The Ebola outbreak in the Democratic Republic of the Congo has reached divergent trajectories, with transmission declining in Ituri province while surging sharply in North Kivu, according to the World Health Organization.
Congo Ebola Outbreak Slows in Ituri But Surges in North Kivu
While some government officials noted signs of slowing nationwide transmission, United Nations and WHO officials urged caution, describing the epidemic as uncontrolled and heterogeneous. Jean-Jacques Muyembe, head of the National Institute of Biomedical Research, stated that the peak is behind them in Ituri, which accounts for nearly 80 percent of confirmed cases. In contrast, North Kivu has recorded a sharp and sustained increase, reaching its highest incidence since the outbreak began and accounting for about one-third of new cases and deaths nationwide.
As of mid-September, government figures reported a cumulative total of 7,258 confirmed cases and 3,510 deaths across 62 health zones in seven provinces, resulting in a crude case-fatality ratio of approximately 48%. The outbreak, driven by the Bundibugyo virus strain, is the largest in the country’s history and second only to the 2014-2016 West African epidemic. Research published in the Morbidity and Mortality Weekly Report indicated that the first 100 days in the DRC expanded faster than any previously documented Ebola outbreak, driven by factors such as ongoing armed conflict, limited infrastructure, attacks on health workers, and community mistrust.
Vaccines and Clinical Trials
With no approved vaccine or specific therapy yet available for the Bundibugyo ebolavirus strain, response efforts rely heavily on experimental treatments and observational studies. More than 3,000 healthcare and frontline workers have been vaccinated with Merck’s Ervebo under research protocols, though its effectiveness against the Bundibugyo strain remains unknown, according to the World Health Organization.
An observational study assessing Ervebo is expected to begin shortly, followed by a mid-to-late-stage trial led by the National Institute of Biomedical Research and partners to evaluate efficacy. That trial will assess Ervebo first, followed by other vaccine candidates targeting Bundibugyo Ebola from Moderna and the University of Oxford. Two new vaccines against the Bundibugyo virus are also in safety trials in Britain and Canada, with the WHO aiming to start clinical efficacy trials in the DRC in October or November. Additionally, trials are underway for treatments including the antiviral drug obeldesivir and monoclonal antibody therapies.
International Response and Challenges
WHO Director-General Tedros Adhanom Ghebreyesus emphasized that the response must be scaled up, noting that tracking chains of transmission remains a major challenge. Many deaths have occurred among people not on known contact lists, and unsafe burials continue to fuel transmission.
The Strait Times reported that the international community has been urged to increase funding for the Congolese government-led response plan, which is seeking $1.3 billion. While the WHO has shipped 320 tons of supplies and expanded testing capacity to 3,000 tests per day, officials warned that sustained high population mobility across borders continues to pose a risk of regional spread.