Congo’s Ebola epidemic could be the worst in history: 4 things that could help end it

The Democratic Republic of Congo’s fight against Ebola has reached a critical point. This could accelerate what has been done to control this latest outbreak, or risk allowing it to persist as the worst Ebola epidemic on record.

As of September 1, 2026, more than 6,186 confirmed cases and 3,007 deaths have been reported since May 2026 when the disease was first announced. This is the deadliest Ebola outbreak in Congo’s history. This outbreak was triggered by the Bundibugyo virus strain which causes Ebola disease. There is currently no licensed vaccine or specific treatment for Bundibugyo.

The outbreak is thought to have originated in the high-mobility mining area of ​​Mongbwalu in Ituri, northeastern Congo, in late April 2026, before spreading through interconnected communities and health care networks to Rwampara and Bunia – health zones in Ituri province – and onwards to Uganda.

The response to this outbreak is being led by the Congolese government nationally, together with the Africa Centers for Disease Control, the World Health Organization (WHO) and other partners who are supporting expanded surveillance, laboratory capacity, treatment centers, infection prevention and control, vaccination, logistics, community engagement and safe and dignified burials.

Significant progress has been achieved, including ending the infection in Uganda through decisive national leadership and close collaboration with the community.

However, in the Democratic Republic of Congo, insecurity, population mobility, delays in detection, gaps in financing and supplies, and a lack of community ownership continue to be causes of infection.

Therefore, the response has not been sufficient to stop transmission in Congo. This underscores the need to bring surveillance, testing, treatment, vaccination and community involvement closer to the village level.

As public health experts who specialize in Ebola and have been at the forefront of containing the latest outbreak in Congo, we are of the view that more efforts are needed to contain this.

What is needed is based on four factors that make this epidemic difficult to control:

• Congo’s difficult geographical and humanitarian environment
• highly mobile population
• low trust and poor community engagement
• an incomplete scientific arsenal against the Bundibugyo virus.

These four factors

First, this is an outbreak that occurred in a very difficult environment. The affected areas are vast, remote and, in many places, unsafe. Short distance trips can take a day or more on bad roads, especially during the rainy season (currently).

Second, the population is highly mobile. Mining communities, motorbike transport, refugee camps and cross-border movement connect villages and health zones that are difficult to monitor. The outbreak is concentrated in several interconnected areas, particularly in Ituri, about 2,886 km from Kinshasa, the capital of Congo. Bunia, the main urban center in Ituri, is connected to the surrounding transmission areas. Community movements are important in this response.

Third, community trust and involvement is still a challenge. When people are afraid, when health facilities are closed after health workers die, or when families are exposed to Ebola without seeing an effective response, they may delay or avoid getting help. This directly affects supervision. Recent investigations carried out by our team show that the majority of cases were identified outside of existing contact lists. Therefore, the response cannot rely solely on traditional contact tracing.

Fourth, unlike Ebola caused by the Zaire species, Bundibugyo virus does not have a licensed vaccine or specific treatment. Therefore, clinical research is part of the response itself.

Fourth, unlike Ebola caused by the Zaire species, Bundibugyo virus does not have a licensed vaccine or specific treatment. Therefore, clinical research is part of the response itself.

Congo has launched Ebola vaccinations in Kisangani. The first shots were given to health workers and other frontline workers. More than 50,000 doses have been received. The International Coordination Group for Vaccine Supply has approved 70,000 doses of Ervebo for use in the country. About 20,000 doses will be used in clinical trials to assess its effectiveness against the Bundibugyo strain.

The response so far
It is important to know how much has been achieved in just three months – between 15 May and 15 August 2026.

More than 20 Ebola treatment and isolation facilities have been established or supported. At the peak of the crisis in late May 2026, treatment capacity was overwhelmed, with bed occupancy rates exceeding 200%. By the end of August, occupancy had dropped to around 66%.

Laboratory capacity has increased dramatically, with 22 laboratories operating in the five affected provinces. Previously there was only one in Kinshasa capable of detecting Bundibugyo. This helps reduce the turnaround time between sample collection and results, from more than a week to just a few hours.

Safe and dignified burials have also improved substantially, and most burials now occur within 24 hours.

This improvement is important. These are signs that the response can change the course of the epidemic if resources, coordination and technical capacity are combined.

There are also encouraging epidemiological signals. The effective reproductive number has decreased significantly from the very high level (Rt 4.0) observed in May. The average number of people infected per patient has decreased from four to more than one.

There are also encouraging epidemiological signals. The effective reproductive number has decreased significantly from the very high level (Rt 4.0) observed in May. The average number of people infected per patient has decreased from four to more than one.

The scale of resources being mobilized to tackle the outbreak is enormous, with US$1.72 billion pledged, including US$118.5 million pledged by African countries. About US$867 million (about half of the pledge) has reportedly been disbursed.

The continental response plan launched on June 27, 2026 by Africa CDC and WHO was designed around a simple principle: one plan, one budget, one team, one monitoring and evaluation framework, with communities at the center.

What is required

The next phase should be centered on the villages. Regional representatives, health workers and leaders must be active partners in surveillance, early detection, referral, risk communication and community protection.

Digital tools can support this, but technology must benefit society, not replace it.

Commercial motorcyclists, who connect communities over great distances, must be included as partners in emergency response efforts and not simply treated as a risk.

Vaccination must be brought closer to the community. Research must be conducted where the epidemic occurs. Clinical trials of vaccines and treatments must be conducted with urgency and scientific rigor.

Rebuilding trust

Essential health services must continue alongside Ebola control.

The same applies to school reopenings. This should be done through infection prevention measures, including teacher training, providing hygiene facilities, developing clear referral mechanisms, and adapting communication about the epidemic to school children and families.

Humanitarian and Ebola responses must also be integrated. Communities facing insecurity, displacement, and disease cannot be expected to use separate systems for each crisis.

Lastly, Ebola knows no national borders. The collaboration between Congo and Uganda shows what regional solidarity can look like. It’s about joint surveillance, bringing diagnostic capacity closer to border communities, information sharing and coordinated action. DRC-Uganda learning should be extended to South Sudan, the Republic of Congo and other neighboring countries as agreed in Bangui, Central African Republic, in mid-August.