While I thought it always was an international health emergency, the WHO (World Health Organization) continually refused to declare the Ebola outbreak that.  It had been considered just a regional issue.  Today they declared otherwise.

The trigger for this declaration was the death of a pastor from Ebola.  This pastor contracted the virus in Butembo and then travelled south to Goma (unaware of his condition) where he developed symptoms and was diagnosed.  He was sent back to Butembo due to the superior treatment facilities there, but that is where he died.

There are two million people in Goma.  Unlike Butembo and surrounding area which is relatively isolated from neighbouring countries, Goma is right on the border with Rwanda and has vastly greater transportation connections to Rwanda and elsewhere.

Before today, the WHO has only declared a public health emergency four times since the International Health Regulations, which govern global health emergency responses, were enacted in 2007.  The first time was in 2009, with the outbreak of the H1N1 swine flu pandemic. The second time was in May 2014, concerning polio. The third time, in August 2014, came as the Ebola outbreak in West Africa was growing out of control. The fourth time was related to Zika in 2016.

Update:  A good summary from MSF:  https://www.msf.org/drc-ebola-outbreak-crisis-update