WHO says Ebola outbreak in DR Congo still outpacing response as Bundibugyo strain spreads to Uganda

The outbreak's toll

The Ebola outbreak in the Democratic Republic of Congo, first declared on 15 May, has now spread across three eastern provinces: Ituri, North Kivu, and South Kivu. Congolese authorities have confirmed 344 cases of the rare Bundibugyo strain, with 60 deaths. The number of suspected cases has fallen sharply from 906 to 116 as testing capacity improves and backlogged samples are processed. Neighbouring Uganda has reported 15 confirmed cases including one death, its health ministry said Tuesday. One of those cases involved a Congolese resident who had travelled to the United Arab Emirates before arriving in Uganda.

The outbreak had a big head-start and we're still behind.

A virus with no vaccine

The Bundibugyo strain driving this outbreak has no approved medicine or vaccine. Getting a potential vaccine to the region could take months. Dr. Aruna Abedi, a Congolese epidemiologist who has managed previous outbreaks in the country, told The Associated Press that it is difficult to have an effective vaccine that adheres to scientific protocol available quickly. At least five people have recovered from the virus, offering rare signs of hope amid the crisis.

Contact tracing and insecurity

Tedros said only about 45% of contacts of infected people have been followed up, far short of the 90% needed to get ahead of the outbreak. Insecurity, displacement, and mobile populations make contact tracing especially difficult. Armed groups active in the region include the Rwanda-backed M23 rebel group, which seized the key cities of Goma and Bukavu over a year ago, and the Islamic State-allied Allied Democratic Forces operating in the border region between Congo and Uganda. Wary residents have attacked health centres, and misinformation about Ebola and distrust of humanitarian help remain rampant.

The true extent of the outbreak remains difficult to assess. Extremely limited testing capacity and difficulties accessing certain areas necessitate interpreting these figures with caution.

Aid cuts and delayed detection

The United States had been the largest donor to the Democratic Republic of Congo, financing roughly 70% of humanitarian work there, according to Physicians for Human Rights. Most of that aid was shut off after Elon Musk and President Trump slashed USAID programmes. Jeremy Konyndyk, who oversaw the response to the 2014 Ebola epidemic for the agency, said the outbreak would not have been missed for so long if those programmes were still at full strength and the USAID mission team was still present. The virus is believed to have spread for weeks in one of the world's most vulnerable regions before lab testing confirmed it.

I don't think there is any way that this outbreak would have been missed for so long if all those programs were still at full strength and the U.S.A.I.D. mission team was still there.

Kenya quarantine controversy

The US government has decided to build a quarantine facility at a base in Kenya, intended to isolate Americans who had visited DR Congo. The project has drawn protests from Kenyans and a court order has blocked it. Kenya's Health Minister Aden Duale told Parliament on Wednesday that the isolation centre would proceed, stating that quarantine is not only for Americans and that Kenyans will also be isolated at the facility. Tedros avoided a question about the US quarantine centre, saying countries can do whatever they think is right based on their risk assessment.

Laikipia airbase is one of the 23 quarantine isolation centers we are building. And we will not stop it.

The road ahead

The WHO has assessed the risk from the outbreak as very high at the national level, high at the regional level, and low at the global level. Tedros said he was very encouraged by the level of commitment he saw during his visit to the epicentre in Ituri province, but warned that the virus is still ahead and health authorities need to move faster. Laboratory and diagnostic resources are improving, yet the tracing of contacts remains the critical gap.