Ebola crisis in eastern DRC deepens amid political turmoil and armed group violence

In mid-May 2026, the World Health Organization declared the Ebola outbreak in eastern Democratic Republic of the Congo a Public Health Emergency of International Concern. The Africa CDC followed suit the next day. On June 5, both institutions launched a six-month joint response plan, calling for $518 million. The outbreak, caused by the rare Bundibugyo strain for which no vaccine or approved treatment exists, is now spreading through a region already shattered by conflict and destabilized by the reshaping of US aid. This 17th Ebola epidemic since 1976 hits at a time when multiple armed groups and persistent violence have created profound instability. The crisis raises urgent questions: how will this epidemic worsen security and humanitarian conditions in eastern DRC and complicate access to care? What risks does it pose to regional stability in Central Africa? And what does the resurgence of Ebola reveal about the international community’s ability to handle major health crises?

Conflict and health: a deadly combination

This new Ebola wave strikes a region in deep, structural crisis. Affecting primarily the DRC, it is the 17th epidemic since the virus was first identified in Yambuku in 1976, and this time it is the Ebola Bundibugyo strain. Currently, even though some treatments are being tested, there is no vaccine or approved therapy for this strain, which can kill one out of every two infected individuals. The eastern provinces—North Kivu, South Kivu, and Ituri—are particularly vulnerable to epidemic spread. Last year, the United Nations reported one of the worst cholera outbreaks in 25 years. Additionally, since 2020, a massive Mpox outbreak has been spreading, especially since September 2023. Ituri, the epicenter of the current Ebola outbreak, is one of the most troubled provinces in the DRC, with poor road networks, frequent attacks by armed groups, and nearly one million displaced people crowded into camps. The health crisis thus overlays a pre-existing humanitarian and security emergency. Endemic conflict, particularly intense since the M23 offensive in 2023, has created a daily climate of instability marked by constant displacement and overcrowded camps. These conditions fuel the resurgence of pathogens and their rapid spread. Moreover, the complex crisis in eastern DRC—with only rare periods of calm—has severely weakened social fabric and health services, which currently cannot meet essential needs, creating a structural dependence on Western foreign aid. Systemic violence, especially against women and children, has deprioritized health and normalized brutality.

The Congolese health minister, Samuel-Roger Kamba Mulamba, called Ebola an absolute emergency. By May 31, 2026, national data showed 282 confirmed cases and 42 deaths, with 19 new positive tests. As of June 1, the WHO reported 349 suspected cases under investigation, mainly in Ituri province, specifically in the health zones of Bunia, Rwampara, and Mongbwalu. Bunia hospital was quickly overwhelmed, forcing the establishment of treatment centers on the outskirts and in rural areas. However, the recovery of four infected health workers offers a glimmer of hope. By June 5, pressure on the health system had increased further. Local sources indicate that about six health centers in Bunia were temporarily closed for disinfection. This measure reduces the city’s capacity to treat patients and particularly worries pregnant women seeking care. Some patients with other conditions received only minimal care before being redirected or sent home. The rapid adaptation required to fight Ebola has also disrupted routine health services, restricting access to everyday care.

Fragmented response in a divided territory

A critical problem is the lack of coordinated response from Kinshasa in a zone partly occupied by the Rwandan proxy M23 and numerous armed groups active for extractive reasons. This reflects a recurring issue: controlling national unity in a country of nearly 100 million people and providing effective basic social and health services. In M23-controlled areas, several cases have also been reported. Since the Congolese government has not coordinated the health response with illegally occupying armed groups, the risk of epidemic spread remains high. While some reports suggest possible negotiations, they have not yet established the health coordination framework needed for an effective response. Territorial fragmentation in the east prevents a unified response. Two Ebola treatment centers are reportedly being set up in Goma, the capital held by M23/AFC, with limited capacity, and the armed group claims to have taken the situation seriously and implemented health contingency plans. The epidemic is thus advancing in rebel-held areas. When the state no longer has a territorial monopoly, who manages public health?

Community resistance adds another layer of difficulty. As during the 2018-2020 episodes, acceptance of the response is far from guaranteed. An anti-response protest in Rwampara escalated into the incineration of a suspected case’s body. Distrust and hostility toward medical teams are significant stability variables. Community resistance stems from cultural factors. The health authorities’ refusal to return the bodies of Ebola victims to their families is seen as unbearable symbolic violence. In eastern DRC societies, funeral rituals—especially washing the body and physical contact with the deceased—are a spiritual imperative. Yet these practices are among the main transmission routes for the Ebola virus. The resentment of Ituri and Kivu populations is rooted in structural suspicion inherited from decades of violence, state abandonment, and perceived predatory external interventions. The health response is often seen as another form of imposed control, fueling rumors and conspiracy theories.

Regional spillover risks

The Ebola epidemic could have lasting consequences on relations between the DRC and its neighbors. Currently, there is high tension and extractive competition between the DRC and its eastern neighbors, particularly Rwanda, with sometimes strained relations with Uganda. When an epidemic spreads through a state where part of the territory escapes central control, making a coordinated national response difficult, the response must be transregional, even continental. The Africa CDC has identified about a dozen vulnerable countries that could be affected: South Sudan, Rwanda, Kenya, Tanzania, Ethiopia, Congo-Brazzaville, Burundi, Angola, Central African Republic, and Zambia, in addition to the DRC and Uganda, which already has seven cases. Response capacity varies widely. Kenya and Ethiopia have relatively stronger health and surveillance systems—Kenya has already set up dedicated quarantine structures—while the Central African Republic remains one of the continent’s most fragile states and heavily dependent on foreign aid. South Sudan faces a severe internal crisis compounded by the war in neighboring Sudan. By definition, an epidemic knows no artificial borders; it affects living beings regardless of status. The poorest are most vulnerable, especially when borders are extremely porous. According to the WHO, imported cases from Ituri have reached North Kivu and Kampala, Uganda, where two travelers returning from the DRC tested positive, one of whom died. A case was also reported in South Kivu, and the M23 spokesperson said the patient came from Kisangani in Tshopo province. This dynamic is accompanied by border closures and diplomatic tensions, not to mention major economic consequences. Uganda suspended flights and passenger transport with the DRC on May 21, 2026. Rwanda closed its border with Goma. These unilateral measures hit already extremely tense bilateral relations with the DRC. The conflict in the east is directly contributing to the epidemic’s spread. It is advancing in areas like Goma, captured in late January 2025, and Bukavu, taken in February 2025, raising fears of a regional conflagration. Health has become another arena for the Kinshasa-Kigali rivalry, with the M23 acting as a de facto public health actor in the territories it controls. Facing this cross-border threat, the East African Community called on its member states to activate their laboratory networks and strengthen border surveillance, holding an extraordinary ministerial meeting of health ministers on June 1-2, 2026. According to official sources, the ministers committed to harmonizing health checks at entry points without closing borders, creating a regional technical working group to coordinate surveillance, and strengthening diagnostic capacity and health worker protection.

International response under strain

This epidemic comes at a time when the response may be weakened by the restructuring of US aid. Specifically, cuts to health aid beginning in January 2025—withdrawal from the WHO, dissolution of USAID, reductions at the CDC, and lower health aid to the DRC and Uganda—have weakened vital systems needed to respond to such outbreaks. Some experts believe these cuts may have delayed detection. Today, the DRC has a bilateral agreement with the US (as do Rwanda and Uganda) under an explicit America First approach. Part of the health funding has been transferred to the State Department through this new agreement, promising $900 million over five years, but with extractive conditionalities and a shift from multilateralism to transactional bilateralism between the US and the DRC. This restructuring, driven by the new US stance, is not fully controlled: the US response to the Ebola resurgence has been late and outside the UN framework. Moreover, humanistic and solidarity principles in addressing the epidemic have been deprioritized. The objective is first to protect Americans. The State Department mobilized $23 million in emergency funds and announced financing for up to 50 clinics, but due to the US withdrawal from the WHO, it did not indicate support for a WHO-led response, breaking with past practice. The WHO’s emergency fund is thus operationally fragile, as other donors have not filled the gap left by the US withdrawal. In this context, the response must be activated by national institutions in the most affected countries, with support from the WHO and NGOs, despite their reduced capabilities due to the US pullout and a hostile security environment. The WHO, as per its mandate, declared the epidemic a Public Health Emergency of International Concern and is coordinating the response. The European Centre for Disease Prevention and Control (ECDC) issued a risk assessment to support coordination, especially with the Africa CDC. In the field, medical NGOs such as Médecins Sans Frontières and ALIMA have deployed care teams. The Red Cross in the DRC is mobilizing volunteers for dignified and safe burials, risk communication, and community engagement. Nevertheless, the humanitarian response remains far too limited to contain the epidemic. On the continental side, the Africa CDC and WHO announced a joint six-month response plan covering June to November 2026 and launched a call for $518 million to support African countries in early detection, prevention, and control. Based on the operational principle of “one plan, one budget, one team” promoted by the WHO director-general, this plan is a coordinated response led by affected countries. The funding call relies on the WHO, Africa CDC, and partners like UNICEF, UNHCR, WFP, IFRC, FIND, UN agencies, African governments, and international donors. So far, only $315.8 million has been pledged, falling short of even the goal for a single coordinated plan. This co-coordinated plan shows initial continental-level response efforts, but it also structurally highlights a hybrid strategy of several African states. On one hand, countries sign bilateral agreements, notably with the US, for conditional aid to support health systems and fight infectious diseases. On the other hand, they demonstrate their ability to coordinate through multilateral mechanisms during a major crisis. Only time will tell if this articulation will bear fruit over the long term.