Tedros Adhanom Ghebreyesus returned to the Democratic Republic of the Congo as health officials confront a rapidly expanding Ebola Bundibugyo outbreak complicated by militia violence, public distrust, striking workers and the absence of an approved vaccine or treatment for the strain.
By yourNEWS Media Newsroom
World Health Organization Director-General Tedros Adhanom Ghebreyesus arrived in the Democratic Republic of the Congo on Wednesday for his second visit during an Ebola outbreak that has spread across borders, infected more than 3,600 people and killed nearly 1,600.
Tedros began the visit in Kinshasa, where he met with government officials and “health and humanitarian partners” to coordinate a larger response to the epidemic. He shared an image from the meeting Wednesday afternoon and called for an immediate expansion of medical, surveillance and community-level operations.
“We all agree that we must urgently and massively scale up all our efforts across all pillars of the response and by all partners,” Tedros said. “That means reaching every affected community despite insecurity and displacement, strengthening coordination under the Government’s leadership, ensuring health workers have the protection, training, and support they need, and accelerating access to care, surveillance, and safe, dignified burials.”
The outbreak is being driven by the Bundibugyo strain of Ebola, a less common form of the virus for which no approved vaccine or treatment is available. The vaccine developed after the West African Ebola epidemic that began in 2013 targets the more prevalent Zaire strain and does not currently appear effective against Bundibugyo.
The WHO’s latest outbreak figures recorded 3,626 confirmed cases connected to the current epidemic. Of those, 3,605 were identified in the DRC, 20 in Uganda and one in France, with the cases outside Congo traced to the outbreak’s original source.
At least 1,589 patients had died as of the Aug. 1 update, producing a fatality rate of approximately 44%.
The outbreak has become the fastest-spreading Ebola epidemic on record since Tedros first traveled to the eastern provinces of Ituri and North Kivu in late May and early June. Its expansion has been aided by armed militia activity, displacement, inadequate treatment and monitoring facilities, distrust of health workers and labor disputes involving medical personnel who say they have not received promised bonuses for hazardous work.
Tedros’s return follows a commitment he made before his first trip to the outbreak zone. In a May open letter to the Congolese people, he promised to oversee the response personally rather than from WHO headquarters.
“I will be there in person, alongside my colleagues, meeting your leaders, listening to your concerns, and doing everything in my power to help you,” Tedros wrote. “I will not be managing this from a comfortable office far away.”
Tedros also documented that commitment publicly before traveling to the region.
The Ethiopian-born WHO chief has emphasized his previous involvement in Ebola operations in eastern Congo. During an outbreak from 2018 through 2020, immediately before the WHO’s response to the novel coronavirus outbreak that began in Wuhan, China, Tedros repeatedly traveled to North Kivu.
“From 2018 to 2020, I came fourteen times to North Kivu, the epicentre of the outbreak,” he wrote in May. “Mistrust ran deep, and the security situation cost us precious time. Our health workers were attacked. Clinics were targeted. People who were only trying to save lives found themselves caught in the middle of a conflict they did not start. Lives were lost that we might have saved, and that weighs on me still.”
During his first trip associated with the current outbreak, Tedros visited Ituri, where the Bundibugyo strain has been concentrated, as well as neighboring North Kivu. A central focus of that visit was the widespread suspicion surrounding international health operations.
Some residents reject outside medical assistance because they believe Ebola is not a genuine disease and instead view the response as a form of foreign “population control.” Others accept that the disease exists but rely exclusively on spiritual practices or traditional herbal remedies rather than seeking clinical treatment.
“Community mistrust is a serious barrier. Some community leaders told me that they believe Ebola is not real,” Tedros said during a June briefing. “Building trust with the communities is therefore critical to bringing the outbreak under control.”
Health officials are also struggling with limited capacity to isolate infected patients and monitor people who may have been exposed. The United Nations announced Aug. 1 that it was constructing a new Ebola treatment center in Bunia, the capital of Ituri province. Once completed, the facility is expected to be the largest Ebola treatment center in the DRC.
Doctors Without Borders, also known as MSF, urged authorities and international organizations to devote greater resources to contact tracing as Tedros returned to the country.
Health workers remain unable to connect many newly diagnosed patients to previously identified transmission chains, indicating that the virus is spreading through communities faster than surveillance teams can track it.
“New suspected cases are being reported almost daily in new locations, outside already identified transmission chains. To prevent further loss of life, the response must outpace the current rate of transmission,” MSF Deputy Medical Director Philippa Boulle said in a statement. “The international medical response must scale up without delay, and many critical gaps still need to be addressed.”
Boulle said most patients arriving at the MSF treatment center in Bunia had not previously been identified as contacts of infected people.
“Undeniable progress has been made in screening and contact tracing, but these efforts remain very insufficient to contain the epidemic,” she said. “In the MSF Ebola treatment centre in Bunia, 90 percent of admitted patients were not traced contacts, while in the whole of Ituri province only 59 percent of contacts were traced.”
She said efforts to contain the outbreak would remain incomplete unless residents were directly involved in surveillance, reporting and follow-up work.
“Without communities at the centre of the response, surveillance and contact tracing will continue to miss cases. Better integration of local communities is essential to ensure cases are detected as early as possible and followed up rigorously,” Boulle said.
Tedros’s second visit comes as international health organizations attempt to close those surveillance gaps, protect workers operating in conflict zones and expand access to treatment despite the absence of a strain-specific vaccine. The response also depends on persuading skeptical communities to cooperate with medical teams while ensuring that frontline personnel receive the security, training and compensation required to continue working.
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