Congo Ebola response strained a month after WHO declares international emergency

NAIROBI/LONDON/DAKAR — Health workers responding to an Ebola outbreak in eastern Democratic Republic of Congo are facing severe shortages of staff, ambulances, and basic construction materials needed to build isolation units, according to officials and aid workers.

One month after the World Health Organization declared an international emergency, the outbreak of the rare Bundibugyo strain has surpassed 800 confirmed cases. Health experts warn it could become the worst Ebola outbreak on record, exceeding the 2014–2016 West Africa epidemic that killed more than 11,000 people.

Jean Kaseya, director general of the Africa Centres for Disease Control and Prevention (Africa CDC), said response teams are overwhelmed and unable to trace tens of thousands of contacts linked to confirmed cases. He cited insecurity and the outbreak’s location in an urban, mining-heavy region as major obstacles.

“After four weeks, we have an outbreak in an urban area where there is insecurity, where there is mining and trade activity, and where we are not reaching all the people who must be on the contact list,” Kaseya told Reuters. “If we don’t reach these people, we cannot say we can win this outbreak.”

Health officials say even confirmed or suspected patients are not always being properly isolated or treated. Some patients reportedly leave treatment centers, while others who test positive are not admitted due to capacity constraints. In some cases, admitted patients are believed to be receiving inadequate care.

A World Health Organization report showed that roughly one-third of 241 alerts for new suspected cases in Ituri province were not followed up as of June 14.

In Bunia, Oxfam Ebola Response Coordinator Manel Rebordosa described delays in emergency response, including a recent case of a symptomatic woman at a local medical center who waited hours for assistance.

“They were calling the surveillance system, but nobody came because they cover many health zones and do not have enough ambulances,” Rebordosa said.

Africa CDC data also indicates severe resource gaps, with only about 15% of required personnel deployed for safe burials and decontamination efforts in Ituri, and just 7% of needed vehicles available.

Congo’s Health Minister Samuel-Roger Kamba rejected claims that the outbreak is outpacing the national response. He said the government has trained 1,200 community health workers and deployed 1,000 of them to conduct door-to-door contact tracing, with follow-up currently at around 63%.

However, internal documents shared with response teams in Ituri highlight ongoing operational challenges, including patients moving between health zones, lost contact tracing cases, and fuel shortages affecting mobile units.

Professor Salim Abdool Karim, an adviser to Africa CDC who recently visited the region, said shortages of essential supplies remain a critical barrier.

“There is a need for more resources for almost everything, from personal protective equipment to gravel,” he said, noting that construction of isolation facilities has been delayed due to material shortages, including prefabricated building components.

He also pointed to the absence of some international support mechanisms, saying the reduction in U.S. aid infrastructure has been felt on the ground.

Medics working in affected areas have also reported shortages of protective equipment, while dozens of health workers have reportedly been infected with the Bundibugyo strain, for which there is currently no approved vaccine or specific treatment.

Africa CDC’s Kaseya added that in some cases, essential supplies exist but are not reaching frontline teams in time. “Sometimes the materials are sitting in warehouses,” he said.

The African Union says it has secured only about one-fifth of the $518 million required for its response plan. Aid organizations also report declining donor support compared with previous Ebola outbreaks.

Asked whether Western governments should increase assistance, Kaseya said international awareness of the outbreak’s severity is improving. “I think they are starting to understand that it is serious,” he said. -Reporting by Emma Farge, Jennifer Rigby and Clement Bonnerot; Editing by Hugh Lawson and Deepa Babington/Reuters