The latest outbreak of Ebola in the Democratic Republic of Congo is growing in magnitude and there seems now to be a threat of spread to neighbouring African countries. This eleventh outbreak of the Ebola virus in the Equateur Province, a north-western region of the Democratic Republic of Congo, was declared this summer on the 1st of June. Just a few weeks later on the 25th of June, the tenth outbreak of Ebola in the northeast of the country was as officially declared to be over, and the WHO has determined that this eleventh outbreak is caused by a different, distinct virus.

The UN has now reported that up until the 11th of September there have been 113 cases and 48 deaths, as a result of this new, eleventh outbreak, and that 12 health zones in the north-western Equateur Province are now affected. Because of the geographic location of the regions affected, the concern is that there will be further spread to neighbouring countries as well as neighbouring regions. WHO Spokesperson Fadéla Chaib told the UN: “The most recently affected area, Bomongo, is the second affected health zone that borders the Republic of Congo, which heightens the chances of this outbreak to spread into another country.”

The Ebola virus was first discovered in 1976 and causes what is known as Ebola virus disease or Ebola haemorrhagic fever. This is a severe disease that usually has around a 50% fatality rate, although rates vary significantly between outbreaks and have been reported to be as low as 25% and as high as 90% depending on a range of factors. Strategies for care and treatment to improve fatality rates have been established but are often difficult to implement in regions like the Equateur province where communities are rural and exceedingly difficult to reach.

Managing this latest outbreak has proven additionally challenging given a variety of factors. Firstly, local health workers have been on strike for around four weeks which has significantly hampered the government’s response. In addition, there have been over 10,000 cases of COVID-19 in the Democratic Republic of Congo to date, and over 260 deaths. Actual case numbers are also likely to be higher given a lack of widespread testing. The UN also reports that inadequate funding from organizations supporting the control and management of Ebola such as the WHO makes the allocation of sufficient resources and manpower to manage these diseases difficult.

The Democratic Republic of Congo is also still one of the poorest countries in the world, the World Bank reports that in 2018, 72% of the population was living in what is classified to be ‘extreme poverty,’ earning less than $1.90 a day. The country has also grappled with conflict since the 1990s, and the BBC estimates that around 5 million lives were lost between 1994 and 2003 and violence continues in some regions, particularly in the east. The tenth outbreak of Ebola in the country was located in the east of the country in an active conflict zone, which significantly contributed to the severity of the outbreak and made management and containment of the disease difficult. In fact, the tenth outbreak was officially the world’s second-largest Ebola outbreak, as indicated by the WHO analysis.

It is hoped that careful and stringent measures for disease control as well as working closely with local communities will allow this next outbreak to be contained, preventing further spread within and outside of the country. However, given the significant challenges that face healthcare workers and supporting NGO’s for controlling this disease, it seems likely that at least some spread will not be unavoidable.