'Finish the fight against Ebola,' MSF head urges

All the ingredients for the west African Ebola outbreak are still there one year after a public health emergency was declared, the head of medical charity Doctors Without Borders said Wednesday.

"The Ebola epidemic in west Africa is far from under control," according to Joanne Liu, who heads the aid body known as MSF, after its French name Medecins Sans Frontieres.

Cases are still reported weekly, new communities are being infected, and bodies are still being buried in secret—a major problem for a disease transmitted though direct contact with body fluids, she wrote in a comment published in the science journal Nature.

"All the ingredients that enabled last year's devastation are still with us: rainy seasons, an uncoordinated response, fear and distrust," Liu said.

MSF's volunteer medical personnel were key in the international response to the epidemic which has infected about 28,000 people in Guinea, Sierra Leone and Liberia since late 2013, and killed more than 11,000.

Liu said "fatigue and waning focus" were prolonging the epidemic.

The number of cases in the past three months—about 330—was "more than the third largest Ebola outbreak in history", she pointed out.

Liberia, declared "Ebola free" in May, reported six new cases in June. And 20-27 cases have been confirmed in Guinea and Sierra Leone every week from mid-June to mid-July.

Cases have emerged in Guinea's Boke province, on the border with Guinea-Bissau—a country with a weak health system and "almost non-existent epidemiological surveillance and blood-testing capacity," said Liu.

Also of concern was that governments and aid agencies had still not won the trust of communities, causing people to hide their sick and dead.

The goal is to have no new cases in the three countries for 42 days—double the incubation period of the haemorrhagic fever virus, and the cut-off for the UN's World Health Organization (WHO) to declare the epidemic over.

But this would require "a major push," said Liu.

"Ministries of health and aid agencies must do more to engage and empower communities... and to re-establish people's trust in government officials and health workers," she wrote.

"The surveillance systems to locate and track new Ebola cases across Sierra Leone, Guinea and Liberia need to be properly supported—including in the districts that have not had an Ebola case for months."

And basic health infrastructure, left in tatters by the epidemic, must be rebuilt.

"We need to push through the fatigue and complacency and put everything we have learned into action to end this epidemic," Liu said.

"We must finish the fight against Ebola."

A UN-appointed panel of experts reported last month that the WHO had been too slow in its response to the outbreak, and recommended "fundamental change".

The outbreak began in Guinea in December 2013. The WHO declared a global public health emergency on August 8 last year.

© 2015 AFP