On 17 may 2026, the world health organization declared the ebola outbreak in eastern democratic republic of the Congo and Uganda a public health emergency of international concern, with the africa cdc following suit the next day. On 5 june, both institutions launched a joint six-month response plan and appealed for $518 million. Caused by the rare bundibugyo strain, which has no approved vaccine or treatment, this 17th epidemic strikes a region ravaged by conflict and destabilized by the reshaping of u.s. aid. The crisis unfolds amid profound instability driven by numerous armed groups and persistent violence. How might this outbreak worsen security and humanitarian vulnerabilities in eastern drc and complicate access to care? What risks does it pose to regional balances in central africa? And what does ebola’s resurgence reveal about the international community’s current capacity to tackle major health crises?

In a context of armed conflict, political instability, and deep economic and social fragility, especially in eastern drc, how is the ebola epidemic affecting internal stability in affected areas and complicating health measures that ensure populations’ access to care?

This latest ebola wave arrives in a zone of multiple and structural crises. Primarily affecting the democratic republic of the Congo, it marks the 17th epidemic since the virus was first identified in yambuku in 1976, this time caused by the ebola bundibugyo strain. Currently, even though treatments are being tested, there is no approved vaccine or treatment for this strain, which can kill one in two infected individuals. The eastern regions of drc—north and south kivu, and ituri—are particularly vulnerable to epidemic spread. Last year, the united nations reported one of the worst cholera outbreaks in 25 years. Furthermore, since 2020, mpox has been spreading massively, especially since september 2023. Ituri, the epicentre of the ebola epidemic, is one of drc’s most troubled provinces, with poor road access, plagued by armed group violence, and where nearly a million displaced people crowd into camps. The health crisis thus overlaps a pre-existing humanitarian and security crisis. This stems from endemic instability and conflict, particularly intense since the m23 offensive in 2023. Local populations live in daily insecurity, marked by regular internal displacement and overcrowded camps. Combined, these conditions favour the resurgence and rapid spread of pathogens. Moreover, the complex crisis in eastern drc, with only rare calm periods, has severely weakened social fabric and health services, which currently cannot meet the vital needs of local populations, creating a structural dependence on foreign aid. The systemic violence from waves of conflict in drc’s east has deprioritised health and normalised violence, especially against women and children. In this precarious context, a large-scale epidemic superimposes and aggravates the crisis amid a security collapse.

Congo’s health minister, samuel-roger kamba mulamba, stated that “ebola is an absolute emergency.” According to national data, as of 31 may 2026, there were 282 confirmed cases including 42 deaths, after 19 new positive tests were recorded. The who indicated on 1 june that 349 suspected cases were under surveillance awaiting results, mainly in ituri province, specifically in the health zones of bunia, rwampara and mongbwalu. Bunia hospital quickly became overwhelmed, prompting the setup of reception centres on the outskirts and in rural areas. However, the recovery of four infected health workers offers a glimmer of hope. By 5 june 2026, pressure on the healthcare system had intensified further; according to local sources, about six health centres in bunia were temporarily closed for disinfection. This measure reduces the city’s reception capacity and particularly worries pregnant women coming for consultations, as well as patients with other ailments who received only minimal care before being redirected or sent home. Additionally, faced with ebola’s spread, health services forced to adapt rapidly have become disorganised, also limiting access to routine care.

What is truly problematic is the lack of coordinated response from Kinshasa in an area partially occupied by the rwandan proxy m23, where many armed groups proliferate for extractive reasons. This highlights the recurrent issue of controlling national unity in a country of nearly 100 million inhabitants and the effectiveness of basic social and health services. In m23-controlled areas, several cases have also been counted. Since the congolese government has not coordinated the health response with armed groups illegally occupying territory, the risk of epidemic spread remains. While negotiations may be underway according to some information, they have not yet established the necessary health coordination framework for an effective response in the area. Territorial fragmentation in the east prevents a unified response. Two ebola treatment centres are reportedly being set up in goma, the m23/afc-held capital, with limited capacity, and the armed group claims to have taken the measure of the situation and implemented health contingency plans. Thus, the epidemic is also progressing in rebel-held areas. Who manages public health when the state no longer has a territorial monopoly?

Added to this are community resistances, as during the 2018-2020 episodes; acceptance of the response is far from guaranteed. An anti-response protest in rwampara escalated to the incineration of a suspected case’s body. Mistrust and hostility towards medical teams are significant stability variables. Community resistance is rooted in cultural logic. Health authorities’ refusal to return bodies of ebola victims to families is experienced as unbearable symbolic violence. In eastern drc societies, funeral rituals—particularly cleansing and physical contact with the deceased—are spiritual imperatives. Yet these exact practices are among the main vectors of ebola virus transmission.

The resentment of ituri and kivu populations stems from structural suspicion, inherited from decades of violence, state abandonment, and perceived predatory external interventions. Thus, the health response is easily equated with a new form of imposed control, fuelling rumours and conspiracy theories.

Could the ebola epidemic have lasting consequences on drc’s relations with its neighbours? To what extent might this crisis destabilise regional stability in central africa?

We are in a situation of high tension and extractivist competition between drc and its eastern neighbours, notably Rwanda, but not only, with sometimes strained relations with Uganda. When such an epidemic spreads in a state where part of the territory escapes central control, making a coordinated national response difficult, the response must be transregional, even continental. Currently, the africa cdc, the operational health arm of the au for identifying epidemiological hotspots, indicated that about ten vulnerable countries could be affected: south Sudan, Rwanda, Kenya, Tanzania, Ethiopia, Congo-Brazzaville, Burundi, Angola, central african republic, and Zambia, in addition to drc and Uganda, already hit with seven cases. However, response capacity varies greatly between countries. Kenya and Ethiopia have relatively stronger health and surveillance systems—Kenya has already started setting up dedicated quarantine structures—while the central african republic remains one of the continent’s most fragile states, heavily dependent on external aid. South Sudan combines a serious internal crisis with repercussions from the war in neighbouring Sudan.

By definition, an epidemic does not respect artificial borders; it affects living beings regardless of status. Some are more vulnerable, especially the poorest, particularly where borders are extremely porous. According to the who, imported cases from ituri reached north kivu and kampala, Uganda, where two travellers returning from drc tested positive, one of whom died. A case was also reported in south kivu, according to the m23 spokesperson; the patient came from kisangani in tshopo province. This dynamic leads to border closures and diplomatic tensions, not to mention major economic consequences. Faced with the risk, Uganda suspended flights and passenger transport with drc on 21 may 2026. Rwanda closed its border with goma. These unilateral measures affect drc’s already extremely tense bilateral relations.

Compounding this is the entanglement with the eastern conflict, which directly contributes to the epidemic’s spread. The outbreak is progressing in areas like goma, taken in late january 2025, and bukavu, which fell in february 2025, raising fears of regional conflagration. Health thus becomes an additional battleground in the Kinshasa-kigali rivalry, with m23 imposing itself as a de facto public health actor in territories it controls. Faced with this cross-border risk, the east african community called on its member states to activate laboratory networks and strengthen border surveillance, and held an extraordinary ministerial meeting of health ministers on 1-2 june 2026. According to official sources, after the meeting, ministers committed to harmonising health checks at entry points without closing borders, creating a regional technical working group to coordinate surveillance, and strengthening diagnostic capacities and health worker protection.

Do health crises like ebola reveal the current limits of the international humanitarian system, especially after the cuts to usaid funding? What role do international organisations like the who and ngos play in managing this crisis?

Added to the regional instability, this epidemic occurs in a context where the response may be weakened upstream by the restructuring of u.s. aid architecture. The cuts, specifically to health aid, were “quadripartite” starting january 2025: withdrawal from the who, dissolution of usaid, reductions at the cdc, and decreased health aid to drc and Uganda, weakening vital systems to respond to such outbreaks. Some experts even believe these cuts may have delayed detection of the epidemic.

Today, drc has concluded a bilateral agreement with the united states (as have Rwanda and Uganda) under an “america first” logic. Part of health funding has been transferred to the state department via this new agreement, promising $900 million over five years, in a dynamic of extractive conditionality and a shift from multilateralism to transactional bilateralism between the us and drc. More precisely, this restructuring, driven by the new u.s. position, is not fully under control, as the u.s. response to this ebola resurgence has been late and outside the un framework. Additionally, there is a deprioritisation of humanitarian and solidarity principles in approaching the response. The primary goal is to protect americans. The state department has mobilised $23 million in emergency funds and announced funding for up to 50 clinics, but due to the withdrawal from the who, it has not indicated a desire to support a who-led response, a break from past practices. With the us withdrawn from the who, the organisation’s contingency fund for emergencies is operationally fragile, as other donors have not filled the gap left by the american pullout.

In this context, the response must be activated by national institutions of the most affected countries, with support from the who and ngos, given the virus’s spread, even as their resources have been reduced by the american withdrawal and they operate in a hostile security environment. The who, as part of its mandate, declared the epidemic a public health emergency of international concern and coordinates the response; the european centre for disease prevention and control (ecdc) published a risk assessment to support coordination, particularly with africa cdc. On the ground, medical ngos such as doctors without borders and alima (the alliance for international medical action) have deployed care teams. Finally, the red cross of drc mobilises its volunteers for dignified and safe burials, risk communication and community engagement. Nevertheless, the humanitarian response remains far too limited to contain the epidemic.

On the continental response side, africa cdc and the who announced on 5 june 2026 a joint six-month response plan covering june to november 2026, and launched an appeal to mobilise $518 million to support african countries in early detection, prevention and control. Articulated around the operational principle “one plan, one budget, one team” advocated by who director-general tedros adhanom ghebreyesus, this plan aims for a coordinated response under the leadership of affected countries. It is a funding appeal relying on who, africa cdc and their partners (unicef, unhcr, wfp, ifrc, find), un agencies, african governments and international donors. So far, only $315.8 million has been pledged, falling short of even the goal of having a single coordinated plan.

Furthermore, while this co-coordinated plan shows initial response elements being managed at the continental level, it also structurally highlights a hybrid strategy among several african states. On one hand, countries sign bilateral agreements, especially with the united states, under donor-conditioned aid to support their health systems and fight infectious diseases; on the other, they demonstrate their ability to coordinate during a major crisis through multilateral mechanisms. Time will tell whether this articulation will bear fruit over the long term.