This Issue Brief describes what has changed in the broader international Ebola response landscape since 2014, and considers the status of U.S. government (U.S.) engagement in responses to the Ebola outbreaks in the Democratic Republic of the Congo (DRC). Just days after the World Health Organization (WHO) declared the end to an Ebola outbreak in the Equateur Province of DRC, a new, separate outbreak was reported in a different region of that country, centered in the North Kivu Province. Investigations into the full extent of this new outbreak continue, but as of August 11 there have already been 52 cases and 39 deaths reported, making the North Kivu outbreak of equal or even greater magnitude compared to the prior Equateur Province outbreak. These Ebola outbreaks in DRC are the largest since 2014, when a major Ebola epidemic hit West Africa and highlighted weaknesses in the ability of international institutions and governments to respond to such events. At that time, the United States ended up playing a major, leading role in helping to control the outbreak, providing more financial assistance than any other donor, mobilizing large numbers of U.S. staff from multiple departments and agencies, and jump-starting a broader, worldwide effort to strengthen global health security. So far, the U.S. has played a much less prominent role in responding to these recent DRC outbreaks. While this has led some to raise questions about the U.S. response, suggesting that more engagement from the U.S. was needed, today's context is quite different compared to 2014, with an improved international response capacity resulting in quicker action by the World Health Organization, the DRC, and other partners, and new tools available to contain outbreaks. The successful containment of the Equateur Province outbreak was yet another indicator that national and global responses have improved since 2014. Even so, the new outbreak in North Kivu presents some unique, additional complications that are challenging response efforts. North Kivu is a complex and insecure region of the country, making it more difficult to access populations at risk and track suspected Ebola cases and their contacts. The region has a large number of refugees (an estimated 1 million of the 8 million population in the province is comprised Today, the increased capacity of WHO to address Ebola outbreaks and its quick response in partnership with DRC mean that the current landscape, as well as the potential role for the U.S., may be quite different from four years ago.
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