Congo: Six months after an Ebola outbreak was declared in the Democratic Republic of Congo, the disease remains out of control, with containment efforts struggling amid rising infections, funding concerns and ongoing conflict.
More than 11,000 cases have been recorded, and nearly half of those infected have died, according to government data. The outbreak is the deadliest among the country's 17 recorded Ebola outbreaks and threatens to surpass the West African epidemic of 2014-2016, which claimed approximately 11,000 lives.
Basic containment measures, including contact tracing and patient isolation, remain inadequate. Health experts say there is little prospect of bringing the outbreak under control within the next year.
By the time the outbreak was officially declared in mid-May, 43 deaths had already been recorded, indicating that the virus may have been circulating undetected for an extended period. It has since spread to eight of Congo's 26 provinces, with new infection hotspots continuing to emerge and placing additional pressure on an already overstretched healthcare system.
Funding and management concernsCommunity transmission remains widespread. According to the Africa Centres for Disease Control and Prevention (Africa CDC), 80 per cent of new cases are being detected outside the health surveillance system, suggesting that most infections are going untracked.
Around one-third of deaths occur at home or elsewhere in communities, where burials and other procedures are frequently carried out without specialist supervision, increasing the risk of further transmission.
The response has also been affected by repeated strikes by healthcare workers over months of unpaid salaries. In some instances, patients with confirmed infections have been left without treatment.
Concerns have also emerged over the management of international assistance. Last month, the Africa CDC raised questions about more than USD 700 million in Ebola response funding that remains unaccounted for.
Humanitarian organisation Doctors Without Borders (MSF) said there continued to be a troubling gap between the substantial resources mobilised for the response and the support actually reaching patients, frontline workers and affected communities.
Children face disproportionately high death ratesChildren remain among the most vulnerable groups, particularly those suffering from pre-existing conditions such as malnutrition.
According to UNICEF, children accounted for 35 per cent of recorded Ebola deaths through November 4. Children under five represented 21 per cent of all deaths, while nearly 72 per cent of infected children in this age group died.
Limited access to specialised treatment has contributed to the high mortality rate among children.
Conflict and attacks undermine containment effortsEfforts to contain the outbreak are further complicated by armed conflict and attacks on healthcare workers and medical facilities.
Health workers have faced repeated attacks, with some killed while carrying out prevention and containment activities. The response has also encountered challenges in communities where public health measures conflict with established social and cultural practices.
The outbreak is concentrated in eastern Congo, particularly in Ituri and North Kivu provinces, where communities are already facing a severe humanitarian crisis.
Fighting between government forces and hundreds of armed groups, including the Rwanda-backed M23 rebels, has disrupted healthcare services and humanitarian operations. The Islamic State-affiliated Allied Democratic Forces have also continued attacks against civilians.
The spread of Ebola beyond Congo has raised concerns about a wider regional health emergency. Nigeria, Kenya and Uganda have also confirmed cases, making this the most geographically widespread Ebola outbreak on record.