DRC Ebola disease outbreak

MSF teams are working around the clock on a large-scale response in the DRC, in collaboration with the Congolese health authorities, WHO, and partners. More than 1,400 of our colleagues are responding to the outbreak.

One of our main activities is operating Ebola treatment centres in areas where cases have been reported. These centres provide specialised care and contain the spread of the disease. We currently have Ebola treatment centres in Mongbwalu, Komanda, and Bunia in Ituri province, Goma and Butembo in North Kivu province, and Bukavu and Lwiro in South Kivu province. We continue to set up a centre in Beni in North Kivu province, and an additional 65-bed centre in Mongbwalu.

We are also running and establishing isolation units and triage systems within health facilities across the three provinces. In several locations, we are supporting the health authorities with the safe transportation of Ebola patients. We are also providing training on Ebola disease management to health facilities in Kisangani, Tshopo province.

Several tonnes of equipment and supplies have made it to the DRC, and more are on the way. This includes personal protective equipment (PPE), medical equipment, medicines, generators, solar panels, disinfectants, and hygiene equipment.

The rest of our response activities are still being defined. However, our response is being structured around the following pillars:

• treatment and care of patients;
• isolation and triage;
• infection prevention and control, including safe provision of other essential care;
• surveillance and detection;
• strengthening response capacity, including through material and human resources support; and
• continuity of essential healthcare services.

Importantly, protecting staff and patients through safeguarding, duty of care, and Ebola prevention measures, while ensuring continued access to essential healthcare services, are among our priorities. Community engagement is also a key aspect of the response. The outbreak response must be built with communities and cannot come at the expense of other lifesaving healthcare.

In Uganda, we have rehabilitated an Ebola treatment centre in Kampala and an isolation centre in Bwera, a town near the border with the DRC. We remain in contact with the Ugandan Ministry of Health to increase our response if needed.

The DRC has faced 16 outbreaks of Ebola disease since it was first identified in 1976 – this outbreak is the 17th. Nearly all of the previous outbreaks have been of the Ebola (Zaire) virus.

However, the 2026 Ebola outbreak is caused by the Bundibugyo virus. Dealing with this outbreak will be difficult, given there is a short supply of testing kits for diagnosis and there are no approved treatments or vaccines for Bundibugyo virus. While there have been improvements in testing capacity, with a few hundred Bundibugyo-specific tests arriving in DRC, nobody knows the true scale and severity of this outbreak as many communities still have limited access to them. The availability of diagnostic tests and other essential tools for the response must continue to expand.

People in the areas affected in the DRC are also living through extreme levels of conflict and displacement. It may be complicated to identify, follow up, and isolate cases as people are on the move and the health system is under resourced.

Ebola disease outbreaks have been officially declared in the DRC and Uganda. In DRC, cases have been identified in Ituri, North Kivu, and South Kivu provinces. Cases originating from elsewhere in DRC have been confirmed in Tshopo and Haut-Uele provinces. In Uganda, 20 cases have been confirmed.

Outside of the Ebola outbreak, people living in Ituri, North Kivu, and South Kivu provinces in the DRC are already facing a humanitarian crisis. The provinces are affected by violence, displacement, chronic poverty, and weak infrastructure. These elements place strain on health facilities and hinder surveillance, contact tracing, and timely treatment — the main pillars of an effective response. As well, poor roads, armed checkpoints, shifting frontlines, and needing to move between areas under the control of different armed groups slow down the transportation of tests to laboratories.

“Ebola disease” is a disease caused by any virus within the genus of Orthoebolavirus. We are not dealing with a strain of Ebola, but a virus. Bundibugyo virus is among the three well-known species: Ebola (or Zaire) virus, Sudan virus, and Bundibugyo virus.

This is the third detected outbreak involving the Bundibugyo virus, following outbreaks in Uganda in 2007-2008 and in the DRC in 2012.

There are no approved vaccines or treatments available for Bundibugyo virus and those which have been developed for Ebola virus have not been approved for Bundibugyo. Diagnosing people is also challenging for Bundibugyo virus; tools, such as GeneXpert – an automated, cartridge-based molecular diagnostic system – developed for Ebola virus cannot be used. Conventional PCR testing, which is more cumbersome and requires a higher level of training to use, is needed, however there is currently a shortage of the test kits specific to Bundibugyo virus.

A clinical trial was launched in early July to identify the first effective treatments for Bundibugyo virus. This clinical trial is sponsored by the WHO, and is being coordinated by the Institut National de Recherche Biomédicale (INRB) in DRC, the Institute of Tropical Medicine in Belgium, and the University of Oxford in the United Kingdom. MSF is collaborating on the trial, along with other humanitarian, clinical, and international research partners. The trial is supported by the African Centres for Disease Control and Prevention.

One of our biggest concerns is that we do not know the full picture of the outbreak, due to a lack of diagnostics and underreporting of cases. Communities and health workers have been facing the outbreak for weeks, and today the epidemiological situation is unclear and moving fast.

We also see that the current response, including our own, falls short of what is needed, despite recent efforts to scale up. Critical gaps in surveillance, testing, and rapid case detection must be urgently addressed. The local health system needs laboratories and training to safely conduct tests, and the producers of diagnostic tests and other essential tools need to scale up availability. We are also facing major constraints, including airport closures and travel restrictions, which, among delaying the arrival of critical medical supplies, humanitarian aid, and specialised personnel, also complicate surveillance and containment efforts.

The response is also concentrated in urban areas, which makes it difficult for people in hard-to-reach areas to seek and reach Ebola care.

The affected areas in DRC are also highly insecure. People are moving across the borders with Uganda and South Sudan, driven by conflict and mining activities, which may accelerate transmission and complicate efforts to contain the outbreak. Health facilities are also under immense strain, and may not have adequate infection prevention and control measures to manage Ebola cases.

MSF has vast experience responding to Ebola disease outbreaks. We have been an active partner in many Ebola responses, including the 2014-2016 Ebola epidemic in West Africa. We also have experience with Ebola caused by Bundibugyo virus, having responded to outbreaks in 2007 and 2012.