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Incredible dedication & commitment all teams-hugely impressive & humbling very difficult & at times frightening environment – dedicated, committed teams from #DRC, @MinSanteRDC, across Africa, Ukraine, Bangladesh from @WHO, @WFP, @MSF @AlimaOng @MONUSCO, @UN, @SamaritansPurse 
Commitment of all teams to patients,families,communities & to do whatever it takes to bring epidemic to an end with approach that is trusted & locally led is remarkable teams that are often away from their families in really tough conditions-the world owes them all a huge amount
Commitment so many people reason epidemic not bigger,spread further in DRC & across borders, what everyone there & those who support globally are doing is making the difference-care of patients,diagnostics,communities, communication,trust,vaccination,logistics,security,leadership
Epidemic can be stopped community support,care patients,follow up patients & contacts,safe practices,infection control,treatment,vaccination & trust. It is in a critical phase-all of that only possible in relatively secure environment,without security the epidemic will get worse
A peaceful political settlement in DRC with the support of all parties & international community will allow the incredibly dedicated teams in North Kivu to bring this epidemic under control, to build trust, engage communities, work out what treatments work & deploy vaccines
What are the risks? The biggest risk is that the security situation gets worse & the critical public health interventions are interrupted, people migrate because of violence & ebola spreads across DRC or across borders, the next month is critical.
My reflections-we should prepare for this epidemic going on for many months, we should prepare for good & bad scenarios and not be surprised by either, as always we should be prepared to deal with the unexpected, an unrelated epidemic ebola or other elsewhere as we deal with this
Trust in the community is at the heart of every public health response, can take years to build & can be lost in an instant, communication & understanding of community beliefs & their involvement critical.
Infection control in all settings, clinical facilities, triage, safe burials, community settings is absolutely crucial.
Access to rapid diagnostics & real time sequence of virus to inform about transmission chains & true scale of the epidemic would be invaluable. The best care possible, fluids, oxygen, critical care, and when possible assessment of the four potential drugs for ebola.
Been remarkable that almost 60,000 people been vaccinated,teams who have engaged with communities, offered vaccine & deployed it have been amazing, the logistics & those developed vaccine @Merck @MSDInvents deserve great credit-Guniea,@MSF,@WHO,@NIH,@EU,@DFID_UK, @wellcometrust
Personal view-vaccine made huge difference to epidemic,reduced number patients & geographic spread,protected health care workers & given hope-but we need more. I believe @JNJNews vaccine should be fast tracked via study & deployed & used complementary way to @MSDInvents vaccine
What more is needed-continued strong support of neighbouring countries - Uganda, Rwanda, Burundi have kept borders open,provided staff logistics & support-they deserve huge credit. Continued surveillance in these countries & across DRC for spread of this epidemic or a new event.
I finish with huge respect & admiration for people working in extraordinary circumstances at personal risk in a rough environment-humbling visit, you have & more than deserve all our support-your work makes the difference North Kivu, it makes all of us safer - thank you.
Remarkable ~60,000 people been vaccinated,teams have engaged with communities,offered vaccine & deployed it been amazing, logistics & those developed & tested vaccine @Merck @MSDInvents deserve great credit with Guniea,@MSF,@WHO,Norway, Canada, @NIH,@EU,@DFID_UK, @wellcometrust
