Sustainable strategies for Ebola virus disease outbreak preparedness in Africa: a case study on lessons learnt in countries neighbouring the Democratic Republic of the Congo

From May 2018 to September 2022, the Democratic Republic of Congo (DRC) experienced seven Ebola virus disease (EVD) outbreaks within its borders. During the 10th EVD outbreak (2018-2020), the largest experienced in the DRC and the second largest and most prolonged EVD outbreak recorded globally, a W...

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Published in:	Infectious diseases of poverty Vol. 11; no. 1; p. 118
Main Authors:	Ryan, Caroline S, Belizaire, Marie-Roseline D, Nanyunja, Miriam, Olu, Olushayo Oluseun, Ahmed, Yahaya Ali, Latt, Anderson, Kol, Matthew Tut, Bamuleke, Bertrand, Tusiime, Jayne, Nsabimbona, Nadia, Conteh, Ishata, Nyashanu, Shamiso, Ramadan, Patrick Otim, Woldetsadik, Solomon Fisseha, Nkata, Jean-Pierre Mulunda, Ntwari, Jim T, Nzeyimana, Senya D, Ouedraogo, Leopold, Batona, Georges, Ndahindwa, Vedaste, Mgamb, Elizabeth A, Armah, Magdalene, Wamala, Joseph Francis, Guyo, Argata Guracha, Freeman, Alex Yao Sokemawu, Chimbaru, Alexander, Komakech, Innocent, Kuku, Muhau, Firmino, Walter M, Saguti, Grace E, Msemwa, Faraja, O-Tipo, Shikanga, Kalubula, Precious C, Nsenga, Ngoy, Talisuna, Ambrose Otau
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 02-12-2022 BioMed Central BMC
Subjects:	Analysis Capacity development Case studies Case study Congo (Kinshasa) Coronaviruses COVID-19 COVID-19 - epidemiology COVID-19 - prevention & control Democratic Republic of the Congo Democratic Republic of the Congo - epidemiology Disease Outbreaks - prevention & control Disease transmission Displaced persons Ebola virus Ebola virus disease Ebola virus infections Emergency preparedness Emergency preparedness and response Epidemics Funding Global health Hemorrhagic Fever, Ebola - epidemiology Hemorrhagic Fever, Ebola - prevention & control Humans Infections International Health Regulations Laboratories Lessons learned Medical research Medicine, Experimental Outbreaks Pandemics Pandemics - prevention & control Provinces Public health Risk assessment Rwanda South Sudan Sustainability Sustainable development Uganda Virus diseases Democratic Republic of the Congo Congo (Kinshasa) Uganda South Sudan Rwanda Sudan Africa Case study Lessons learned Democratic Republic of the Congo International Health Regulations Emergency preparedness and response Ebola virus disease
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Summary:	From May 2018 to September 2022, the Democratic Republic of Congo (DRC) experienced seven Ebola virus disease (EVD) outbreaks within its borders. During the 10th EVD outbreak (2018-2020), the largest experienced in the DRC and the second largest and most prolonged EVD outbreak recorded globally, a WHO risk assessment identified nine countries bordering the DRC as moderate to high risk from cross border importation. These countries implemented varying levels of Ebola virus disease preparedness interventions. This case study highlights the gains and shortfalls with the Ebola virus disease preparedness interventions within the various contexts of these countries against the background of a renewed and growing commitment for global epidemic preparedness highlighted during recent World Health Assembly events. Several positive impacts from preparedness support to countries bordering the affected provinces in the DRC were identified, including development of sustained capacities which were leveraged upon to respond to the subsequent coronavirus disease 2019 (COVID-19) pandemic. Shortfalls such as lost opportunities for operationalizing cross-border regional preparedness collaboration and better integration of multidisciplinary perspectives, vertical approaches to response pillars such as surveillance, over dependence on external support and duplication of efforts especially in areas of capacity building were also identified. A recurrent theme that emerged from this case study is the propensity towards implementing short-term interventions during active Ebola virus disease outbreaks for preparedness rather than sustainable investment into strengthening systems for improved health security in alignment with IHR obligations, the Sustainable Development Goals and advocating global policy for addressing the larger structural determinants underscoring these outbreaks. Despite several international frameworks established at the global level for emergency preparedness, a shortfall exists between global policy and practice in countries at high risk of cross border transmission from persistent Ebola virus disease outbreaks in the Democratic Republic of Congo. With renewed global health commitment for country emergency preparedness resulting from the COVID-19 pandemic and cumulating in a resolution for a pandemic preparedness treaty, the time to review and address these gaps and provide recommendations for more sustainable and integrative approaches to emergency preparedness towards achieving global health security is now.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2049-9957 2095-5162 2049-9957
DOI:	10.1186/s40249-022-01040-5