The tenth epidemic of Ebola Virus Disease (EVD) in the provinces of North Kivu and Ituri was declared by the Ministry of Health of the Democratic Republic of the Congo on 1 August 2018.
Based on the evolution of the epidemic in the affected health zones, successive response plans (1, 2, 2.1 and 3) were implemented to enable the deployment of the resources required to support the Congolese Government and its partners.
More recently, and despite the implementation of the Strategic Response Plan-3 (SRP-3), the transmission of Ebola continues in both affected provinces. May 2019 saw the highest increase in the number of new cases recorded since the beginning of the epidemic.
Regrettably, insecurity continues to hamper the response in several health zones. Frequent security incidents have affected the response, some of which have had dramatic consequences.
In addition, the risk of spread of the virus to other towns in the Democratic Republic of the Congo and neighbouring countries remains very high. At the beginning of June 2019, several cases of EVD were exported to Uganda from the Mabalako Health Zone via the Congolese border of Kasindi. Despite the three recorded deaths, the progress of the epidemic to Uganda appears to be contained through good cross-border collaboration and preparedness activities undertaken with the Government of Uganda.
The increase in the number of new cases since epidemiological week n ° 19, combined with the persistence of insecurity, calls for major readjustments in response strategies.
In response to these new challenges the Government, supported by its partners, organized an operational review of SRP-3 in Goma from 14 to 15 June 2019. This participatory and inclusive review took stock of the level of achievement of activities against the pillars of the response, identified bottlenecks in the implementation of operational plans and enabled the development of new strategic directions.
The conclusions of this review guided the development of this fourth Strategic Response Plan (SRP-4).
SRP-4 takes into account the new strategy to scale-up the response in order to interrupt the epidemic. It focuses on the following main axes:
Detection and rapid isolation of cases;
Intensification of rapid multidisciplinary public health actions around any confirmed case;
Strengthening community engagement;
Strengthening the health system and effective coordination of the activities of local and international partners;
Synergies between public health activities and those of the security, humanitarian, financial and operational readiness sectors, and operational readiness of neighbouring countries, to create an enabling environment for the response.
The activities of the sectors mentioned above will form a strategy that will be presented in detail in a complementary document, and is structured around the following four pillars:
Strengthening political commitment, security and operational support to improve acceptance of the response and access to insecure areas;
Strengthening support for communities affected by EVD: In collaboration with the humanitarian and development actors present in the region, this pillar aims at strengthening the resilience of the population, fostering community ownership and involvement by the community in the response. This common framework will also develop synergies with social and humanitarian activities in order to respond to the primary needs of populations affected by EVD;
Strengthening financial planning, monitoring and reporting: The World Bank will work with major donors to identify financial needs and plan for early and sustainable financing;
Strengthened preparedness of the surrounding provinces and neighbouring countries to reduce the risk of spread of EVD.
The scale-up strategy requires maximum capacity in all sectors of the response and in all sub-coordinations for a minimum duration of 4 months. This is the precondition for responding immediately to all the epidemic development hypotheses, including the most pessimistic ones, and thus guarantees the availability of the necessary means to stop and prevent the return of the epidemic in the provinces of North Kivu and Ituri.
SRP-4 should thus be the last response plan or the "final push" to definitively defeat the epidemic by reinforcing current strategies and filling gaps, as well as introducing innovations that have demonstrated their effectiveness.
This strategic response plan (SRP-4) covers the period from 1 July to 31 December 2019 and takes into account the strengths and weaknesses as well as the orientations identified during the operational review of the implementation of the SRP-3, and other guidance based on lessons learned and risk analysis to which all partners contributed.