DR Congo Ebola outbreak deepens as WHO warns response must ramp up

The World Health Organization has warned that the Ebola outbreak in the Democratic Republic of the Congo must be brought under control by breaking every chain of transmission. Speaking in Geneva, Director-General Tedros Adhanom Ghebreyesus said the epidemic will continue to threaten the DRC, its neighbours and the wider region until all transmission chains are identified and stopped. The warning comes as official government data show deaths from the disease have now exceeded 3,000.

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Tedros said it remains unclear how many people came into contact with the virus before they died, which means there are transmission chains that health teams have not yet identified. The United States Centers for Disease Control has said containment efforts are below established response targets, and that as many as 80% of new cases are occurring outside known contacts. The WHO chief also said the response is facing a funding gap of more than $1bn, adding to the strain on an already stretched operation.

The outbreak is described as the fastest-growing in history, as well as the deadliest and largest ever recorded in the DRC. Response efforts have been complicated by conflict in mineral-rich areas, poor infrastructure, strikes by unpaid health workers and burial practices that have helped spread the virus. In one sign of the wider disruption, a DRC official said schools in the worst-hit areas reopened this week after plans for remote learning were dropped because of concerns it would harm students' education.

The scale of the outbreak matters beyond the DRC because Ebola can spread quickly where surveillance is weak and health systems are under pressure. The country's eastern and northeastern regions have repeatedly been difficult to secure for outbreak control because of insecurity and limited access to care. That has made contact tracing, treatment and vaccination harder to sustain, especially when many cases are not linked to known contacts.

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The current outbreak began in the remote northeastern province of Ituri and is caused by the Bundibugyo strain of Ebola. That strain adds complexity because the approved Ervebo vaccine is known to be effective against the Zaire strain, while protection against Bundibugyo has been less certain. The WHO has previously recommended further study of the vaccine, and the arrival of doses for frontline workers showed the response was continuing even as the outbreak expanded.

What remains unclear is how quickly health teams can find and break the remaining transmission chains, and whether the funding gap will slow the response further. Officials have not said when the outbreak may peak or how many more communities could be affected. The next developments to watch are whether surveillance improves, whether schools and mobile populations contribute to further spread, and whether the current response can be scaled up fast enough to contain the epidemic.

The deadliest Ebola outbreak ever recorded in the Democratic Republic of the Congo has now passed 3,000 deaths, according to the latest official figures released on Wednesday. Health authorities said the epidemic has caused 3,007 deaths and 6,186 infections, with transmission continuing in the country's conflict-hit east and northeast. The outbreak has now spread to six provinces, underscoring the scale of the public health emergency.

The Congolese National Institute of Public Health said the fatality rate stands at 48.6%, while 1,409 people have recovered. Officials said the disease is spreading faster than efforts to track and slow it, and that the response is being strained by conflict, attacks on health workers, the movement of miners, and weak health infrastructure. They also said the resumption of schools during the outbreak has raised concerns about transmission in classrooms.

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The outbreak began in the remote northeastern province of Ituri and is caused by the Bundibugyo strain of Ebola. Authorities said the virus is affecting areas where the state presence is weak and insecurity is widespread because of armed groups. The health response has been overwhelmed by the rise in cases, and mistrust in some communities has complicated efforts to contain the disease.

A batch of 16,250 vaccine doses for frontline medical personnel arrived in the country at the end of last month, and vaccination began shortly afterwards in Kisangani, the capital of Tshopo province. The latest figures place the outbreak on track to become the deadliest Ebola epidemic on record, overtaking the West African outbreak of 2014. Ebola is transmitted through contact with bodily fluids and causes haemorrhagic fever, and it has killed more than 15,000 people in Africa over the past 50 years.

In the Congolese context, the current outbreak is especially significant because it is unfolding in a region already affected by insecurity and limited access to health services. That combination has repeatedly made outbreak control more difficult in eastern Congo. The Bundibugyo strain adds another layer of difficulty because approved vaccines are effective against the Zaire strain, which caused the largest-known Ebola outbreak to date.

The World Health Organization has recommended a phase three clinical trial using the Ervebo vaccine, but experts have said it is still unclear whether it protects against Bundibugyo, although early data suggest it may offer some degree of protection. The arrival of vaccine doses and the start of immunisation in Kisangani show that the response is continuing, but the available tools remain limited. What remains unclear is how quickly the outbreak can be brought under control in the provinces now affected, and whether insecurity will continue to disrupt surveillance, treatment and vaccination.

Officials have not said when transmission might peak or how many additional communities could be affected. The next developments to watch are whether the health response can be scaled up, whether schools and mobile populations contribute to further spread, and whether the current vaccine strategy proves effective enough to slow the epidemic.

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