The Ebola outbreak in the Democratic Republic of Congo is moving deeper into remote rural communities, even as infections ease in several areas that were hit hardest at the start. Armed violence, meanwhile, is putting health workers and containment efforts at growing risk.
Six months after the outbreak began, case numbers have declined in Bunia and nearby parts of Ituri province. Some treatment centres are operating at roughly half capacity, a sign of progress in parts of the country, U.N. emergency relief coordinator Chikwe Ihekweazu said at a briefing in Geneva.
That improvement, however, is uneven. Infections are continuing or increasing in isolated communities where damaged infrastructure, difficult terrain and insecurity prevent health teams from reaching patients quickly or interrupting transmission.
“Progress is fragile and not enough,” Ihekweazu said, cautioning that gains in individual locations should not be mistaken for control of the wider outbreak.
The World Health Organization (WHO) has urged a faster response in remote areas, where delays in detecting infections and setting up treatment centres could give the virus more time to spread.
Security has emerged as the most serious barrier.
Julien Harneis, the U.N. Ebola response coordinator with the Office for the Coordination of Humanitarian Affairs (OCHA) in Bunia, said armed attacks had become an immediate danger to civilians as well as to medical personnel working against the outbreak.
In recent days, “more people were killed by ADF violence than by Ebola,” Harneis said in Geneva.
He urged authorities and international partners to treat the threat from the Allied Democratic Forces (ADF), an armed group linked to Islamic State, with greater urgency and to take stronger measures to halt its attacks.
The danger became clear in early November, when ADF fighters killed 66 civilians in eastern Congo, including three health workers. Three health facilities were also looted and set on fire, according to Africa CDC, the African Union’s public health agency.
The attack interrupted Ebola operations in an area where medical teams were already struggling to conduct surveillance and trace people who had been in contact with infected patients.
Patients, including people suspected of having Ebola and those with confirmed infections, fled the facilities. More than 1,000 contacts were reportedly lost to follow-up, while several confirmed cases could not immediately be located. The gaps raised fears that infections would go undetected and spread to additional communities.
The destruction of health centres has also cut vulnerable populations off from essential care, while making it harder for responders to create the secure conditions needed to contain the virus.
A major outbreak with shifting hotspots
The current outbreak, caused by the Bundibugyo virus (BDBV), was declared on May 15, 2026. It is the largest Ebola outbreak in the DRC’s history and the second-largest ever recorded worldwide.
By mid-November, authorities had reported more than 11,000 confirmed cases and over 5,400 deaths across eight provinces and approximately 68 health zones. The reported case fatality rate was nearing 49%, although thousands of people had recovered.
Since the outbreak began, health authorities have expanded treatment capacity, diagnostic services and community outreach. The number of laboratories able to test for the virus has also risen substantially, enabling health teams to identify infections more rapidly.
Yet the disease’s expanding geographic footprint has made containment more difficult.
Ituri continues to be the worst-affected province, but the pattern of transmission has shifted in recent weeks, with North Kivu recording notable increases. Cases have fallen in earlier hotspots including Bunia, Mongbwalu, Rwampara and Nizi, while other locations continue to report sustained transmission.
WHO officials have also recorded hundreds of new infections each week, underscoring how difficult it remains to contain the outbreak despite progress in certain areas.
Eastern DRC has experienced years of conflict involving several armed groups. The violence has displaced communities, damaged infrastructure and severely restricted access to basic services.
The ADF has operated across the region for years, attacking civilians, security forces and health facilities. Its campaign has created an increasingly hazardous operating environment for humanitarian workers, especially teams trying to reach isolated populations.
For Ebola responders, insecurity can force operations to stop, delay testing, disrupt contact tracing and prevent patients from receiving urgent care. Attacks on clinics also erode public confidence and make it more difficult to provide medical services consistently.
Security and community access critical to containment
The response has grown significantly, with authorities expanding diagnostic testing, treatment beds and the number of medical personnel available. Clinical trials for potential vaccines and treatments aimed at the Bundibugyo virus have also started.
Those efforts, however, rely on health workers being able to reach affected communities safely.
In areas controlled or threatened by armed groups, teams face obstacles in moving supplies, opening treatment centres and monitoring people who may have been exposed. When health facilities are destroyed, responders have fewer places from which to act as new infections emerge.
WHO and its partners have repeatedly emphasized that medical expansion alone will not end the outbreak. Community engagement, dependable surveillance and access to remote populations are just as vital.
The crisis has also generated concern beyond the DRC, as neighbouring countries have reported imported or secondary infections during the broader regional health emergency. Continued surveillance and cooperation across borders remain crucial to limiting further spread.
Humanitarian officials now face a dual challenge: stopping a deadly virus while protecting the people working to contain it.
Falling infection numbers in some of the original hotspots show that containment measures can succeed. But as Ebola reaches communities where medical support is difficult to provide, renewed violence threatens to undo those gains.
