World Health Organization resists declaring Ebola emergency — for third time

喀秋莎 2019-6-17 5411

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    This story was supported by the Pulitzer Center on Crisis Reporting.

    Kinshasa, Democratic Republic of the Congo

    The Ebola outbreak that has ravaged the northeast Democratic Republic of the Congo (DRC) — now the second largest on record — spread into neighbouring Uganda this week, raising concerns about whether health officials can contain the virus. But the crisis still does not warrant the World Health Organization’s (WHO) highest level of alarm, agency director Tedros Adhanom Ghebreyesus said on 14 June.

    “Although the spread of Ebola to Uganda is tragic, it is not a surprise,” Ghebreyesus told reporters, speaking from the WHO’s offices in Kinshasa, the DRC’s capital. “Since the beginning of the outbreak, we have said that the risk of spread across the border is high, and it remains high.” But “the fundamental dynamic” of the outbreak has not changed, he said.

    More than 2,100 people have been infected with the virus since the outbreak began in August 2018, and roughly 1,400 had died as of 12 June, according to the WHO. These figures include the first Ebola fatalities in Uganda during this outbreak: a five-year-old boy and his grandmother, who died earlier this week.

    The WHO’s announcement marks the third time since the outbreak began that the agency has decided against declaring a public-health emergency of international concern (PHEIC).

    The handful of Ebola cases confirmed in Uganda have involved people who travelled from the DRC, and there is no evidence that the virus is being transmitted within Uganda. One criteria that the WHO uses to determine whether an outbreak is a global emergency is whether a disease is spreading in more than one country.

    The WHO’s Emergency Committee of independent medical experts also decided against declaring an emergency in part over concerns that doing so could trigger the DRC’s neighbours to close their borders. That could in turn halt trade, damaging the DRC’s economy, and prevent thousands of people from escaping violence in the northeastern DRC, which is home to dozens of armed groups.

    At least 50 people were killed during a recent surge of violence in Ituri, one of two northeast DRC provinces in which Ebola is spreading, the DRC government said on 13 June.

    Difficult decisions

    “This issue of PHEIC and not PHEIC — I think we are carried away by the term,” says Chikwe Ihekweazu, the director-general of the Nigeria Centre for Disease Control in Abuja, who advised the WHO’s Emergency Committee during its latest deliberations. “Of course it is an emergency of international concern, translated literally, but making this additional declaration — to be honest, I don't see the extra benefit it would bring.”

    Oly Ilunga Kalenga, the DRC’s minister of health, agrees. “From my point of view, there is no need for a PHEIC,” he says. About 25,000 people per day travel through 80 entry points that connect the DRC’s North Kivu and Ituri provinces with Uganda. But only a handful of people with Ebola have managed to cross from the DRC to Uganda, he notes.

    What makes this outbreak difficult, Kalenga says, is the roiling violence and distrust of government in areas of the DRC where the virus is spreading. “I compare this outbreak to a monster with many heads,” he says. “You cut off one head and another appears. You have to respond to the face in front of you.”

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    Other experts argue that declaring an emergency is needed to bring the current Ebola outbreak under control. “I'm baffled. I'm actually bewildered. I simply don't understand the reasoning,” says Lawrence Gostin, a health-law and policy specialist at Georgetown University in Washington DC. “The WHO was roundly criticized for delaying for six months its declaration of an emergency in West Africa, and now it’s repeating history.”

    Gostin had hoped that an emergency declaration for the DRC outbreak would prompt an outpouring of financial help and other assistance from governments and aid organizations — similar to that seen during the 2014–2016 Ebola outbreak in West Africa, when donors contributed an estimated US$3 billion to fight the virus. The WHO has said that it needs at least another $54 million in donations to support its Ebola response through July.

    But Ghebreyesus says that the declaration of a public-health emergency should not be viewed as a fundraising exercise. “Resources should be mobilized before you sound the alarm, you don't wait to patch the roof until after the storm comes,” he told Nature.     “Using a PHEIC to mobilize resources is dangerous because by then, it's too late.”

    doi: 10.1038/d41586-019-01893-1


我在上班,别发骚图了。
最新回复 (8)
  • Silence 2019-6-17
    0 2
    在里站居然还能学英语!
    一个莫得理智的方舟Doctor
  • 喀秋莎 2019-6-17
    0 3
    这是Nature上的一篇文章,老外真的是性子直,这么恶心的事情都能说出来,整篇文章就差说非洲人命不值钱了。
    我在上班,别发骚图了。
  • 欧派兽 2019-6-17
    0 4
    真的恶心
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  • Silence 2019-6-17
    0 5
    当发生利益冲突时,总会有人作出牺牲。
    不过我们不知道,牺牲的是否是我们自己。
    一个莫得理智的方舟Doctor
  • 柠檬柠檬酱 2019-6-17
    0 6
    谷歌翻译了一下,大家将就一下哒

    世界卫生组织第三次拒绝宣布埃博拉病毒紧急情况

     这个故事得到了普利策危机报道中心的支持。

        刚果民主共和国金沙萨

        蹂躏刚果民主共和国东北部(DRC)的埃博拉病毒爆发 - 现已成为有史以来第二大疫情 - 本周蔓延到邻国乌干达,引发了人们对卫生官员是否能控制病毒的担忧。但危机仍然不能保证世界卫生组织(WHO)最高级别的警报,机构主任Tedros Adhanom Ghebreyesus在6月14日表示。

        “虽然埃博拉病毒传播到乌干达是悲惨的,但这并不令人意外,”Ghebreyesus在世界卫生组织驻刚果民主共和国首都金沙萨的办事处对记者说。他说:“自疫情爆发以来,我们已经说过,跨境传播的风险很高,而且仍然很高。”但爆发的“基本动态”没有改变。

        据世界卫生组织称,自2018年8月爆发疫情以来,已有2100多人感染了这种病毒,截至6月12日已有大约1,400人死亡。这些数字包括乌干达在此次爆发期间的首次埃博拉死亡案件:一名五岁男孩和他的祖母,他们本周早些时候去世了。

        世界卫生组织的公告标志着自疫情爆发以来该机构第三次决定不再宣布引起国际关注的突发公共卫生事件(PHEIC)。

        在乌干达确认的少数埃博拉病例涉及从刚果民主共和国旅行的人,并且没有证据表明该病毒正在乌干达境内传播。世卫组织用于确定疫情是否是全球性紧急情况的一个标准是疾病是否在一个以上的国家蔓延。

        世卫组织独立医疗专家紧急委员会也决定不再宣布紧急情况,因为担心这样做可能会导致刚果民主共和国的邻国关闭边界。这可能反过来阻止贸易,破坏刚果民主共和国的经济,并阻止成千上万的人逃离刚果民主共和国东北部的暴力活动,该地区是数十个武装团体的家园。

        刚果民主共和国政府于6月13日表示,最近在刚果民主共和国东北部两个省份之一伊图里爆发的暴力活动中,至少有50人丧生。

        艰难的决定
        “这个PHEIC而不是PHEIC的问题 - 我认为我们被这个术语带走了,”阿布贾尼日利亚疾病控制中心总干事Chikwe Ihekweazu说道,他在最近的审议期间为世界卫生组织的突发事件委员会提供了建议。 “当然,这是一个国际关注的紧急事件,从字面上翻译,但做出这个额外的声明 - 说实话,我没有看到它带来的额外好处。”

        刚果民主共和国卫生部长Oly Ilunga Kalenga对此表示赞同。 “从我的观点来看,没有必要使用PHEIC,”他说。每天约有25,000人通过80个入境点,将刚果民主共和国的北基伍省和伊图里省与乌干达连接起来。但他指出,只有极少数患有埃博拉病毒的人设法从刚果民主共和国过渡到乌干达。

        Kalenga说,这次爆发的困难之处在于病毒传播的刚果民主共和国地区政府的暴力和不信任。 “我把这次爆发与一个有很多脑袋的怪物进行比较,”他说。 “你切断了一个头,另一个出现了。你必须回应面前的面孔。“
        其他专家认为,需要宣布紧急情况才能控制当前的埃博拉疫情。 “我很困惑。我其实很困惑。我根本不理解这个推理,“华盛顿特区乔治敦大学的健康法律和政策专家劳伦斯戈斯汀说。 “世界卫生组织因在西非宣布紧急状态六个月而遭到严厉批评,现在正在重复历史。”

        Gostin曾希望刚果民主共和国爆发的紧急声明将促使政府和援助组织提供大量财政援助和其他援助 - 类似于2014  -  2016年西非埃博拉疫情期间所见,捐助者估计捐款约30亿美元打击病毒。世界卫生组织表示,它需要至少另外5400万美元的捐款来支持其7月份的埃博拉应对措施。

        但Ghebreyesus说,宣布公共卫生突发事件不应被视为筹款活动。 “在你发出警报之前应该调动资源,你不要等到暴风雨来临之后修补屋顶,”他告诉大自然。 “使用PHEIC调动资源是危险的,因为那时已经太晚了。”

        doi:10.1038 / d41586-019-01893-1
    异瞳兽耳白发贫乳萝莉控
  • 喀秋莎 2019-6-17
    0 7
    柠檬柠檬酱 谷歌翻译了一下,大家将就一下哒 世界卫生组织第三次拒绝宣布埃博拉病毒紧急情况  这个故事得到了普利策危机报道中心的支持。     刚果民主共和国金沙萨     蹂躏刚果民主共和 ...
    告诉大自然,哈哈哈。
    我在上班,别发骚图了。
  • 无头骑士 2021-9-16
    0 8
    undefined
    你讲话好冷漠,好像我不曾让你快乐过
  • 弥柳 2023-1-2
    0 9
    undefined
    今晚的月色真美啊
    • ACG里世界
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