Nurses on front lines of Ebola outbreak at serious risk: ICN calls for urgent action

In response to the gravely concerning and escalating Ebola outbreak in the Democratic Republic of the Congo (DRC) and Uganda, the International Council of Nurses (ICN) warns that nurses and other frontline health workers are being put at serious risk and left fearful for their safety. Nurses are facing shortages of personal protective equipment (PPE) and screening supplies including masks, face shields, protective suits, testing kits, and equipment needed to safely handle highly contagious remains, while working amidst ongoing workforce and staffing shortages. They are at significant risk of contracting Ebola if the correct PPE is not available to them and they are not given the proper training.

With infections and tragic deaths reported among health workers, including the death of a nurse, ICN is raising the alarm that the world is at risk of once again failing to protect those who protect us and repeating the deadly mistakes of the COVID-19 pandemic.

The World Health Organization (WHO) has confirmed that the epidemic is now "outpacing" the response. ICN President José Luis Cobos Serrano emphasized that the outbreak is a stark reminder of the need to protect health workers at the heart of global health security and emergency preparedness, and described how health and aid funding cuts have weakened health systems and surveillance and response capacities in affected areas.

ICN President José Luis Cobos Serrano said:

“A nurse, who tragically lost her life, was the first recorded victim of this Ebola outbreak. ICN is in direct contact with our National Nurses Associations in DRC, Uganda, and neighbouring countries, and nurses are telling us they are scared for their safety because they do not have the equipment to protect themselves.

‘During the COVID-19 pandemic, at least 115,000 nurses and other health personnel lost their lives: nurses paid a devastating price because the world was not prepared and essential protective equipment was unavailable, particularly in lower-income countries. We cannot allow those lessons to be forgotten. Nurses and frontline health workers in DRC and Uganda must have immediate access to PPE, screening equipment and the resources they need to protect themselves, their patients and their communities.

We are also hearing alarming reports of how cuts to aid and health funding for already-fragile health systems in these countries have contributed to the delayed detection and rapid escalation of this outbreak. ICN previously warned, with firsthand evidence, that these cuts threatened emergency preparedness and long-term health security, and we are now tragically seeing our warnings come true.”

Last week, WHO Director-General Dr Tedros Adhanom Ghebreyesus declared the outbreak a Public Health Emergency of International Concern (PHEIC), the first time a Director-General has declared a PHEIC before convening an Emergency Committee, reflecting the extraordinary scale and speed of the epidemic. The World Health Assembly closed on Saturday 23 May, with Member States yet to finalize the Pathogen Access and Benefit-Sharing (PABS) annex that will operationalize the Pandemic Agreement: ICN urges operationalization of this Agreement, which is more needed than ever as the world faces simultaneous outbreaks of Ebola and hantavirus that demand international solidarity and equitable access to resources.

ICN Chief Executive Officer Howard Catton said that the current Ebola public health emergency requires urgent and immediate action to protect frontline health workers and ensure an effective response, commenting:

"We are in constant contact with our National Nurses Associations on the ground. Nurses are doing extraordinary, lifesaving work at personal risk and in extremely difficult conditions, but in many cases, they are reporting a lack of PPE, screening equipment and emergency training required to keep them safe and do their jobs effectively. We are hearing that nurses are fearful of becoming infected and of the consequences: many do not have adequate health coverage or insurance or risk allowances to enable them to afford health care or survive loss of income if they do contract the disease, a tragic situation we also saw during COVID-19.

ICN lobbied for the protection of nurses and health workers throughout last week’s World Health Assembly, and now calls on leaders to immediately provide adequate protective equipment, health insurance coverage, risk allowances, and training to all health workers responding to the outbreak. We also call for urgent investment in nursing workforces and health systems following aid and health cuts and for the Pandemic Agreement to be finalized and made operational.

‘If we fail to protect the nurses and health workers who are risking their lives to contain this outbreak, we fail everyone. There is no response and no global health security without them.”