CO-Ebola Disease Preparedness &response CRISIS STATEMENT: The Ministry of Health (MoH) and the World Health Organisation (WHO) declared an Ebola Virus Disease (EVD) outbreak in Uganda on 20th September 2022. This followed the confirmation of one case of a rare South Sudan strain in Mubende district after a 24-year-old man presented with EVD symptoms and later died. Further reports of a ‘strange’ illness and the sudden deaths of sixpeople (3 adults and 3 children) followed between 1st and 15th September 2022 in two other villages in Mubende district . Since thedeclaration, there has been a steady stream of new cases – with 43 cumulative confirmed cases, 9 confirmed and 20 probable deaths, and a case fatality rate of 20.9% as of 2nd October. Currently, the outbreak appears limited to hot spots in the west-central part of the country in Mubende district .  However, Mubende township is a transit route to several neighbouring districts that are hostingthe majority of refugees from DRC. Already, some of the confirmed alerts have been identified in Kyaka II refugee settlement in Kyegegwa district which has a concentration of over 120,000 refugees.

EVD is not new to Uganda which has experienced 5 previous outbreaks - the deadliest of which was in 2000 registering 425 cases and 224 deaths . This is the second Ebola-Sudan strain in Uganda withthe first case reported in 2012  . Since then, the country has also had outbreaks of Marburg, Crimean Congo Haemorrhagic fever, Yellow Fever, Rift Valley Fever, Avian Influenza, measles and COVID 19. While Uganda therefore has a strong capacity for handling Ebolaoutbreaks, the combination of a highly mobile population due to business activities, existence of concentrated refugee situations (including continued inflow of new arrivals from DRC), possibility of primary transmission from infected vectors, inadequate infection prevention and control measures, and traditional practices that can amplify transmission means there is a continued risk of EVD spreading within Uganda. There is general fear that a dramatic spike in cases or an expansion to other areas, such as Kampala or refugee settlements, could overwhelm the country's healthcare system. This requires urgent action to put measures in place to control andstop further spread.  While restrictions on movements have not yet been enforced in Uganda, immediate measures have been put in place at both national and sub-national levels to strengthen all pillars of the response. These include activation of the incident management system and the National Multi-Stakeholder Task Force (NTF) chaired by the Ministry of Health and co-chaired by WHO to effectively coordinate the response . Additionally, the MoH activated The National Public Health Emergency Operations Centre (PHEOC) to coordinate the response, the National Task Force to provide strategic leadership, appointed an Incident Commander and pillar leads and activated surge capacity support to the region.

Oxfam is the WASH Implementing Partner for UNHCR in the settlements of Kyaka II, Rwamwanja and Kyangwali in Kyegegwa, Kikuube and Kamwenge districts respectively; the designated lead for infection prevention and control (IPC) and part of the Community Engagement and Risk Communication Pillar which requires us to ensure access to Water and Sanitation is not compromised both at the community level and at Ebola Treatment Units (ETUs), and that risk communication and community engagement on health practices is strengthened.

Intervention: This is a 3-month intervention to be implemented by Oxfam in partnership with the target population, District Task Forces (DTFs) of Kyegegwa, Kikuube and Kamwenge and in coordination with UNHCR in the settlements of Kyaka II, Kyangwali and Rwamwanja. We will provide technical, administrative, and financial support and be responsiblefor contract management and monitoring of programme quality. The activities will be aligned to 3 outcome areas:
Outcome 1: Improvedcoordination <(>&<)> leadership at all levels (community, district <(>&<)> national).
Output 1. Strengthening the coordination mechanism to improve on accountability and quality of preparedness for Ebola Preparedness and Response.
Activity 1: Facilitation of DTF meetings; Activity 2: Support assessments and develop response and preparedness plans to address EVD risk management needs; Activity3: Facilitate trainings for district /settlement task force members jointly with the national taskforce for areas that need improvement or where gaps have been identified.