Ebola epidemic in the DRC is deadliest on record, with more than 3,000 deaths

At a briefing for UN-accredited journalists in Geneva on Wednesday, the message by World Health Organisation director general Tedros Adhanom Ghebreyesus could not be clearer: “The current Ebola epidemic in the Democratic Republic of Congo (DRC) is the second largest ever recorded and the fastest spreading.”

The WHO chief confirmed the figures published by the DRC’s National Institute of Public Health that this Ebola epidemic, caused by the Bundibugyo strain, is the deadliest in the continent’s history, with more than 3,000 deaths and over 6,000 recorded infections. The strain also remains highly lethal, with a fatality rate of 48.6 per cent. In comparison, the 2018 to 2020  Ebola epidemic, which had been the worst till now in the DRC, caused 2,300 deaths. Over the past fifty years, more than 15,000 people have died from the hemorrhagic fever in Africa.

Six provinces of the DRC are affected, though the epicentre of the epidemic remains Ituri. “We have identified 85 per cent of infection cases and 88 per cent of deaths there,” Tedros said. “Most of the deaths are recorded among unknown contacts. That is why it is imperative to break the chains of transmission – otherwise, the epidemic will continue to spread.”

‘Something else to do than assign blame’

The WHO is working closely with Congolese health authorities and local actors within affected communities, and has deployed more than 300 experts on the ground. A network of 24 laboratories has been established, enabling 300 tests per day.

WHO technical officer Luca Fontana explained the efforts being undertaken. “We set up about 1,000 beds in less than two months. It’s something that’s never happened before in history. Today we have 1,400 beds and hope to have 2,000 by the end of September and 3,000 later. But  to run 3,000 beds requires about 9,000 healthcare workers that the Ministry of Health, neighbouring countries, and the international community will support.”

All of this comes at a high cost. Managing 1,500 beds requires around CHF15 million per month. This is where the funding issue is felt most acutely. The WHO estimates its financial needs to fight the epidemic at $1.3 billion.

Tedros declined to draw a link between the budget cuts the organisation had to make and the difficulties encountered in fighting the Bundibugyo virus. “If we discover a link in the future, it will be useful for our future actions. But for now, we have other things to do than assign blame. We are focusing on the fight against Ebola,” he said.

The UN agency chief, meanwhile, assured that the WHO is now “stabilised” and that “there will not be a second wave of budget cuts.” Tedros instead recalled that the WHO’s 194 member states agreed in 2023 to double their mandatory contributions by 2031 to provide the organisation with a stronger financial footing.

Two therapies in clinical trial phase

Abdirahman Mahamud, director of the WHO’s health emergency alert and response operations, acknowledged that three crucial factors distinguish the fight against Bundibugyo. The regional context is particularly complex and difficult from a humanitarian standpoint, having been the theatre of conflict between several armed groups for more than three decades. “In addition, the epidemic was detected very late. Chains of transmission were already in place before the virus was detected. Finally, we are in a region where the communities are extremely mobile.”

Mahamud also noted that 1.4 million people in the region have lost all access to primary care –  which, combined with rampant poverty, malnutrition, and the presence of malaria and tuberculosis, makes the population even more vulnerable. Whether the budget cuts made in Geneva played a role or not, the WHO’s regional office has been affected, and the disease surveillance system has collapsed.

WHO chief scientist Sylvie Briand noted that there is currently no vaccine specifically for the Bundibugyo virus. Additionally, there is currently no scientific evidence that the Ervebo vaccine, used against the Zaïre strain of Ebola, provides protection against the Bundibugyo strain. However, medical personnel who wish to use it voluntarily may do so. “Two therapies are currently in the clinical trial phase,” Briand explained. “One to treat sick patients, the other as prophylaxis for people who have been exposed to the virus. And two potential vaccines are in phase 1 clinical trials.”

The WHO does not paint an entirely bleak picture. It is convinced that with genuine political will, the Ebola epidemic can be defeated. It also notes that Uganda successfully fought off the Bundibugyo virus.