Speech delivered by the Minister of Health of Cuba at the ALBA-TCP Extraordinary Summit on Ebola

Fecha de publicación:

20 October 2014

Imagen principal:

Army General Raúl Castro Ruz, President of the Councils of State and Ministers.

Your excellencies Heads of State, Foreign Ministers and Ministers of Health of the countries here with us today.

Mr. David Nabarro, Special Envoy of the United Nations Secretary-General on Ebola.

Dear Dr. Carissa Etienne, Director of the Pan American Health Organization.

Distinguished guests.

This is a meeting of great significance for our countries. The dramatic situation in West Africa due to the epidemic of hemorrhagic fever caused by the Ebola virus, the largest outbreak of this disease so far, described by the World Health Organization as an event of international importance, forces us to take emergency measures in order to prevent its spread to the Latin America and Caribbean region.

This virus is included in the list of very dangerous diseases, located in the highest risk group (IV), reaching a fatality rate of up to 90%.

It was first detected in 1976 in two simultaneous outbreaks in Nzara (Sudan) and Yambuku (Democratic Republic of the Congo). The village where the second outbreak occurred is located near the Ebola River, from which the disease takes its name. The current outbreak began in Guinea Conakry, in December 2013.

In viral hemorrhagic fevers (particularly Lassa, Ebola, Marburg and Crimean-Congo), the virus is proved to be transmitted to humans from wild animals and from person to person through fluids such as urine, feces, blood, saliva, sweat, breast milk and semen; airborne transmission has not been ruled out.

The disease has an incubation period of 2 to 21 days and the clinical picture is characterized by the sudden onset of high fever, severe weakness, muscle pain, headache and sore throat, followed by vomiting, diarrhea, rash, symptoms of impaired kidney and liver function, and in some cases, internal and external bleeding.

A total of 9,391 cases of Ebola have been reported so far, out of which 5,301 have been confirmed. There have occurred 4,638 deaths with an overall fatality rate of 49.4%, being the following countries the ones reported with the highest transmission:

• Sierra Leone: 3,508 cases and a fatality rate of 34.8%.

• Liberia: 4,262 cases and a fatality rate of 58.3%.

• Guinea Conakry: 1,528 cases and a fatality rate of 57.3%.

Health-care workers, frontline against communicable diseases, are very vulnerable and often provide the first illness and deaths that occur at the beginning of outbreaks. So far, in countries with transmission, 436 people have been sickened, so it is essential that they receive a preparation on issues such as biosafety, the strict compliance with protocols and procedural manuals, which together with the means of protection can prevent transmission in this risk group.

There are other countries with a low transmission as the Democratic Republic of the Congo (68 patients) that are under control. The United States has reported three cases, one of them, from Liberia, died and two health workers. Spain reports a nursing assistant who treated two patients transferred from Liberia. Senegal reported only one case, with a last update on October 17. Nigeria reported 20 cases and it should close on this day.

Our country has prepared to prevent the entry and spread of this disease, for which it has implemented a National Plan for Prevention of and Confrontation with the Ebola virus. The overall goal of this program is to prevent its introduction and spread into the national territory and to consolidate a set of health measures of surveillance, prevention, care and biosafety, which, together with the participation of all sectors, make possible the early detection of cases and the prompt implementation of monitoring activities.

The general principles are:

• To ensure the protection of the country's border at the entry points in order to contain the introduction of the virus, through rigorous checks at airports, ports and marinas, in accordance with the International Health Regulations.

• To ensure protective measures for workers and the community involved in the prevention of and confrontation with the Ebola virus.

• To strengthen intersectoral working actions to achieve effectiveness in control measures, as well as their compliance by each institution of the Central State Administration.

• To ensure the strict compliance with the monitoring and control measures on passengers and crew coming from areas with transmission.

• To conduct epidemiological and hospital surveillance in designated units to travelers from countries with transmission, and as to isolate suspected cases.

• To trigger intensive outbreak control measures upon the occurrence of suspected cases.

• To develop actions of health education, encouraging the compliance with protective and biosafety measures by health workers and the population in general.

The implementation and enforcement of this plan has allowed:

• To create a Working Group for the Confrontation with Ebola, assisted by the Management Center, which monitors and evaluates the national and international situation 24 hours a day.

This group is responsible for technically coordinating the National Plan for Prevention of and Confrontation with Ebola, together with the National Headquarters of Civil Defense.

• To arrange health care at the different system levels, from the state of suspicion to the conclusion of the epidemiological surveillance.

• To condition health institutions to monitor cases at risk, as well as for the care of any patient suspected of the disease.

• To adapt the protocols of the World Health Organization for the prevention and care of Ebola to the conditions of our country.

• To identify the needs that help to increase the diagnostic capabilities at the “Pedro Kourí” Institute of Tropical Medicine, for processing samples of suspected cases of hemorrhagic fevers.

• To train human resources in the health sector, as well as directors, officers and workers from other sectors of the economy involved in the response, on the prevention, diagnosis and treatment of Ebola virus disease, for their performance in the National Health System or in the fulfillment of missions abroad.

• To ensure the preparedness in monitoring and protective measures of diplomats, collaborators and other Cuban residents, who are in countries where there is risk or transmission of the disease.

• To create the Training Center at the “Pedro Kourí” Institute of Tropical Medicine to carry out these training processes, which include the activities of treatment and control of the disease.

• To ensure multilateral logistics for confronting the epidemic.

• To increase measures of international health control and epidemiological monitoring at the points of entry into the national territory, to reduce the risk of introduction and spread of the Ebola virus.

• To monitoring the epidemiological situation in countries at risk or transmission where there are Cuban medical brigades, taking the necessary measures to ensure the compliance with the instructions for the protection of our personnel.

• To ensure compliance with health legislation, with emphasis on biosafety, during the actions of prevention of and confrontation with the Ebola virus.

• To instruct each institution of the Central State Administration and Provincial Administration Councils to develop the plan with specific actions ensuring the prevention and control of the disease.

• To develop a comprehensive social communication program aimed at guiding the population at the proper time.

The preparation and implementation of this plan has enabled to further identify vulnerabilities in areas that we should strengthen in order to achieve their improvement.

At the request for help by Mr. Ban Ki-moon, Secretary-General of the United Nations and Dr. Margaret Chan, Director-General of the World Health Organization, to the Army General Raúl Castro Ruz, President of the Councils of State and Ministers, the Government of Cuba decided to participate in this global effort under the coordination of the World Health Organization to combat Ebola epidemic in West Africa and called governments and health ministers of all countries to join the fight against this scourge.

Cuba's response was aimed at:

• Maintaining the 32 Cuban medical brigades in Africa, with 4,048 collaborators, out of which 2,269 are doctors, including 23 in Sierra Leone and 16 in Guinea Conakry, countries where there is transmission.

• Sending 256 health professionals of the “Henry Reeve” International

Contingent of Doctors Specialized in Disasters and Serious Epidemics to countries affected by Ebola, of which 165 are already in Sierra Leone, 53 are ready to travel to Liberia and other 38 are ready to go to Guinea Conakry.

• To develop a training program in African countries not affected by the epidemic, where there is the presence of Cuban medical brigades, on issues such as prevention, diagnosis and treatment of the disease. To this end, facilitators were identified within our collaborators, who, by means of the educational materials sent from Cuba, are going to be responsible for training other health partners, other sectors and Cuban residents in these countries and this may also be extended to national professional, if requested by governments.

Specialists were sent to train staff in countries with small medical brigades, where no facilitators were identified.

Due to the number of collaborators in health and other sectors in Angola, a differentiated preparation was envisaged with the participation of specialists who develop the training process by region.

This whole program will enable our professionals, together with the health authorities in each country, to contribute to the prevention of this disease.

At the requests from governments, we are sending specialists to Equatorial Guinea, Nicaragua, Jamaica and St. Vincent and the Grenadines, to work as consultants.

Ladies and gentlemen:

From the opportunity that means holding of this ALBA-TCP Extraordinary Summit, with the purpose of analyzing how to prevent and face this serious health problem, where no region escapes the danger, we would like to share with you some proposals that, through the debate, will be surely enriched and others will emerge, allowing us to work together to preserve the health of our peoples; they are as follows:

• Perform a technical meeting of specialists and executives to exchange knowledge and coordinate preventive and coping strategies towards this disease, which may include topics such as protocols of action, biosafety, organization of services and others as needed.

• To design and implement campaigns for health education on the prevention of and confrontation with Ebola, aimed at increasing risk perception and the preparation of the population.

• In a coordinated effort, to build capacities for the diagnosis of diseases requiring high security laboratories.

• To select professionals from different specialties for receiving training in order to become facilitators and advisors in their own countries and to contribute to developing and implementing a national plan.

• To extend to the ALBA and Caribbean countries, the training program that takes place today in African countries where there are medical brigades, in order to contribute to the prevention of the disease. National professionals can also participate in this program, if deemed necessary.

• To promote scientific research on Ebola, within the ALBA framework, as a contribution to international efforts to address the epidemic.

• To improve the information system among our countries, to keep an update on the epidemiological situation and others required for decision making, as well as on the experiences that can be generalized.

At a time like this, we should remember the ideas of our Commander in Chief Fidel Castro Ruz, when he said in his reflection “Heroes of our time" on October 4th, and I quote: “.... because the worst that can happen is that this epidemic or other more serious illnesses reach our continent, or the heart of any community in any country in the world, where a child, mother or human being could die. There are enough doctors on the planet to ensure that no one has to die to lack of medical attention…” End of quote.

Thank you very much.