Aid group says overwhelmed treatment centres, weak surveillance and insecurity are hampering efforts to contain the disease as cases spread across three provinces
By Bunmi Yekini
One month after an Ebola outbreak was declared in eastern Democratic Republic of Congo, medical charity Médecins Sans Frontières (MSF) warned on Monday that the disease is spreading faster than efforts to contain it, raising concerns that critical gaps in testing, surveillance and community engagement could allow the outbreak to worsen.
Health authorities have reported more than 650 confirmed cases and over 130 deaths since the outbreak was declared, but MSF says the true toll is likely much higher because many infections remain undetected.
“One month on, the Ebola disease outbreak is outpacing the response effort,” said Kate White, MSF’s emergency medical coordinator in Congo.
“No one knows the true scale or exactly where the disease is spreading. What we do know is that most treatment centres in Ituri province are overwhelmed, many patients arrive when they are already severely ill, and most were never identified as contacts before seeking care,” she said.
The outbreak has spread across the eastern provinces of Ituri, North Kivu and South Kivu, with Ituri accounting for nearly 95% of reported cases. Across the border in Uganda, authorities have confirmed 19 cases linked to the outbreak.
The response, led by Congo’s Ministry of Health and supported by international partners, has expanded in recent weeks. However, ongoing conflict and insecurity continue to restrict access to some communities, while shortages in surveillance, testing and contact tracing have slowed efforts to identify and isolate cases.
MSF said testing remains one of the weakest points in the response despite the arrival of hundreds of mobile diagnostic kits designed to detect the Bundibugyo strain of the Ebola virus.
“Many communities, especially those affected by insecurity, still have limited access to testing,” White said. “Treatment centres also continue to experience delays in receiving laboratory results. Without faster and more accessible testing, it becomes much harder to detect cases early enough to stop transmission.”
The outbreak is unfolding in a region already burdened by decades of armed conflict, mass displacement and fragile healthcare systems.
In Ituri province, where MSF has worked for many years, aid workers say fear and mistrust remain widespread, with some communities viewing Ebola response teams with suspicion.
“Setting up activities and explaining the disease is not enough to build community trust,” said Frederic Lai Manantsoa, MSF’s emergency coordinator in Congo. “People’s concerns need to be heard, and communities must be involved in shaping the response.”
Health workers also warn that focusing solely on Ebola could leave other urgent health needs unmet.
“Pregnant women still need maternal healthcare, children still need vaccinations, and patients still need treatment for malaria and cholera,” White said. “Maintaining routine healthcare services is also essential for strengthening disease surveillance.”
Although North Kivu and South Kivu have reported fewer confirmed cases, both provinces face significant challenges. In North Kivu, only one laboratory is available to process blood samples, and obtaining results can take several days or even a week due to logistical delays.
MSF said it has deployed teams to remote and insecure areas to support detection and response efforts, but warned that time is running short.
“This outbreak can still be brought under control, but the window for action is narrowing,” Lai Manantsoa said. “Diagnostics, surveillance, access to care and community engagement must be urgently strengthened if the response is to match the scale of the crisis.”