








In Butembo and surrounding health zones, response activities were repeatedly halted due to a number of serious security incidents taking place from 4-6 May.
GENEVA, Switzerland, May 10, 2019 – The Ebola virus disease (EVD) outbreak response this past week continues to be hampered by insecurity. On 3 May in Katwa, a Safe and Dignified Burial (SDB) team was violently attacked following the completion of a burial for a deceased EVD case. In Butembo and surrounding health zones, response activities were repeatedly halted due to a number of serious security incidents taking place from 4-6 May. On 8 May, a group of over 50 armed militia infiltrated the city centre. Security forces repelled the attack following intense gunfire in close proximity to staff accommodations. Although activities resumed on 9 May, after almost five consecutive days of suspension, threats of further attacks against EVD response teams and facilities remain prevalent.
These security incidents, and especially the resultant lack of access to EVD affected communities, remain a major impediment to the response, with teams unable to perform robust surveillance nor deliver much needed treatment and immunisations. The ongoing violent attacks sow fear, perpetuate mistrust, and further compound the multitude of challenges already faced by frontline healthcare workers. Without commitment from all groups to cease these attacks, it is unlikely that this EVD outbreak can remain successfully contained in North Kivu and Ituri provinces.
EVD transmission remains most intense in Katwa, Butembo, Mandima, Mabalako, Musienene, Beni and Kalunguta hotspot health zones, which collectively account for the vast majority (93%) of the 303 cases reported in the last 21 days between 17 April – 7 May 2019 (Figure 1 and Table 1). During this period, new cases were reported from 78 health areas within 15 of the 21 health zones affected to date (Figure 2). It is expected that the resumption of response activities will bring a substantial increase in the number of cases reported in the coming weeks due to the backlog from the disruptions.
As of 7 May, a total of 1600 confirmed and probable EVD cases have been reported, of which 1069 died (case fatality of 67%). Of the total cases with recorded sex and age, 57% (907) were female and 30% (475) were children aged less than 18 years. The number of healthcare workers affected has risen to 97 (6% of total cases). 442 EVD patients who received care at Ebola Treatment Centres (ETCs) have been successfully discharged.
Adapted vaccination strategies
On 7 May 2019, the Strategic Advisory Group of Experts (SAGE) issued new vaccination recommendations in light of the increasing number of EVD cases and continued insecurity in this outbreak in the Democratic Republic of the Congo (click here for the full recommendations). The panel made recommendations pertaining to adjusting vaccine dosages, expanding vaccine eligibility, ring vaccination operational improvements, and strengthening training of local healthcare workers to aid in the EVD response.
The rVSV ZEBOV GP vaccine dosage and eligibility criteria have been revised. For high-risk individuals such as contacts and contacts of contacts, the new SAGE recommendations advise the use of 0.5mL of vaccine instead of 1mL. This revised dose has been previously used during the 2015 Ebola ça Suffit! trial in Guinea, and is expected to provide similar efficacy in this current EVD outbreak. Those at lower risks are now to receive 0.2mL instead. SAGE also recommends expanding the accessibility of the vaccine to more individuals in affected health areas. In addition to high-risk individuals, it is now recommended that individuals who are potential contacts due to their residence in the villages or neighbourhoods with incident cases (i.e. where EVD cases have been reported in the last 21 days) be offered the rVSV ZEBOV GP vaccine. SAGE believes that by expanding vaccine eligibility, this would address some of the requests from communities in affected health areas for the vaccine to be more widely available, foster greater trust, and improve willingness of communities to engage with other EVD response activities.
SAGE advised the implementation of an adaptive operational approach to ring vaccinations, implemented in two main methods: pop-up vaccinations and targeted geographic vaccinations. Pop-up vaccination would be conducted by inviting contacts and contacts of contacts to a previously agreed upon temporary location some distance away from the residence of contacts. In areas where accurate identification of contacts and contacts of contacts is not possible due to insecurity, targeted geographic vaccination of whole villages or quartiers would be administered at a fixed location with security present. Both of these vaccination operational methods have been utilised successfully before, and are expected to make the vaccination process more efficient and secure for both healthcare providers and the patients they are caring for.
SAGE additionally recommends offering an alternative vaccine (other than rVSV-ZEBOV-GP) to those at lower risk within affected health areas or neighbouring areas. WHO has reviewed evidence provided by two vaccine manufacturers, and the adenovirus 26 vectored glycoprotein / MVA-BN (Ad26.ZEBOV/MVA-BN) investigational Ebola vaccine is being considered and evaluated by a coalition led by the Coalition for Epidemic Preparedness (CEPI) and the London School of Hygiene & Tropical Medicine. At this time, this vaccine is in the late stages of formal trials and is expected to be deployed to the field in the near future. These efforts are in line with previous SAGE recommendations regarding the need for more studies to assess the efficacy of additional, alternative Ebola vaccines.
SAGE also supported the proposal to introduce alternative individual informed consent forms and follow up procedures which can potentially simplify and expedite both the vaccination and safety follow up processes. Aside from pregnant women who will be actively followed up until delivery or end of pregnancy, and infants 6-12 months of age who will receive a single visit at day 21, all other case follow up will be completed through passive reporting of adverse events via telephone.
In addition to technical recommendations, WHO and partners are working closely with residents of Ebola-affected communities to empower them to take on greater ownership of the EVD response. Through intensifying training and engagement with local community members, WHO aims to have the majority of vaccination teams comprised of local healthcare providers by the end of the month. Other key elements to transferring ownership of the response to the communities includes fulfilling community requests made in relation to development projects, and ensuring all persons residing in at-risk areas are well-informed about the status of the outbreak, transmission prevention, and availability of care through further mass communication initiatives.

“I have seen our honourable MP (Luwero District Woman MP Eng. Lillian Nakate) here. We love you very much, but you people (MPs) like causing chaos in Parliament, without knowing that chaos is our business. You try creating the chaos again and we shall come and bring peace in your heads again” – Lt. Gen. Peter Elwelu
Surely, I would never anticipate anything of democratic values or understanding of Parliamentarism from the dude behind the burning Buhikira Royal Palace of the Omusinga Charles Wesley Mumbere Irema-Ngoma and killing of his royal guards plus other casualties. I would not expect that man to care about Members of Parliament, that they supposed to control him and give him as a Lieutenant General a mandate. As the Lt. Gen. Clearly doesn’t understand his role, but that is because the President is acting a militarised leader and not a representative of the people.
The whole NRM is praising the army and what it does. Therefore, it is not surprising that Lt. Gen would say this stuff. However, this proves that the army can easily invade and be strangers in the national assembly as they did during the Age Limit Plenary Sessions on the 27th September 2017. This is done to prepare for the President for the General Election of 2020. Clearly, the Lt. Gen. is ready to do this again. Who needs Parliamentary rules, when the army is ready to cause havoc, because of chaos.
The army man is not finished with his speeches, as the opposition also get also under fire. This being another stern warning, since this man cannot shield himself from himself nor the ability to understand his place again. That is not new, but his just repaying favours to the ones who has promoted him. Therefore, he is defending the UPDF and indirectly the NRM. Which he knows is the reason for his fortune.
“You will not destabilize peace in this country when we as UPDF are here, UPDF will not allow this. We fought for this peace and we shall defend it at whatever cost because we are trained to do that. You will meet us ready, you will meet fire and you will meet a disaster” – Lt. Gen. Peter Elwelu
The Lt. Gen needs some civic education, maybe even some understanding of politics and parliament, but we cannot blame him for this. He is just trained to be this way. We couldn’t expect a man whose proud of killing innocent civilians and being promoted for it. That he would care for civilians, neither caring for civic education either.
The Constitution of 1995 is very clear on the article 79: “Functions of Parliament.
Subject to the provisions of this Constitution, Parliament shall have power to make laws on any matter for the peace, order, development and good governance of Uganda. Except as provided in this Constitution, no person or body other than Parliament shall have power to make provisions having the force of law in Uganda except under authority conferred by an Act of Parliament” (Constitution of 1995).
Clearly, the Lt. Gen cannot grasp this, as he thinks the army has the control and set the bar. Instead of remembering the representatives of the people, the lawmakers are the one setting the standard. Something, the army man doesn’t understand. Maybe, he doesn’t want to. As he just want to show force and intimidate the MPs into submission like the President likes.
Also the Constitution says what the UPDF are supposed to do in the article 210: “Parliament shall make laws regulating the Uganda Peoples’ Defence Forces and, in particular, providing for— the organs and structures of the Uganda Peoples’ Defence Forces” (Constitution of 1995).
Surely, it is not the army man whose supposed to regulate them, but the other way around. This is by law, by the Constitution, the one guiding law and principal document of the Republic. Therefore, the mandate of the UPDF is set by the Parliament. This is why the argument of the Lt. Gen is foolish. He should start to grasp reality, but then again his a hired gun for the regime.
I don’t expect the man has studied the Constitution, his been busy with weapons instead of picking brains, except exposing brain-matter. Peace.


Mr. Guterres expressed concern over the number of new Ebola cases in the east of the DRC on Wednesday, reiterating UN support “for efforts to end the outbreak”.
NEW YORK, United States of America, May 9, 2019 – Now in its tenth month, the Ebola epidemic in the Democratic Republic of the Congo (DRC) has claimed more than a thousand lives, prompting Secretary-General António Guterres to throw the support of “the whole United Nations system” into stemming the spread of the deadly virus.
Mr. Guterres expressed concern over the number of new Ebola cases in the east of the DRC on Wednesday, reiterating UN support “for efforts to end the outbreak”.
“With important shifts in the response now being implemented, the Secretary-General has emphasized his commitment to a collective UN-wide approach, both in Kinshasa, where the UN is led by his special representative, and in the areas affected by the virus, where the response is led by WHO [World Health Organization], all in close liaison with Congolese leaders both in Kinshasa and eastern DRC”, said his Deputy Spokesperson, Farhan Haq, in a statement on behalf of the UN chief.
Mr. Guterres expressed his condolences to the victims’ families and reiterated that the full involvement and engagement of local people “remains the key to successfully controlling the outbreak”.
He also urged “all Congolese leaders to work together across parties and across communities to tackle the outbreak”.
“At this critical juncture”, Mr. Guterres underscored the need for “additional resources” and called on Member States and partner organizations “to ensure the responding agencies have the resources needed to succeed”.
The Secretary-General commended the Government, institutions and Congolese people themselves on the overall response so far, which has contained the outbreak to within parts of two provinces, which are home to multiple armed groups, which have been battling each other and Government forces for years.
He also applauded “the bravery of security, health and humanitarian workers who have put their lives on the line in a challenging environment marked by conflict and insecurity”, including attacks on Ebola Treatment Centres and healthcare facilities and recognized their work in vaccinating more than 100,000 people and saving the lives of hundreds who have contracted the disease.
Life-saving vaccinations
Meanwhile, amidst continuing violence, WHO experts (SAGE) have recommended new Ebola Vaccination Guidelines to address the challenges in stemming the virus.
Since the outbreak was declared in August 2018, WHO has said that despite the use of a highly efficacious vaccine, the number of new cases continues to rise, in part due to repeated violence, which has prevented response teams from immediately identifying and creating vaccination rings around all people at risk of contracting Ebola.
“We know that vaccination is saving lives in this outbreak,” said WHO Director-General Tedros Adhanom Ghebreyesus, but “we still face challenges in making sure the contacts of every case receive the vaccine as soon as possible”.
“These recommendations account for ongoing insecurity and incorporate feedback from experts and from the affected communities that will help us continue to adapt the response”, he affirmed.
Among other things, new SAGE recommendations endorse pop-up and targeted geographic vaccination approaches, when appropriate; advise vaccinating the next level of people who may be exposed, such as in neighborhoods where cases have been reported within the past 21 days; and adjusting the current dose to ensure that the vaccine continues to be available to those at greatest risk of Ebola.







