This brief summarises key considerations concerning cross-border dynamics between South Sudan and the Democratic Republic of Congo (DRC) in the context of the outbreak of Ebola in North Kivu and surrounding provinces. In light of the DRC outbreak, South Sudan began preparedness activities in August 2018 with the development of the first South Sudan National Ebola Preparedness Plan (August 2018 – March 2019) and the formation of the National Ebola Task Force (NTF) and Technical Working Groups (TWGs). Health care workers, frontline workers, community volunteers and military personnel in high risk states were trained on EVD surveillance (detection, alert and investigation), management of suspected and confirmed cases, laboratory safety procedures, safe and dignified burials, risk communication and social mobilisation, and infection prevention and control (IPC).

An Emergency Operations Center (EOC) was established in Juba and a free hotline to report EVD alerts set up (with the call-in number 6666). Rapid Response Teams (RRTs) were put in place across the country and local capacity for GeneXpert testing was established. Screening points and four isolation units were set up and vaccination of frontline health workers started. The focus of the Second EVD Preparedness Plan (April – September 2019) shifted from initial preparedness needs to active response should a single case be confirmed. Priority activities included establishing effective mechanisms for the notification of an event, public messaging on prevention and further spread, the rapid deployment of multidisciplinary RRTs, the implementation of targeted containment measures and a coherent package of activities for the operation of isolation facilities including basic maintenance, the ability to scale up the number of staff and supplies, and streamlined local control and management in the event of patient care being launched. In November 2018, WHO conducted an assessment of South Sudan’s overall Ebola readiness level and rated it 17% prepared. A more recent assessment in March 2019 found the country was 61% prepared and the WHO reported in June 2019 that 2,793 frontline health workers had received prophylactic vaccination with the Merck vaccine (rVSV-ZEBOV).