The Democratic Republic of the Congo’s battle against Ebola has entered an increasingly dangerous phase, with thousands of people dead and health workers warning that the true scale of the crisis may continue to grow even as efforts to contain the virus intensify.
The outbreak, driven by the rare Bundibugyo strain of Ebola, has become the largest Ebola outbreak ever recorded in the DRC. As of August 25, authorities had reported 5,713 confirmed cases and 2,744 deaths across six provinces, while hundreds of patients remained in isolation.
However, in an interview, Prof Pierre Akilimali, the incident manager overseeing the country’s multi-agency Ebola response, noted that the statistics tell only part of a much larger and more painful story.
“It is behind those numbers that matters; it is the father, the child, the loved relative. Behind every case is a person and behind every person is a family. For us Congolese, we hold on to that as we work.”
Prof Pierre Akilimali
That human dimension is becoming increasingly important as the outbreak continues to expand through eastern and northeastern parts of the country, where communities are already dealing with years of armed conflict, displacement, poverty and weak public infrastructure.
The DRC’s current outbreak was declared in May after cases emerged in Ituri province. It has since spread to six provinces and surpassed the country’s previous largest Ebola outbreak, which recorded 3,317 cases between 2018 and 2020. The World Health Organization has described the current emergency as the largest Ebola outbreak ever documented in the DRC.
The speed at which the outbreak has expanded has alarmed health authorities. Yet Akilimali cautions against predicting exactly when the epidemic will reach its peak.
Instead, the response is being shaped around the expectation that improved surveillance and stronger community engagement could initially result in even more cases being identified.
“What I can say is that as we are improving community engagement we expect to have more confirmed cases, so we need to be sure that treatment centres are able to cope with those increased numbers.”
Prof Pierre Akilimali
Although an existing Ebola vaccine, Ervebo, is being considered and tested for possible protection against Bundibugyo, it was developed and licensed for the Zaire strain rather than the virus currently driving the DRC outbreak.
The uncertainty surrounding treatment and prevention has added pressure to an already exhausted health system.
Akilimali, who has spent months working alongside Congolese health workers, noted that the psychological and physical burden on responders is immense.
“Many of my colleagues have been away from their own families for long periods; I do not dwell on it in the daily work, but I would not be honest if I said it was not heavy, to watch the human cost mount, case by case, and to know that behind each number is a family.”
Yet the continued work of frontline teams remains central to the response.
“What carries me and the team is the simple knowledge that every contact followed, every family supported, is a life where the worst was avoided.”
Prof Pierre Akilimali
The pressure is not limited to treatment centres. Health officials are also fighting to maintain essential healthcare services that risk being overwhelmed or neglected as Ebola consumes scarce resources.
That concern is especially significant in eastern DRC, where healthcare access was already limited before the current outbreak. Communities continue to face shortages of basic services while insecurity restricts movement and makes it difficult for health workers to reach affected populations.
Mistrust and Insecurity Complicate Congo’s Fight Against Ebola
For the communities at the centre of the outbreak, Ebola is not occurring in isolation.
Eastern DRC has endured decades of conflict, displacement and institutional neglect, leaving many residents deeply suspicious of authorities and outside organisations. Attacks on healthcare facilities, medical personnel and burial workers have complicated efforts to trace contacts, identify infections and persuade families to seek treatment.
Akilimali noted that mistrust should not simply be dismissed as ignorance or resistance to medicine.
“The DRC has lived through repeated outbreaks, and communities have lived through a great deal periods when the response did not always arrive, of confusing information, and the fear that comes with a disease that is frightening and carries a high toll.”
Prof Pierre Akilimali
He added,“It would be wrong of us to be surprised that some people hesitated at the start; that is not ignorance; in most cases it is the understandable fruit of hard experience, including experience of institutions letting them down.”
That recognition has increasingly shaped the response, with authorities seeking to involve communities more directly rather than relying solely on top-down public health messaging.
“We have seen openness and cooperation grow. But mistrust does not disappear overnight, and we cannot count it out. Complacency about community mistrust is more dangerous than the mistrust itself. There is something profound in that the response that respects communities is the response which lasts.”
Prof Pierre Akilimali
The need for community confidence has become even more urgent as officials seek to convince residents that health facilities remain safe for Ebola treatment as well as for other medical conditions.
Fear of infection can discourage people from visiting hospitals, potentially worsening deaths from illnesses unrelated to Ebola and putting additional strain on households already facing severe economic hardship.
At the same time, health authorities are confronting significant financial and logistical challenges.
Akilimali added that international solidarity remains essential because the outbreak is placing considerable pressure on the Congolese government.
Meanwhile, United Nations Secretary-General Antonio Guterres has appealed for an additional $1.1 billion to fully fund the international response to the Ebola outbreak in the Democratic Republic of Congo (DRC).
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