South Sudan: Ebola Virus Disease Preparedness (EPoA) - DREF Operation n°MDRSS007

A. Situation analysis

Description of the disaster, summary of the current response

The current outbreak of Ebola Virus Disease (EVD) in North Kivu and Ituri provinces is the 10th EVD epidemic declared in the Democratic Republic of Congo (DRC) since the first outbreak of 1976. Following the declaration of the outbreak on 1st August, as of 9 October 2018, there has been a total of 194 cases (159 confirmed and 35 probable), including 120 deaths. This precedes the outbreak declared in May 2018 in the Equateur province; however, there are no proven epidemiological links between the two outbreaks. North Kivu is a densely populated province with a total population of 8 million. It borders four other provinces (Ituri, South Kivu, Maniema and Tshopo), as well as Uganda and Rwanda. Moreover, the province has been experiencing intense insecurity and a deteriorating humanitarian crisis, with over one million internally displaced people and high rates of cross border movement to and from neighbouring countries. DRC is also responding to four additional outbreaks- cholera, measles, Monkey pox, and circulating vaccine derived poliovirus type2 (cVDPV2). The general health situation across South Sudan remains fragile and the ongoing crisis has seriously affected health service delivery. Some parts of the country are inaccessible due to insecurity and impassable road network during the rainy season. Most health infrastructures are dilapidated or destroyed, and essential medical and surgical equipment outdated or lacking. Management and human resource capacity is weak. Moreover, there are refugees from DRC in parts of Former Western Equatorial State (WES) and Yei River state. The very porous border with DRC, the largely informal trade between the two countries, regular cross-border markets, movements that are unregulated and the fact that communities on both sides of the border share language, culture and beliefs are all factors for the increased likelihood of EVD cross-border spread to South Sudan. The risk of EVD importation to South Sudan has been assessed to be very high by WHO. In relation to the risk of spread of the current EVD epidemic in the DRC, South Sudan is one of the countries prioritized to enhance operational readiness and preparedness based on the WHO EVD Preparedness Checklist.

The proximity to the areas currently reporting EVD cases in DRC requires a standby capacity to manage EVD and other viral haemorrhagic fever (VHF) outbreaks. South Sudan did not respond to the EVD in DRC when the outbreak occurred two months ago. This was because the cases were deep inside the DRC, and at the time the risk to South Sudan was minimum. Currently the EVD is getting closer to the borders of the South Sudan, 100km away in one case. This really puts South Sudan at risk, and as such, an immediate response is required.