DRC Ebola outbreak spreads to sixth province as deaths exceed 2,100

Outbreak reaches sixth province

The Ebola outbreak in the Democratic Republic of the Congo spread to a sixth province on Thursday, August 13, when a man died in Bas-Uélé after traveling from Isiro in Haut-Uélé to Buta, the provincial capital. Jean Kaseya, director general of Africa CDC, confirmed the death during an online exchange with journalists. Bas-Uélé, which borders the Central African Republic, had been previously spared. The outbreak now affects six of DRC's 26 provinces: Ituri, Nord-Kivu, Sud-Kivu, Haut-Uélé, Tshopo, and Bas-Uélé. Ituri accounts for approximately 80% of all deaths. The outbreak also threatens to spread to neighboring South Sudan.

The latest health ministry bulletin, dated August 11, reports 2,128 deaths out of 4,566 confirmed cases. The WHO estimates that authorities have visibility on only one-third of cases, meaning the true toll is significantly higher. Over the past week, the average daily death rate has reached 30 people per day.

A virus ahead of the response

WHO sequencing shows the outbreak began in February, months before it was officially declared on May 15 with several weeks of delay. This is DRC's 17th Ebola outbreak, already considered the largest in the country's history. The current outbreak is caused by the Bundibugyo virus, for which there are no approved vaccines or treatments. Health authorities report that between 60% and 70% of new cases are recorded outside the contacts being monitored, indicating the disease is spreading beyond tracked chains of transmission.

Dr. Mohamed Yakub Janabi, WHO regional director for Africa, described the situation in stark terms during a briefing this week.

The situation of Ebola is catastrophic. In three months, we have only had access to a third of the situation. We need to sit down, ask ourselves difficult questions and change our approach.

The WHO has called for a revised strategy focused on community-based detection campaigns to identify cases and contacts more quickly. Dr. Gisèle Mbuyi, who oversees case surveillance, cited mistrust toward response teams as a key obstacle, noting that some communities continue to deny the existence of Ebola.

Health workers strike, treatments trialled

Health workers at the Nizi treatment center in Ituri province went on strike on Thursday, causing the temporary closure of the facility. The workers said they had not been paid for three months. The strike compounds an already difficult environment marked by threats from rebel groups, community anger, and misinformation asserting that Ebola is not real.

Clinical trials of two potential treatments for the Bundibugyo strain of Ebola began last month in Ituri, the worst-affected province. The death toll in this outbreak has been reached almost three times faster than in the 2014-16 West Africa outbreak, which killed more than 11,000 people. On Wednesday, WHO director general Tedros Adhanom Ghebreyesus said the current outbreak could eclipse that record.

Funding and coordination challenges

The cost of the response has scaled dramatically. The initial national plan, designed for three months, was budgeted at $240 million. The new plan presented by the government now stands at $940 million, according to Anne Ancia, the WHO representative in DRC. The expanded plan covers both the fight against the virus and the continuity of essential health services.

The United States announced $242 million in additional funding, bringing total US commitments to $512 million for direct Ebola response and preparedness. However, the WHO noted that this money does not pass through the organization, as Washington uses its own mechanisms and operators. The Congolese health minister has called for "one plan, one budget, one coordination," and President Tshisekedi has requested a mapping of donors and their activities. Kinshasa wants to manage a larger share of external financing directly, including paying doctors and nurses.