Ebola outbreak in eastern Africa feared to become worst ever as cases rise in DRC and Uganda

Africa's top public health body has warned that the Ebola outbreak spreading in eastern Africa could become the worst ever recorded if it is not brought under control quickly. The warning came as health officials reported at least 837 infections and 196 deaths in the Democratic Republic of Congo, the epicentre of the outbreak, and 19 cases with two deaths in neighbouring Uganda. The alert was issued during a virtual meeting of African heads of state and international donors in Burundi, underscoring the regional scale of the emergency.

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Jean Kaseya, the director-general of Africa CDC, said the virus is spreading faster than health workers can track it and that international funding has slumped. He said the situation could become worse than previous outbreaks in West Africa and eastern Congo if transmission is not stopped soon. The current outbreak is being driven by the Bundibugyo virus, one of the known Ebola strains, which has caused outbreaks in eastern Congo before.

The figures reported so far point to a severe public health crisis with cross-border implications. Ebola is spread through bodily fluids, and people remain highly infectious after death, which makes safe burial practices and rapid contact tracing central to containment efforts. The outbreak has already affected at least two countries, and the spread into Uganda shows the challenge of preventing movement across porous borders in the region.

The warning matters because the current outbreak combines a high fatality rate with limited treatment options for the strain involved. Health officials say the Bundibugyo virus has a death rate of between 30% and 50%, and there are no approved vaccines or treatments for it, although some are in early development. By contrast, vaccines and approved treatments were used in the 2018-2020 outbreak in the Democratic Republic of Congo, which was caused by a different strain and was contained with large-scale vaccination.

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The comparison with earlier Ebola emergencies helps explain the concern. The 2014-2016 West Africa outbreak was the largest on record, infecting nearly 29,000 people and killing more than 11,000. A later outbreak in the Democratic Republic of Congo in 2018-2020 infected about 3,400 people and killed more than 2,000.

Africa CDC's warning suggests officials fear the current outbreak could outstrip those crises if funding gaps and delayed detection continue. The current outbreak is also significant because it is unfolding in a region where Ebola has appeared before, including in eastern Democratic Republic of Congo in 2007 and 2012. The Bundibugyo strain is rarer than the Zaire strain that has driven some of the best-known Ebola emergencies, and that makes the response more complicated.

Officials have said vaccines developed for the Zaire form cannot simply be used against Bundibugyo without testing by the World Health Organization. For now, the main unknowns are whether the outbreak can be contained in the Democratic Republic of Congo and Uganda, and whether additional cases will be confirmed in other neighbouring countries. The scale of donor support, the speed of case detection and the ability of health workers to trace contacts will be central to the next phase of the response.

What happens in the coming days will determine whether the outbreak can be stabilised or whether it continues to expand across the region.