MSF warns DRC Ebola outbreak is still expanding, not shrinking

MSF warns against premature optimism

Doctors Without Borders has issued a stark warning about the current Ebola situation in the Democratic Republic of Congo (DRC). The organization stresses that the outbreak is not receding; instead it is moving into districts that have limited capacity to respond.

"The outbreak is not shrinking, it is moving," said an MSF official who is overseeing field operations in the affected provinces.

Scale of the DRC outbreak

Since the first case was confirmed in early 2022, the DRC has recorded more than 5,000 confirmed infections and over 3,000 deaths, making it the largest Ebola episode in the country's history. The virus belongs to the Sudan strain, which has a higher fatality rate than the West African strain that caused the 2014‑2016 crisis.

Geographic spread into new provinces

Initial transmission was concentrated in the North Kivu province, but recent data show a clear shift toward Ituri, South Kivu and even the distant province of Haut‑Uélé. Health facilities in these areas lack the isolation units and trained staff that were established in the early epicenter.

Challenges facing the response

Health system gaps

The DRC health system has long struggled with limited infrastructure, especially in remote regions. Many clinics lack basic laboratory capacity, making rapid diagnosis difficult. In addition, community mistrust of health workers hampers contact tracing efforts.

• Insufficient personal protective equipment for frontline staff.
• Limited cold chain capacity for vaccine storage.
• Scarcity of trained epidemiologists in rural districts.

Vaccine rollout hurdles

Since the approval of the Sudan‑Ebola vaccine, the DRC has administered only a fraction of the doses required to achieve herd protection. Logistical obstacles include poor road conditions, seasonal flooding, and security concerns in conflict‑affected zones.

According to the World Health Organization, the vaccine needs to be delivered within a strict time window to retain efficacy. Delays in reaching remote villages therefore reduce the overall impact of the immunisation campaign.

International coordination and funding

Role of WHO and partners

The WHO leads the coordination of the multi‑agency response, working closely with national authorities, the United Nations Office for the Coordination of Humanitarian Affairs, and non‑governmental organisations such as MSF. Funding gaps remain a major obstacle; the UN has called for an additional US$120 million to sustain treatment centres, laboratory support and community outreach.

For more details on the WHO's emergency plan, see the official Ebola response page.

What the data show

Case numbers and trends

Weekly surveillance reports indicate a modest decline in new cases in the original hotspots, yet a steady rise in the newly affected districts. The reproduction number (R) in Ituri has risen above 1, signalling ongoing transmission.

Transmission patterns

Unlike earlier outbreaks that were largely confined to urban markets, the current wave is driven by transmission within families and funeral practices. Cultural rituals that involve close contact with the deceased have amplified spread.

Research published in The Lancet highlights the importance of adapting safe burial protocols to local customs in order to break chains of infection.

Implications for neighboring regions

Risk of cross border spread

The DRC shares porous borders with Uganda, Rwanda, Burundi and South Sudan. Mobile populations, including traders and refugees, increase the likelihood of the virus crossing into adjacent countries. Health ministries in these nations have intensified border screening and coordinated with the DRC to share laboratory results.

Uganda's Ministry of Health provides regular updates on its preparedness measures through its official website.

Key actions needed now

1. Accelerate vaccine delivery to underserved provinces.
2. Expand training programmes for local health workers on infection control.
3. Strengthen community engagement to build trust and encourage early reporting of symptoms.
4. Secure additional international funding to keep treatment centres operational.
5. Improve surveillance at border crossings to detect any spillover events.

The situation remains fluid, and the warning from MSF underscores that complacency could reverse the hard‑won gains of the past months. Continued vigilance, resources and coordination are essential to halt the spread of Ebola in the DRC and protect the wider region.