Ebola risk ‘very high’ in eastern DR Congo as UN intensifies response

This article is published in association with United Nations.

The UN is rushing emergency personnel, funding and supplies into eastern Democratic Republic of the Congo (DRC) to counter the fast-growing Ebola outbreak spreading through conflict-ravaged provinces.

The UN World Health Organization (WHO) on Friday raised the national risk assessment for DRC to “very high” – although the global risk remains “low”.

So far, 82 cases and seven deaths have been confirmed in DRC, but WHO says the real scale of the outbreak is likely far larger, with nearly 750 suspected cases and 177 suspected deaths reported.

The outbreak is unfolding amid intensified fighting, mass displacement and deep mistrust of outside authorities, fuelled by rumours and misinformation.

One hospital in Ituri province on Thursday was set on fire by angry relatives after authorities refused to release the body of a deceased family member, fearing contamination, according to reports.

How the UN system is responding

• WHO raises Ebola risk in DRC to “very high”; regional risk remains “high” and global risk “low”
• WHO deploys 22 international staff; UNICEF sends emergency response team to Bunia.
• Health teams support contact tracing, treatment centres, risk communication and community engagement
• UN relief chief allocates up to $60 million for the response in DRC and neighbouring countries; WHO releases $3.9 million
• WHO and Africa CDC establish a continental incident management support team
• MONUSCO airlifts nearly 30 tons of emergency supplies – including medicines, tents and protective equipment
• The UN peacekeeping mission also runs an air bridge and deploys vehicles to strengthen logistics
• WHO and partners prepare clinical trials for experimental Ebola treatments and potential vaccines targeting the Bundibugyo strain.
• Red Cross volunteers carry out door-to-door awareness campaigns and mobilise safe and dignified burial procedures 

Read more about the outbreak here and about ebola symptoms and prevention here.

Two cases in Uganda

Two cases – linked to travel from DRC – have been confirmed in Uganda, including one death.

Two American nationals – including a doctor and another person described as a “high-risk contact” – have been transferred to Europe for treatment or monitoring.

The outbreak is caused by the Bundibugyo strain of Ebola, for which there are currently no approved vaccines or therapeutics. Only two previous outbreaks of the strain have ever been recorded – in Uganda in 2007 and DRC in 2012.

Conflict complicates response

The outbreak is unfolding in Ituri and North Kivu provinces, regions long scarred by armed violence and humanitarian crises.

“Across both provinces, around four million people need urgent humanitarian assistance, two million are displaced and ten million face acute hunger,” Tedros said.

Fighting has intensified in recent months, displacing more than 100,000 people and hampering health operations.

Emergency $60 million allocated

Also on Friday, UN Emergency Relief Coordinator Tom Fletcher announced the allocation of up to $60 million from the Organization’s Central Emergency Response Fund to support the response in DRC and neighbouring countries.

“These are tough operating environments for lifesaving work,” Mr. Fletcher said. “We face conflict and high population movement.”

He stressed the importance of securing access for frontline responders, including in areas controlled by armed groups. “It is essential that there is no obstruction,” he said.

Ebola ‘fabrication’ charge

Aid agencies stressed that misinformation and distrust could undermine efforts to contain the outbreak.

Gabriela Arenas of the International Federation of Red Cross and Red Crescent Societies (IFRC) said many communities still carry trauma from previous Ebola epidemics.

“They remember the fear. They remember the rumours spreading to villages,” she told reporters in Geneva from Nairobi. “They remember neighbours disappearing into treatment centres.”

While many residents are seeking information and treatment, others still believe “that Ebola is fabricated,” she said.

The IFRC said Red Cross volunteers were already going door-to-door in affected areas to share information and support safe and dignified burials.

“During an Ebola outbreak, trust and community acceptance can mean the difference between containment and wider transmission,” Ms. Arenas said.

Women at greatest risk

Social dynamics driving transmission could leave women disproportionately affected, as they have in previous Ebola outbreaks, agencies warn.

“Women are more likely to be infected in the first place,” said Sofia Calltorp, UN Women’s Chief of Humanitarian Action.

During the 2018–2019 Ebola outbreak in DRC, women and girls accounted for roughly two-thirds of reported cases.

“This is because Ebola transmission follows social realities,” Ms. Calltorp said. “The virus spreads along the lines of caregiving, domestic labour, frontline health work and burial practices.”

Pregnant women face particular risks, she added, while quarantines can increase gender-based violence.

Containment efforts intensify

WHO said it had deployed 22 international staff to the field and released $3.9 million from its contingency fund, while a continental incident management team was being established with the Africa Centres for Disease Control and Prevention.

The agency and its partners are also accelerating work on experimental vaccines and therapeutics for the Bundibugyo strain.

Tedros said WHO’s research advisory group had recommended prioritising two monoclonal antibodies for clinical trials, along with testing the antiviral drug obeldesivir for high-risk contacts.

He also underscored the importance of restoring confidence. 

“Building trust in the affected communities is critical to a successful response, and is one of our highest priorities,” he said.