Africa’s top health body warned on Thursday that Congo’s Ebola outbreak is spreading rapidly beyond its Ituri province epicenter, with new cases and deaths surging sharply in neighboring North Kivu and Haut-Uele. Government figures show 6,843 total cases and 3,310 deaths as authorities grapple with severe insecurity and limited vaccine supplies.
Escalating Numbers and Shifting Epicenters in Eastern Congo
The fastest-growing Ebola outbreak on record in eastern Congo is rapidly spreading beyond its epicenter, according to the Africa Centres for Disease Control and Prevention. While new infections and deaths have recently declined in Ituri province—the hardest-hit area with more than 5,400 of the total cases—they are climbing steeply in neighboring regions.
Latest government figures released on Thursday put the total caseload at 6,843 reported cases, including 3,310 deaths. Ituri province remains the hardest-hit province, with more than 5,400 cases while North Kivu has reported over 1,000 cases since the outbreak was declared in May.
The World Health Organization has said the outbreak remains out of control and is on track to surpass the 2014-2016 West Africa Ebola outbreak, the deadliest on record, which killed more than 11,000 people, primarily in Guinea, Liberia and Sierra Leone.
Insecurity and Conflict Complicate North Kivu Response
The outbreak in eastern Congo is spreading under extremely difficult conditions, fueled by insecurity, displacement, a health workers’ strike and intense population movements. The situation is particularly concerning at displacement sites, where residents already live in extremely precarious conditions.
In North Kivu, new cases more than doubled to 381 in the latest three-week period, from 165 in the earlier period, Yap Boum, Africa CDC’s head of emergency preparedness and response, said Thursday.
The virus recently reached two more health zones in North Kivu, where fighting between government forces and Rwanda-backed M23 rebels, who control the provincial capital Goma, has complicated the response.
Vaccination Trials and Supply Shortages Target New Zones
Last month, Congo began vaccinating health and other front-line workers with the Ervebo vaccine that was effective in past Ebola outbreaks caused by a different, more common type called Zaire.
Clinical trials are underway to find a licensed vaccine for the Bundibugyo virus.
The vaccination trials started in the eastern Tshopo, Haut-Uele and Bas-Uele provinces, Placide Mbala Kingebeni, Africa CDC’s director for research, clinical trials and innovation, said Thursday.
Kingebeni said the vaccination campaign initially targeted newly affected provinces to help prevent further spread. Vaccinations in Ituri are set to start next week, he added.
A key challenge is the limited supply of doses, said Kingebeni. Congo has received 70,000 doses so far.
Historical Context and Public Health Infrastructure
The Ebola virus disease, formerly known as Ebola hemorrhagic fever, is a severe and often fatal zoonosis in humans. The 2013–2016 West African Ebola outbreak had distinctive characteristics, and it was the largest and most complex epidemic since the virus discovery in 1976. Although the 2018–2020 Ebola outbreak in the Democratic Republic of the Congo had many similarities, there were additional challenges due to the presence of armed rebel groups at the epicenters of the epidemic.
Despite these challenges, the extraordinary commitment of the World Health Organization (WHO) regional office for Africa, in collaboration with Africa Union (AU) member states through the Africa Centres for Disease Control and Prevention (Africa CDC), and WHO’s prompt declaration of a Public Health Emergency of International Concern (PHEIC) shepherded an effective coordinated response to contain the epidemic.
DR Congo is the largest second country on the African continent, with a population of over 70 million and is the hub of Africa’s most crucial continental crossroad, being bordered by Rwanda, Uganda, Burundi and Tanzania to the east, Central African Republic and South Sudan to the north, Angola and Zambia to the south, and the Republic of the Congo in the west. Formally established as a Belgian colony in 1908, DR Congo became independent in 1960, became Zaire in 1972, and became the Democratic Republic of the Congo in 1997. DR Congo has more than 200 ethnic groups and different languages, including French, Lingala, Kingwana, Kikongo, and Chilva as National languages.
The conflict in DRC has resulted in a health-system collapse and created a humanitarian disaster. An estimated 5.4 million excess deaths occurred from 1997 to 2004, with fewer than 10% attributable to violence and the rest to preventable and treatable medical conditions such as malaria, diarrhoea, pneumonia and malnutrition. In eastern Congo, the prevalence of rape and other sexual violence is documented as among the highest in the world.
The country public health system is based on a four-tiered pyramid model. The first level consists of a community health centre where nurses provide primary care. The second level is a referral centre with resident doctors. The third level includes local hospitals that provide professional care and a university hospital representing the fourth level. The government works with many Non-Governmental Organizations to oversee the public health sector alongside the private sector.
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