The World Health Organisation has declared a public health emergency of international concern in the Democratic Republic of Congo as the Ebola crisis worsens.
The disease, which had been largely contained to the Kivu region, has killed more than 1,600 people since August 2018.
The declaration followed a meeting of the International Health Regulations Emergency Committee for Ebola in Congo, which has overseen the WHO's response to the crisis.
“This is still a regional emergency and by no way a global threat,” said Prof Robert Steffen, chairman of the IHR committee, but he urged the international community to take notice.
The emergency was declared after infections travelled 500 kilometres, the threat of infection in the city of Goma and with the fight against the disease about to pass a year in August, Prof Steffen said.
This week, the death of a pastor from the disease in Goma, a city of more than one million people, sparked concerns of a devastating outbreak.
In declaring the emergency, WHO Director General Tedros Adhanom Ghebreyesus said the risk of Ebola spreading within the Congo and region was “very high”, but risk of it moving outside remained low.
Ebola spreads through contact with bodily fluids, making it extremely infectious. A vaccine was created during the last major outbreak between 2014 and 2016.
So far, more than 160,000 people have been given the vaccine, but only those who have been in contact with an Ebola patient are eligible.
Fighting the outbreak has been made increasingly difficult by attacks on aid workers in Congo.
Dr. Joanne Liu, president of Doctors Without Borders, said she hoped the emergency designation would prompt a radical reset of Ebola response efforts.
"The reality check is that a year into the epidemic, it's still not under control, and we are not where we should be," she said. "We cannot keep doing the same thing and expect different results."
Liu said vaccination strategies should be broadened and that more efforts should be made to build trust within communities.
The emergency declaration is one of the most serious actions available to the WHO, and Wednesday’s declaration is only the fifth time it has been used. Previous emergency declarations have focused on the emergence of Zika in the Americas, the swine flu pandemic and polio.
The most recent of those occasions was the major Ebola outbreak in West Africa in 2014-16, which killed more than 11,000 people.
Dr Ghebreyesus commended the government of Congo for its transparency and called for more international attention on the issue.
““The government of Congo is showing exceptional transparency in sharing information every single day,” he said on Wednesday evening.
“They are doing everything they can. They need the support of the international community. That includes its financial support.”
The WHO has previously said it needs $98 million (Dh359.9m) to fight the outbreak and is severely underfunded.
But it does not discourage travel or trade because this could “actually hamper the fight", Dr Ghebreyesus said.
"Closing borders could have disastrous consequences for the lives and livelihoods of the people who cross the border every day for trade, education or to visit relatives," he said.
"Such restrictions force people to use informal and unmonitored border crossings, increasing the potential for the spread of disease.
"They will also serve no useful purpose. Already there have been more than 75 million screenings for Ebola at border crossings and other checkpoints.
“Now is the time for the international community to stand in solidarity with the people of Congo, not to impose punitive and counter-productive restrictions that will only serve to isolate it."
On Monday, the US and EU committed to further assistance for the Congo in tackling the outbreak.
US charge d'affaires in Geneva, Mark Cassayre, said the US would "provide more in the coming months" to help respond to the Ebola outbreak, while EU ambassador Walter Stevens said the bloc would examine possibilities to scale up its response.
He told a UN conference on Ebola on Monday that the US was calling on member states to increase their contributions to the response.
Mr Stevens said the EU had provided about $20m in support since last year, plus in-kind and logistical support, and "will look into possibilities to scale up the response".