Each time we travel to the Democratic Republic of the Congo (DRC), we first go to listen.
In Bunia, we have met dozens of community representatives: survivors, women, young people, local organisations, health workers and leaders from affected areas. Their message is direct: involve us. We know our communities. We know where families seek care, how information moves and why trust is breaking down. Give us the means to help drive the response. They are right.
Ebola spreads through communities and communities hold the knowledge required to stop it. They can identify illness early, alert health teams, help identify and trace contacts, challenge dangerous rumours and support families through access to treatment and safe, dignified burials. The response always moves faster when communities lead alongside national authorities and health workers.
One hundred days ago, the government of the DRC declared the country’s 17th Ebola outbreak, following confirmation of the Bundibugyo virus. WHO subsequently declared a Public Health Emergency of International Concern, followed by Africa CDC’s declaration of a Public Health Emergency of Continental Security.
The scale of the emergency is immense. As of August 21, the DRC has reported 5,290 confirmed cases and 2,516 deaths across 56 health zones. This is now the second-largest Ebola outbreak ever recorded and it is moving faster than any previous one. It is being fuelled by insecurity caused by decades of armed conflict that have undermined law, order and social services, and displaced more than a million people.
At the centre of the response are the people who show up every day. Health workers care for patients. Laboratory teams identify the virus. Contact tracers follow its path. Community health workers build trust where fear and misinformation have taken hold. Burial teams help families honour their loved ones safely and with dignity.
They are working under extraordinary pressure, often in insecure and hard-to-reach areas. Some have contracted Ebola in the line of duty.
Their service must be met with action: safety, protective equipment, training, sufficient medical supplies, timely payment, psychosocial support and access to rapid diagnosis and high-quality supportive care if they fall ill. The safety of frontline workers is central to stopping transmission.
The response has made progress. Under the leadership of national authorities, Congolese responders, WHO, Africa CDC and partners have expanded surveillance, deployed laboratories, supported treatment centres, reinforced infection prevention and delivered essential supplies.
Neighbouring Uganda has interrupted locally acquired transmission of the virus. Several health zones in northern Ituri and South Kivu provinces in the DRC have also interrupted transmission. These experiences prove that the outbreak can be stopped more quickly when rapid detection, decisive national leadership and close cooperation with communities break the chains of transmission.
But the continued emergency in the rest of Ituri province and five other provinces demands urgently scaled-up action.
To turn the corner, surveillance teams are being expanded and equipped to detect cases early and rapidly identify contacts. Safe clinical care and infection prevention measures are being increased wherever people seek treatment.
More risk communication and community engagement teams are being deployed to reach out to communities to empower them to participate in the response and address barriers to care. More safe and dignified burial teams are working to prevent transmission associated with deaths. Special efforts are being made to reach vulnerable populations and communities in insecure and hard-to-reach areas.
But despite all these efforts, more is needed. We need to scale our response by two to three times current capacities, across all the response pillars.
Health facilities also require urgent protection from infection. As of August 20, 158 health workers have been infected and 45 have died. Every facility in an affected or high-risk area needs trained staff, protective equipment, clean water, sanitation and functioning infection-prevention systems.
National and local teams need predictable funding for surveillance, laboratories, treatment, logistics, infection prevention and community engagement. Frontline workers must be paid on time. Local organisations need direct support to work consistently with communities. Supplies must arrive before stocks run out.
Delayed financing costs lives. Fragmented financing leaves gaps. Ebola exploits both. On the ground, we at WHO and Africa CDC have established tight integration among health and relief organisations working with the government. Donors therefore need to support and enhance that integration, rather than back siloed and disconnected efforts.
Cross-border coordination also must remain strong. People move within and between countries to trade, work, study, seek care and support their families. Borders must serve as bridges for coordinated public health action. This does not require closing borders or imposing blanket travel and trade restrictions. Such measures can disrupt response operations and livelihoods without stopping transmission. The priority is coordinated surveillance, rapid information-sharing and prepared health services along movement routes.
The first 100 days have made the priorities clear.
Find every case. Follow every contact. Break every chain of transmission, protect every health and frontline worker, save lives and ensure that no community is left behind. Bring testing and treatment closer to every affected community. Bolster cross-border coordination. Scale up international support. Turn every pledge into action.
WHO and Africa CDC will continue working with the DRC, neighbouring countries, communities and partners to deliver on these priorities. Our responsibility is to bring the full strength of international and continental cooperation behind the nationally-led response.
Uganda and areas in DRC have shown how the course of the outbreak can be turned, through rapid detection, decisive action and close cooperation with communities. But these measures must be delivered at scale. Success depends on sustained national leadership, continental solidarity and international support. We must rise to this challenge, together.
The views expressed in this article are the authors’ own and do not necessarily reflect Al Jazeera’s editorial stance.
