The Ebola epidemic in the Democratic Republic of the Congo (DRC) shows no signs of slowing down. This grim assessment was confirmed on August 5 by the deputy medical director of Médecins Sans Frontières during an official visit by the World Health Organization’s director-general to the eastern region of the country. Now two and a half months into the outbreak—declared on May 15—this flare-up has become the second-largest on record, with an alarming rate of transmission unlike anything previously observed.
Official data from Congolese authorities and the World Health Organization indicate the virus has already claimed 1,850 lives out of approximately 4,000 confirmed cases, pushing the fatality rate beyond 40%. The Bundibugyo strain, responsible for this outbreak, has already caused more fatalities in a comparable period than in all prior recorded outbreaks combined, according to the Africa Centres for Disease Control and Prevention (Africa CDC). During the previous major epidemic in the DRC, which spanned from 2018 to 2020, it took over ten months to reach a similar death toll. “Today, I cannot confidently say we have this outbreak fully under control,” admitted Jean Kaseya, director-general of Africa CDC, in late July.
Violence and instability hinder disease containment
The unparalleled spread of the virus can be attributed to multiple compounding factors. A critical delay in early detection played a pivotal role. Eastern DRC, particularly the Ituri province—ground zero of the outbreak—poses immense challenges for medical coordination and case identification. This region has long been plagued by frequent terrorist attacks by the Allied Democratic Forces (ADF) from Uganda, alongside a proliferation of armed militias vying for control over land, minerals, and local influence. Meanwhile, the neighboring North Kivu province remains largely outside government control, with vast areas seized over a year ago by the M23—a Rwandan-backed armed group—following intense clashes with the Congolese army.
Years of relentless violence have displaced millions of civilians into neighboring Uganda, Burundi, or safer zones within the DRC. This humanitarian and security crisis has pushed populations into dire living conditions with inadequate sanitation, further fueling the epidemic’s spread. Compounding the issue, surveillance systems and diagnostic capabilities were severely under-resourced at the outbreak’s onset, delaying the identification and confirmation of cases.
Contact tracing efforts have also fallen critically short. Médecins Sans Frontières reports that in Bunia—an epidemic hotspot—90% of admitted patients were not registered contacts, while only 59% of contacts were traced across Ituri province. Africa CDC estimates that for every confirmed urban case, roughly 40 contacts must be monitored. With approximately 3,360 confirmed cases as of now, the required tracing effort should involve about 134,400 people. Yet, only 17,500—just 13% of the target—have been reached. One in five registered cases also lacks regular follow-up due to personnel shortages or ongoing insecurity. Another troubling indicator: 60% of recorded deaths occurred within communities rather than in healthcare facilities.
Research advances and international challenges
Amid these grim statistics, scientific progress offers a glimmer of hope. A first-in-human trial of a vaccine targeting the Bundibugyo strain began this month at the University of Oxford, with one volunteer receiving the dose. The trial aims to enroll 50 adults to assess the vaccine’s safety. Additionally, the Coalition for Epidemic Preparedness Innovations (CEPI) is funding the rapid development of another vaccine candidate by Hilleman Laboratories in Singapore, with plans to produce and test doses in the DRC.
In the absence of a licensed vaccine for this highly lethal strain, Africa CDC announced on August 6 its plan to deploy the existing Ebola Zaïre vaccine widely across affected populations. While not a perfect match for the Bundibugyo variant, early evidence suggests it may reduce symptom severity and prevent fatalities. Over 40 patients are also participating in a clinical trial evaluating a combination of experimental treatments.
Jean Kaseya emphasized plans to expand the use of remdesivir—an antiviral medication—across the DRC, citing its success in neighboring Uganda, where authorities quickly contained a related outbreak. “Uganda’s case fatality rate of 10% is largely attributed to their widespread use of remdesivir for both confirmed patients and high-risk contacts,” Kaseya stated. International health authorities warn this outbreak could surpass the devastating 2014–2016 West Africa epidemic, which claimed over 11,000 lives—the deadliest on record.
Global aid response remains delayed and inadequate
Another major obstacle has been the sluggish international aid response. Early in 2025, the U.S. administration suspended decades-long health and medical assistance through USAID, severely crippling the DRC’s response capacity. It wasn’t until August 5 that the U.S. State Department announced a $242 million allocation, bringing total U.S. direct funding for the Ebola response to $512 million. This belated injection finally enables the WHO and CDC to access the $518 million required for the initial six-month response plan—three months after the outbreak began. Still, this amount remains far below previous U.S. contributions to similar humanitarian and health crises. Despite this, the United States remains the largest single donor, outpacing contributions from the European Union.