to identifying all of their remaining transmission chains, and controlling further spread of the disease. However, the funding for the 800 people deployed by the World Health Organization to lead that work runs out at the end of the month. The situation is precarious, as it would be devastating to the response effort to lose those 800 people in the field due to budget constraints.
This crisis is quite different from many other humanitarian crises that we’re dealing with globally right now. With Ebola, the crisis is not over until the very last case has been isolated and there is confidence that no more infections are hidden out there in the community. The Ebola outbreak in West Africa requires a level of programmatic perfection that is rare in other humanitarian and public health responses. We have to have the right financing and the right people on the ground to get to zero cases, and we cannot have gaps. If we have gaps in the surveillance and response capacity, we will have more flare ups of the disease that could lead to Ebola on a large scale again.
Achieving this level of precision will be even harder during the rainy season, which is fast approaching. We have to have that infrastructure in place well in advance and it must be solid in order to find new cases, track the transmission chains and shut this outbreak down. If we don’t, then problems with transport over rain-sodden dirt roads will severely hinder these countries’ ability to maintain and make progress towards zero cases during the rainy season.
The World Health Organization is committed to finishing this outbreak and to helping the affected countries get back on track again, but we need resources and the commitment of the global community to achieve these goals. The world cannot let the affected countries down at this crucial time.
Take action! Donate to the Ebola Response Fund to help us get to zero.