On May 17, 2026, the World Health Organization declared the ongoing Ebola outbreak in eastern Democratic Republic of Congo and neighboring Uganda a “public health emergency of international concern,” followed the next day by the Africa CDC. By June 5, both organizations had launched a joint six-month response plan, seeking $518 million in funding. The rare Bundibugyo strain—with no approved vaccine or treatment—has struck a region already devastated by conflict and destabilized by shifting American aid policies. This crisis unfolds against a backdrop of chronic instability in eastern DRC, where armed groups and persistent violence dominate the landscape. How will this Ebola surge exacerbate existing security and humanitarian vulnerabilities? What regional risks does it pose across Central Africa? And what does this resurgence reveal about the international community’s capacity to tackle major health emergencies? We explore these questions with Fatou Élise Ba, IRIS researcher and Human Security Program Lead.

How does the Ebola outbreak deepen instability in eastern DRC and disrupt access to healthcare amid armed conflict and political fragility?

This is the 17th Ebola outbreak in the DRC since 1976—when the virus was first identified in Yambuku—and the first involving the Bundibugyo strain. While experimental treatments are under evaluation, no approved vaccine or cure exists for this variant, which can be fatal in up to half of cases. The virus has taken hold in eastern DRC—particularly in North Kivu, South Kivu, and Ituri—regions already grappling with severe humanitarian and security crises. Last year, the UN reported one of the worst cholera outbreaks in 25 years across the country, and since 2020, mpox has surged dramatically, especially since September 2023. Ituri, the current epicenter, is among the most unstable provinces, plagued by armed violence, poor infrastructure, and overcrowded displacement camps housing nearly a million people. The health crisis compounds an already dire humanitarian situation, marked by chronic instability, recurring displacement, and extreme overcrowding in camps—conditions that accelerate pathogen spread.

Eastern DRC has seen limited periods of calm amid ongoing conflict since the M23 offensive in 2023. This persistent instability has eroded social cohesion and crippled health services, leaving communities dependent on external aid. The systemic violence in the region, including widespread abuse of women and children, has deprioritized healthcare and normalized suffering. Against this backdrop, a major epidemic threatens to collapse an already fragile system.

The Congolese Health Minister, Samuel-Roger Kamba Mulamba, has called Ebola an “absolute emergency.” As of May 31, 2026, 282 confirmed cases and 42 deaths had been recorded, including 19 new positive tests. By June 1, the WHO reported 349 suspected cases under monitoring, primarily in Ituri—especially in Bunia, Rwampara, and Mongbwalu health zones. Bunia’s main hospital quickly became overwhelmed, forcing the establishment of peripheral and rural care centers. While four infected healthcare workers have recovered, the strain on the system has intensified. By June 5, six health centers in Bunia were temporarily closed for disinfection, further reducing capacity and disrupting routine care—particularly for pregnant women and non-Ebola patients, who now receive minimal attention before being redirected or sent home.

A major challenge is the lack of coordinated response from Kinshasa in areas partially controlled by the M23—a proxy force backed by Rwanda—and other armed groups operating for extractive purposes. The fragmentation of national control, especially in a country of nearly 100 million people, undermines the effectiveness of basic health services. Several cases have been confirmed in M23-held territories, and without coordinated health interventions, the risk of further spread remains high. While negotiations may be underway, no framework for joint health action has been established. Territorial fragmentation prevents a unified response. Two Ebola treatment centers are reportedly being set up in Goma—under M23 control—with limited capacity. The armed group claims to have contingency plans but lacks the legitimacy or infrastructure to lead a public health response. The question remains: who controls public health when the state no longer holds a monopoly over territory?

Community resistance also hampers efforts. During the 2018–2020 outbreak, communities in Rwampara staged protests that escalated into the burning of a suspected Ebola victim’s body. Distrust of medical teams runs deep. Cultural norms in eastern DRC dictate that families must perform ritual washing and physical contact with the deceased—practices that are also major transmission vectors for Ebola. The refusal of health authorities to return bodies for traditional burial is seen as a profound violation, fueling suspicion and resistance.

Years of state neglect, violence, and perceived predatory external interventions have fueled deep resentment in Ituri and Kivu. Health responses are often interpreted as new forms of control, breeding rumors and conspiracy theories that undermine trust in aid efforts.

Could the Ebola outbreak strain relations between DRC and its neighbors, and how might it destabilize Central Africa?

The outbreak occurs at a time of high tension and extractive competition between the DRC and its eastern neighbors—especially Rwanda, but also Uganda. When a disease spreads in a state unable to mount a coordinated national response due to territorial fragmentation, the response must be regional or continental. The Africa CDC, the AU’s operational arm for disease surveillance, has identified ten vulnerable countries that could be affected: South Sudan, Rwanda, Kenya, Tanzania, Ethiopia, Republic of Congo, Burundi, Angola, Central African Republic, and Zambia—on top of the DRC and Uganda, which already report cases. However, health system capacities vary widely. Kenya and Ethiopia have relatively robust surveillance and health systems, with Kenya already setting up dedicated quarantine facilities, while the Central African Republic remains one of the continent’s most fragile states, heavily reliant on external aid. South Sudan, meanwhile, faces internal turmoil and spillover from the war in neighboring Sudan.

Ebola does not respect borders. Since May 21, Uganda has suspended flights and passenger transport to and from the DRC, and Rwanda has closed its border with Goma. These unilateral measures have strained already tense bilateral relations. Additionally, the epidemic is spreading in contested areas like Goma (captured in January 2025) and Bukavu (taken in February 2025), raising fears of regional escalation. Health has become another battleground in the Kinshasa–Kigali rivalry, with the M23 de facto acting as a public health authority in the territories it controls.

In response to the cross-border threat, the East African Community convened an extraordinary ministerial meeting on June 1–2, 2026, calling on member states to activate laboratory networks, strengthen border surveillance, and harmonize health screening at entry points—without closing borders. They also agreed to create a regional technical working group to coordinate surveillance, enhance diagnostic capacity, and protect healthcare workers. However, the ability to implement these measures remains uneven across countries.

Does the Ebola outbreak expose the limits of the international humanitarian aid system, especially after USAID funding cuts?

The current outbreak coincides with a weakening of the global health response architecture following U.S. policy shifts. In January 2025, Washington began a “quadruple withdrawal”: exiting the WHO, dissolving USAID, reducing CDC funding, and cutting health aid to the DRC and Uganda—weakening systems critical for outbreak detection and response. Some experts argue these cuts may have delayed the detection of this outbreak.

Today, the DRC has signed bilateral agreements with the U.S.—aligned with the “America First” doctrine—transferring health funding to the State Department. A $900 million, five-year deal promises conditional support, shifting from multilateral to transactional bilateralism. While the U.S. has pledged $23 million in emergency funding and plans to support up to 50 clinics, it has not committed to supporting a WHO-led response, breaking with past practices. With the U.S. no longer contributing to the WHO’s Contingency Fund for Emergencies, the fund’s operational capacity is weakened, and other donors have been unable to fill the gap.

In this context, response efforts must rely on national institutions with support from the WHO and NGOs, despite reduced capacity and a hostile security environment. The WHO has declared the outbreak a Public Health Emergency of International Concern (PHEIC) and is coordinating the response. The European Centre for Disease Prevention and Control (ECDC) has issued risk assessments to support coordination, particularly with the Africa CDC. On the ground, medical NGOs like Doctors Without Borders (MSF) and ALIMA (The Alliance for International Medical Action) have deployed care teams, while the DRC Red Cross mobilizes volunteers for safe and dignified burials, risk communication, and community engagement. Yet, the humanitarian response remains insufficient to curb the epidemic.

On June 5, 2026, the Africa CDC and WHO launched a joint six-month response plan (June–November 2026) and appealed for $518 million to support early detection, prevention, and containment in affected countries. Led by the WHO and Africa CDC, with partners including UNICEF, UNHCR, WFP, IFRC, and FIND, the plan emphasizes a “one plan, one budget, one team” approach under the leadership of affected countries. However, only $315.8 million has been pledged so far—below the target needed for a unified, coordinated effort.

This hybrid strategy—where some African states sign bilateral agreements with the U.S. while coordinating multilaterally—raises questions about long-term effectiveness. The future will tell whether this model can deliver lasting results in the face of such a complex and fast-moving crisis.