On May 17, 2026, the World Health Organization declared the Ebola outbreak raging in eastern Democratic Republic of the Congo (DRC) and persisting in neighboring Uganda a \”public health emergency of international concern.\” The following day, the Africa CDC echoed this assessment. By June 5, both organizations had launched a six-month joint response plan, accompanied by a call to mobilize $518 million. Driven by the rare Bundibugyo strain—with no approved vaccine or treatment—this 17th epidemic is striking a region already devastated by conflict and destabilized by shifting American aid priorities. How will this outbreak deepen the region’s security and humanitarian vulnerabilities, complicating access to care for local populations? What risks does it pose to Central Africa’s fragile regional stability? And what does the resurgence of Ebola reveal about the global community’s capacity to handle major health crises?

In a context of armed conflict, political instability, and profound economic and social fragility—especially in eastern DRC—how is the Ebola outbreak exacerbating internal instability in affected areas and complicating efforts to establish healthcare systems that ensure population access to essential services?

This new Ebola wave is striking a region already grappling with multiple, deep-rooted crises. While DRC has seen 17 outbreaks since 1976 (when the virus was first identified in Yambuku), this is the first caused by the Bundibugyo strain. Currently, although experimental treatments are under evaluation, no licensed vaccine or cure exists for this variant, which can kill up to half of those infected. The provinces of North Kivu, South Kivu, and Ituri are particularly vulnerable to epidemic spread. Last year, the UN reported one of the most severe cholera outbreaks in 25 years. Since 2020, Mpox has also surged, with especially rapid transmission since September 2023. Ituri, the current epicenter, ranks among DRC’s most troubled provinces: poorly connected by road, plagued by armed group violence, and hosting nearly a million internally displaced persons in overcrowded camps. The health crisis is thus compounding pre-existing humanitarian and security emergencies. This stems from endemic instability and conflict, intensifying since the M23 offensive in 2023. Local populations endure daily instability, frequent displacement, and cramped conditions in overcrowded camps—conditions that facilitate the emergence and rapid spread of pathogens. The prolonged crisis in eastern DRC has eroded social fabric and health infrastructure, leaving these systems unable to meet basic needs. Structural dependence on Western aid has become the norm. The systemic violence driven by years of conflict in eastern DRC has deprioritized health, particularly targeting women and children. Into this precarious landscape descends a major epidemic, deepening the crisis amid collapsing security.

DRC’s Health Minister, Samuel-Roger Kamba Mulamba, declared Ebola \”an absolute emergency.\” As of May 31, 2026, national data reported 282 confirmed cases, including 42 deaths—with 19 new positive tests recorded that day. By June 1, WHO data indicated 349 suspected cases under surveillance, pending results, primarily in Ituri Province, especially in Bunia, Rwampara, and Mongbwalu health zones. Bunia’s main hospital quickly became overwhelmed, forcing the establishment of peripheral and rural care centers. Yet, the recovery of four infected healthcare workers offered a glimmer of hope. By June 5, pressure on the healthcare system had intensified further: local reports noted six health centers in Bunia temporarily closed for disinfection, reducing the city’s capacity and alarming pregnant women seeking care. Some patients with other conditions received minimal treatment before being redirected or sent home. Facing Ebola’s spread, health services scrambled to adapt, further restricting access to routine care.

The crux of the problem lies in the lack of coordinated response from Kinshasa. In areas partially controlled by the M23—a Rwandan-backed proxy—armed groups proliferate, driven by extractive motives. This reflects a recurring challenge: maintaining national unity across a country of nearly 100 million people and ensuring functional basic health and social services. Cases have also been reported in M23-controlled zones, where Kinshasa has not coordinated the health response with occupying armed groups, leaving the risk of epidemic spread intact. While negotiations may be underway, they have yet to establish the necessary sanitary coordination for an effective regional response. Territorial fragmentation in the east prevents a unified effort. Two Ebola treatment centers are reportedly being set up in Goma, the rebel-held capital, with limited capacity. The armed group claims to have recognized the severity of the situation and implemented contingency plans. The epidemic is thus advancing in rebel-controlled areas. Who governs public health when the state no longer controls the territory?

Community resistance also harks back to earlier outbreaks, such as 2018–2020. Acceptance of the response is far from guaranteed. In Rwampara, a protest against containment measures escalated into the incineration of a suspected case’s body. Distrust and hostility toward medical teams are now key variables in regional stability. Such resistance is rooted in cultural norms. The refusal to return Ebola victims’ bodies to their families is perceived as an unbearable symbolic violence. In eastern DRC’s societies, funeral rites—including washing and physical contact with the deceased—are spiritual imperatives. Yet these very practices are major transmission vectors for Ebola.

Resentment in Ituri and Kivu stems from structural suspicion, forged over decades of violence, state abandonment, and perceived predatory external interventions. The health response is easily framed as a new form of imposed control, fueling rumors and conspiracy theories.

Can the Ebola outbreak reshape DRC’s relations with its neighbors? How might this crisis further destabilize Central Africa?

This outbreak occurs amid heightened tensions and extractive competition between DRC and its eastern neighbors—particularly Rwanda, but also Uganda, with whom relations are often strained. When an epidemic spreads in a state where part of the territory lies beyond central control—hampering a unified national response—the solution must be transregional, if not continental. Africa CDC, the AU’s operational arm for epidemic surveillance, has warned that up to ten vulnerable countries could be affected, including South Sudan, Rwanda, Kenya, Tanzania, Ethiopia, Republic of the Congo, Burundi, Angola, Central African Republic, and Zambia—on top of DRC and Uganda, which already report seven cases. Yet, response capacities vary widely. Kenya and Ethiopia boast relatively robust health systems and surveillance networks; Kenya has already begun setting up dedicated quarantine facilities. Meanwhile, Central African Republic remains one of the continent’s most fragile states, heavily dependent on external aid. South Sudan faces internal turmoil compounded by spillover from Sudan’s war.

Epidemics, by definition, ignore artificial borders. They strike living beings regardless of status—though the poor are often most vulnerable. With borders highly porous, risks escalate. According to WHO, imported cases from Ituri have reached North Kivu and Kampala, Uganda, where two travelers returning from DRC tested positive—one of whom died. A case was also reported in South Kivu; the M23 spokesperson claimed the patient had traveled from Kisangani in Tshopo Province. This has prompted border closures and diplomatic tensions, with potentially severe economic consequences. Facing the threat, Uganda suspended flights and passenger transport with DRC on May 21, 2026. Rwanda closed its border with Goma. These unilateral measures have collided with already strained DRC relations with its neighbors.

The conflict in eastern DRC further fuels the epidemic’s spread. As the virus advances in areas like Goma—seized in January 2025—and Bukavu—taken in February 2025—the risk of regional conflagration grows. Health has become an additional battleground in the Kinshasa-Kigali rivalry, with M23 de facto assuming a public health role in the territories it controls. In response to this cross-border threat, the East African Community has called on member states to activate laboratory networks and strengthen border surveillance. An extraordinary ministerial meeting of health officials was held on June 1–2, 2026. Following the meeting, ministers pledged to harmonize sanitary controls at entry points without closing borders, establish a regional technical working group to coordinate surveillance, and bolster diagnostic capacities and healthcare worker protection.

Do health crises like Ebola expose the limits of the international humanitarian aid system—especially after USAID funding cuts? What role do international bodies like WHO and NGOs play in managing this crisis?

This epidemic unfolds as the aid architecture is weakened by shifts in U.S. policy. Cuts to health aid—including withdrawal from WHO, dissolution of USAID, reductions at CDC, and decreased support to DRC and Uganda—have undermined systems critical for outbreak response. Experts suggest these cuts may have delayed detection of the epidemic. DRC has since signed a bilateral deal with the U.S. under an \”America First\” framework, transferring some health funding to the State Department. A $900 million pledge over five years comes with extractive conditionalities, marking a shift from multilateralism to transactional bilateralism. Yet, this realignment remains poorly coordinated. With WHO sidelined, the U.S. response has arrived late and outside UN frameworks. Humanitarian principles have been deprioritized; protection of Americans is the stated goal. The State Department has mobilized $23 million in emergency funds and pledged up to 50 clinics, but has not indicated support for a WHO-led response—a sharp departure from past practices. With the U.S. no longer funding WHO’s Contingency Fund for Emergencies (CFE), the fund’s operational capacity is weakened, and other donors have not filled the gap.

In this environment, response must be driven by national institutions in affected countries, supported by WHO and NGOs—but only as the virus spreads. WHO, mandated to lead, 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 a risk assessment to support coordination, particularly with Africa CDC. On the ground, medical NGOs like Doctors Without Borders and ALIMA (The Alliance for International Medical Action) have deployed care teams. The DRC Red Cross mobilizes volunteers for dignified, safe burials; risk communication; and community engagement. Yet, the humanitarian response remains far too limited to curb the epidemic.

At the continental level, Africa CDC and WHO launched a six-month joint response plan on June 5, 2026—running through November 2026—with a call for $518 million to support African nations in early detection, prevention, and containment. Championed by WHO Director-General Tedros Adhanom Ghebreyesus under the principle of \”one plan, one budget, one team,\” the initiative aims to deliver a unified, country-led response. It relies on WHO, Africa CDC, and partners such as UNICEF, UNHCR, WFP, IFRC, FIND, and other UN agencies, African governments, and international donors. To date, only $315.8 million has been pledged—well short of the coordinated plan’s needs.

While this coordinated plan signals early continental action, it also reveals a hybrid strategy among some African states. Some sign bilateral agreements—especially with the U.S.—tying health aid to conditionalities that support their systems and combat infectious diseases. Yet, they also demonstrate capacity for coordinated crisis response through multilateral mechanisms. Whether this dual approach endures remains to be seen.