On 1 August 2018, the Ministry of Health of the Democratic Republic of the Congo declared a new outbreak of Ebola virus disease in North Kivu Province. The Ministry of Health, WHO and partners are responding to this event, and working to establish the full extent of this outbreak1.
This new outbreak of Ebola virus disease is affecting north eastern provinces of the Democratic Republic of the Congo, which border Uganda. The province of North Kivu is among the most populated provinces, with eight million inhabitants. It shares borders with four other provinces (Ituri, South Kivu, Maniema and Tshopo) as well as with Uganda and Rwanda. The subregion has been experiencing intense insecurity and worsening humanitarian crisis, with over one million internally displaced people and a continuous efflux of refugees to the neighboring countries, including Uganda, Burundi and Tanzania.
Therefore, potential risk factors for transmission of EVD at national and regional levels include the transport links between the affected areas, the rest of the country, and neighboring countries; the internal displacement of populations; and displacement of Congolese refugees to neighboring countries. The country is concurrently experiencing several epidemics and a long-term humanitarian crisis. Additionally, the security situation in North Kivu may hinder the implementation of response activities. Based on this context, the public health risk is considered high at the national and regional levels and low globally.
This context puts limitations to the implementation of the ring vaccination strategy based on the identification of contacts, as recommended by SAGE in April 20172. Hence, there was a need to urgently review options for alternative strategies for the use of rVSVΔG-ZEBOV-GP vaccine should ring vaccination strategy become unfeasible.
Given the urgency of the matter, the members Strategic Advisory Group of Experts (SAGE) Working Group on Ebola vaccines and the SAGE members have reviewed the epidemiological situation and the evidence available to the Working Group with regard to the different candidate Ebola vaccines and the impact of different interventions.
- Position paper