GOMA, NORTH KIVU, DEMOCRATIC REPUBLIC OF CONGO - 2019/06/15: Medical staff dressed in protective gear before entering an isolation area at an Ebola treatment centre in Goma. DR Congo is currently experiencing the second worst Ebola outbreak in recorded history. More than 1,400 people have died. (Photo by Sally Hayden/SOPA Images/LightRocket via Getty Images)
The World Health Organization declared on 17 May 2026 that the Ebola epidemic raging in eastern Democratic Republic of the Congo and persisting in Uganda represents a public health emergency of international concern, followed the next day by a similar declaration from the Africa CDC. On 5 June, both institutions launched a joint six-month response plan and appealed for 518 million dollars. Caused by the rare Bundibugyo strain, for which no licensed vaccine or treatment exists, this 17th epidemic strikes a region already ravaged by conflict and destabilised by the reorganisation of American aid. The crisis unfolds in a context marked by deep instability due to numerous armed groups and ongoing violence. This epidemic threatens to deepen the security and humanitarian vulnerabilities of eastern DR Congo and complicate access to care. It also raises risks for regional balances in Central Africa and exposes the international community’s current capacity to handle major health crises.
In a setting of armed conflict, political instability, and severe economic and social fragility, especially in eastern DR Congo, how does the Ebola epidemic affect the internal stability of affected areas and hinder the establishment of health systems guaranteeing access to care for populations? This new Ebola wave hits a zone of multiple, structural crises. Primarily affecting the DR Congo, it is the 17th epidemic since the virus was first identified in Yambuku in 1976, this time caused by the Ebola Bundibugyo strain. Currently, although treatments are being tested, there is no approved vaccine or cure for this strain, which can kill one out of every two infected people. The eastern regions of North and South Kivu and Ituri are particularly vulnerable to epidemic spread. Last year, the United Nations reported one of the worst cholera outbreaks in 25 years. Moreover, since 2020, Mpox has spread massively, especially from September 2023. Ituri, the epicentre of the current Ebola outbreak, is one of the most troubled provinces, with poor road access, violence from armed groups, and nearly a million displaced people crammed into camps. The health crisis thus overlays an existing humanitarian and security crisis, stemming from endemic instability and conflict, particularly intense since the M23 offensive in 2023. Local populations face daily uncertainty, with frequent displacements and overcrowded camps. These conditions favour the resurgence and rapid spread of pathogens. Furthermore, the complex crisis in eastern DR Congo, with only rare periods of calm, has severely weakened the social fabric and health services, which cannot currently meet the vital needs of locals, creating a structural dependence on foreign Western aid. The systemic violence from successive conflicts in the east has deprioritised health and normalised violence, especially against women and children. A large-scale epidemic now compounds this precarious security collapse.
The Congolese health minister, Samuel-Roger Kamba Mulamba, called Ebola an absolute emergency. National data as of 31 May 2026 showed 282 confirmed cases with 42 deaths, after 19 new positive tests. The WHO reported on 1 June that 349 suspected cases were under surveillance awaiting results, mainly in Ituri province, specifically in the health zones of Bunia, Rwampara, and Mongbwalu. Bunia hospital was quickly overwhelmed, forcing the setup of peripheral treatment centres in rural areas. However, the recovery of four infected health workers offers a glimmer of hope. As of 5 June 2026, pressure on the health system intensified; local sources say about six health centres in Bunia were temporarily closed for disinfection, reducing the city’s capacity and worrying pregnant women and patients with other conditions who received only minimal care before being redirected or sent home. Moreover, the rapid adaptation to Ebola has disorganised services and restricted access to routine healthcare.
The real problem is the lack of coordinated response from Kinshasa, in a zone partially occupied by the Rwandan proxy M23 and where numerous armed groups operate for extractive reasons. This highlights the recurring issue of national unity control in a country of nearly 100 million people and the effectiveness of basic social and health services. In M23-controlled areas, several cases have also been counted. Since the Congolese government has not coordinated the health response with the illegally occupying armed groups, the risk of epidemic spread remains. Although negotiations may be underway, they have not yet established the necessary health coordination framework for an effective response in the area. Territorial fragmentation in the east prevents a unified response. Two Ebola treatment centres are reportedly being set up in Goma, the M23/AFC-held capital, with limited capacity, and the armed group claims to have assessed the situation and implemented contingency plans. The epidemic thus also progresses in rebel-held areas. Who manages public health when the state no longer has territorial monopoly?
Community resistance adds to the challenge. As in the 2018-2020 episodes, acceptance of the response is far from guaranteed. An anti-response protest in Rwampara escalated to the burning of a suspected case’s body. Distrust and hostility toward medical teams are stability variables in their own right. Community resistance is rooted in cultural logic. The refusal of health authorities to return bodies of Ebola victims to their families is seen as unbearable symbolic violence. In eastern DR Congo societies, funeral rituals, especially washing and physical contact with the deceased, are spiritual imperatives. Yet these practices are among the main vectors of Ebola transmission. The resentment of Ituri and Kivu populations stems from structural suspicion inherited from decades of violence, state abandonment, and perceived predatory external interventions. Thus, the health response is easily seen as a new form of imposed control, fueling rumours and conspiracy theories.
Can the Ebola epidemic have lasting consequences on relations between the DR Congo and its neighbours? How might this crisis destabilise regional stability in Central Africa? We are in a situation of high tension and extractive competition between the DR Congo and its eastern neighbours, especially Rwanda, but also with sometimes strained relations with Uganda. When an epidemic spreads in a state where part of the territory escapes central control, making a coordinated national response difficult, the response must be transregional, even continental. The Africa CDC, the operational health arm of the African Union for epidemiological hotspot detection, has indicated that about ten vulnerable countries could be affected: South Sudan, Rwanda, Kenya, Tanzania, Ethiopia, Congo-Brazzaville, Burundi, Angola, Central African Republic, and Zambia, in addition to the DR Congo and Uganda, which already has seven cases. Response capacity varies greatly between countries. Kenya and Ethiopia have relatively stronger health and surveillance systems, with Kenya already setting up dedicated quarantine structures, while the Central African Republic remains one of the continent’s most fragile states, heavily dependent on external aid. South Sudan faces both a severe internal crisis and repercussions from the war in neighbouring Sudan.
By definition, an epidemic ignores artificial borders; it affects living beings regardless of status. Some are more vulnerable than others, especially the poorest, particularly where borders are extremely porous. According to the WHO, imported cases from Ituri have reached North Kivu and Kampala, Uganda, where two travellers returning from DR Congo tested positive, one of whom died. A case was also reported in South Kivu, according to the M23 spokesperson, with the patient coming from Kisangani in Tshopo province. This dynamic is accompanied by border closures and diplomatic tensions, not to mention potentially major economic consequences. Facing the risk, Uganda suspended flights and passenger transport with the DR Congo on 21 May 2026. Rwanda closed its border with Goma. These unilateral measures hit already extremely tense bilateral relations with the DR Congo. The entanglement with the conflict in the east directly contributes to the epidemic’s spread. The outbreak’s progression into areas like Goma, taken in late January 2025, and Bukavu, fallen in February 2025, raises fears of a regional conflagration. Health thus becomes another arena for the Kinshasa-Kigali rivalry, with the M23 emerging as a de facto public health actor in the territories it controls. Facing this cross-border risk, the East African Community called on its member states to activate laboratory networks and strengthen border surveillance, holding an extraordinary ministerial meeting of health ministers on 1-2 June 2026. According to official sources, the ministers committed to harmonising health checks at entry points without closing borders, creating a regional technical working group to coordinate surveillance, and strengthening diagnostic capacity and health worker protection.
Health crises like Ebola reveal the current limits of the international humanitarian aid system, especially following the cuts to USAID funding. What role do international organisations like the WHO and NGOs play in managing this crisis? Added to the regional instability, this epidemic occurs in a context where the response risks being weakened upstream by the reorganisation of American aid. The cuts specifically to health aid were quadripartite from January 2025: withdrawal from the WHO, dissolution of USAID, reductions at the CDC, and reduced health aid to the DR Congo and Uganda, weakening vital systems to respond to such outbreaks. Experts estimate these cuts may have delayed detection of the epidemic. Today, the DR Congo has signed a bilateral agreement with the United States (as have Rwanda and Uganda) under an avowed America First approach. Part of the health funding has been transferred to the State Department via this new agreement, promising 900 million dollars over five years, in a dynamic of extractive conditionality and a shift from multilateralism to transactional bilateralism between the US and DR Congo. This reorganisation, driven by the new American stance, is not fully controlled; faced with this Ebola resurgence, the US response has been late and outside the UN framework. Moreover, there is a deprioritisation of humanitarian and solidarity principles in approaching the epidemic response. The primary goal is to protect Americans. The State Department mobilised 23 million dollars in emergency funds and announced financing for up to 50 clinics, but due to the withdrawal from the WHO, it did not indicate support for a WHO-led response, breaking with past practices. With the US out of the WHO, the organisation’s Contingency Fund for Emergencies is operationally fragile, as other donors cannot fill the gap left by the American withdrawal.
In this context, the response must be activated by the national institutions of the most affected countries, with support from the WHO and non-governmental organisations, given the virus’s spread, even as their resources have been reduced by the US withdrawal and they operate in a hostile security environment. The WHO, as per its mandate, declared the epidemic a Public Health Emergency of International Concern and coordinates the response. The European Centre for Disease Prevention and Control published a risk assessment to support coordination, especially with the Africa CDC. On the ground, medical NGOs such as Médecins Sans Frontières and ALIMA have deployed care teams. The DR Congo Red Cross mobilises volunteers for safe and dignified burials, risk communication, and community engagement. Nevertheless, the humanitarian response remains far too limited to contain the epidemic. On the continental side, the Africa CDC and WHO announced on 5 June 2026 a joint six-month response plan covering June to November 2026 and appealed for 518 million dollars to support African countries in early detection, prevention, and control. Articulated around the operational principle of one plan, one budget, one team advocated by WHO Director-General Tedros Adhanom Ghebreyesus, this plan aims for a coordinated response under the leadership of affected countries. It is a funding appeal relying on the WHO, Africa CDC, and their partners (UNICEF, UNHCR, WFP, IFRC, FIND), UN agencies, African governments, and international donors. So far, only 315.8 million have been pledged, falling short even of the goal of a single coordinated plan. Moreover, while this co-coordinated plan shows first elements of a continental-level response, it also structurally highlights a hybrid strategy by several African states. On one hand, countries sign bilateral agreements, particularly with the United States, under donor-conditional aid to support their health systems and fight infectious diseases; on the other, they demonstrate their ability to coordinate in a major crisis through multilateral mechanisms. Time will tell whether this articulation will bear fruit over the long term.
