UNICEF warns of risk of worsening Ebola situation in the Democratic Republic of Congo

The WHO Regional Director for Africa, Mohamed Janabi, described the epidemiological situation as alarming, denouncing that promises from the international community have not translated into operational funds. Janabi stated during a virtual press conference that the initial estimated budget was 518 million dollars (a little over 450 million euros), and despite various funding promises, the money has not yet been credited to the accounts.

Threats and Financial Needs

After 45 days of field efforts to control the spread of the Bundibugyo strain, the WHO regional director warned that the combination of armed violence and financial restrictions could trigger a crisis projected to reach 1,500 confirmed cases in DRCongo by mid-month.

Last June, the WHO and the African Centres for Disease Control and Prevention (Africa CDC) indicated that the response to the outbreak now requires 1.4 billion dollars (approximately 1.2 billion euros). However, to date, only 13% of the promised 910 million dollars (about 800 million euros) has actually been delivered.

Impact of Insecurity on the Ground

Pierre Akilimani, head of medical response in DRCongo, warned that health teams are working under the direct effect of instability in the provinces of Ituri and North Kivu. The actions of militias have compromised mandatory contact tracing due to violent confrontations suffered by civilian professionals, who are targets of attacks by rebel groups, such as the March 23 Movement (M23), supported by Rwanda, and also by the Congolese army, even with the presence of the UN peace mission (MONUSCO).

Akilimani also admitted that the current security situation greatly hinders contact tracing, as his teams are being attacked. He mentioned that community engagement remains a challenge, and there have been reports of treatment centers being set on fire.

Regional Risks and Viral Circulation

Marie Belizaire, WHO regional director for emergencies, emphasized that the virus is circulating in a scenario of insecurity caused by armed conflict, preventing medical teams from reaching the most isolated communities, which record the highest number of infections. She added that there is a very high risk of cross-border spread: 15 of the 20 confirmed cases in Uganda were brought from DRCongo. This entire conflict area also borders South Sudan, and the capacity of the South Sudanese health system to manage such an emergency is a major concern.

Belizaire reiterated that the flow of international funding does not match local operational demands. Although she did not state that Ebola would become a global pandemic, she stressed that a virus does not recognize borders. The pathogen is circulating in a complex ecosystem of humanitarian crisis, and if control is delayed, the regional and periodic export of cases is inevitable.

Crisis Data in DRCongo

The WHO highlighted the scale of the crisis in DRCongo, where the current 447 deaths and 1,460 infections exceed the sum of all previous outbreaks of the Bundibugyo variant. According to the latest bulletin from the DRCongo Ministry of Communication and Media, with data collected up to July 1st, the fatality rate is 30.6%, a reduction of 0.6 percentage points compared to the previous day. Recent data also indicates that 595 patients are undergoing treatment and another 213 people have recovered from the disease.

According to the latest bulletin issued by the Ministry of Communication and Social Media of DRCongo, data collected up to June 28 indicates that the current mortality rate is at 28.8%. Furthermore, there are 615 individuals hospitalized or in isolation.

Outbreak Evolution and Recoveries

The report released late Monday points out that the contact tracing rate reached 87.3%, and 180 people managed to overcome the disease.

Government Alert and Epicenter

The Congolese government appealed to the population, urging them to maintain preventive practices, such as frequent hand washing and restricting risky contacts, and to rely solely on information provided by health authorities, warning that rumors endanger lives.

The outbreak was formally declared on May 15 in Ituri, a province located on the border with Uganda and South Sudan, serving as the epicenter of the epidemic. However, the disease has also spread to the eastern Congolese provinces of North Kivu and South Kivu.

Regional Spread and International Cases

The epidemic has also spread to Uganda, where 20 confirmed cases have been identified. Of these, 15 are considered imported from DRCongo, resulting in two deaths recorded in that country.

Additionally, the French government confirmed the detection of the first positive Ebola case, involving a doctor who had returned from a mission in DRCongo.

Virus Characteristics and Global Classification

This outbreak is associated with the Bundibugyo strain, whose lethality rate varies between 30% and 50%. The World Health Organization (WHO) reports that there is no approved vaccine or specific treatment for this strain. The WHO assesses the risk of spread as 'high' in Sub-Saharan Africa and 'low' globally.

The WHO estimates that the virus began circulating in Ituri approximately two months before the official declaration of the outbreak and classified the epidemic as a 'public health emergency of international concern' on May 17.

Historical Context of the Epidemic

This episode represents the third worst Ebola epidemic recorded to date. The current outbreak is surpassed only by the epidemic that affected West Africa between 2014 and 2016, responsible for about 11,000 deaths and 28,000 cases, and by another occurrence in eastern DRCongo between 2018 and 2020, which caused 2,299 deaths and 3,481 cases.

The Ebola virus is transmitted through direct contact with body fluids of infected people or animals and causes severe symptoms such as hemorrhagic fever, vomiting, diarrhea, and internal bleeding.

Although Satish Pillai, who is responsible for the outbreak response at the Centers for Disease Control and Prevention (CDC), reassured journalists that the risk to the United States remains low, the CDC decided to increase its response level to Level 1, the highest.

Increase in Health Response

This elevation is similar to the measure adopted during the record Ebola outbreak in 2014. A CDC manager pointed out that this high level functions as an 'internal signal,' indicating that the situation has become the 'highest priority' within the agency. The change aims to allow for the faster mobilization of additional personnel and resources, if necessary.

Current Outbreak Situation

More than a month after its declaration, the current Ebola outbreak in the Democratic Republic of Congo has not yet been contained. According to the latest report, it has already resulted in at least 304 deaths and infected 1,115 people, spreading to neighboring Uganda, where twenty cases have been recorded, including two fatalities.

American health authorities warned that if the outbreak is not quickly contained, it could reach or even surpass the magnitude of the outbreak that occurred on the African continent between 2014 and 2016. This outbreak, the deadliest in Ebola history, began in Guinea and spread across West Africa, causing more than 11,000 deaths, according to World Health Organization (WHO) data.

Support and Experimental Treatment

To combat the progression of the current outbreak, which involves the rare Bundibugyo variant of the virus—for which there is no approved vaccine or treatment—the United States announced support for sending doses of MBP134. This is an experimental monoclonal antibody-based treatment intended for the Democratic Republic of Congo and Uganda.

Furthermore, other doses of this same treatment will be sent to the University of Oxford in the United Kingdom to be used in a clinical trial. American health authorities also stated that they are prepared to dispatch 2,500 tests capable of detecting Ebola infection in deceased individuals and identifying the variant involved.