By Kumba Leigh
Health authorities and international partners responding to an Ebola outbreak in the Democratic Republic of Congo say the situation is showing early signs of improvement, but warn that sustained action is needed to fully interrupt transmission.
Officials said new cases have plateaued over the past two weeks, while several health zones have gone more than 42 days without reporting infections. However, response leaders cautioned that the progress remains fragile and that the outbreak cannot be considered under control until transmission is completely interrupted.
“We need to reach 100 percent control,” said Dr. Wessam Mankoula, Regional Director for the North Africa Regional Coordinating Centres at the Africa Centres for Disease Control and Prevention (Africa CDC), stressing that even a single new case could signal ongoing transmission.
Mankoula said the response has expanded across six affected provinces, with 60 health zones currently reporting infections and another 91 under heightened surveillance because of the risk of further spread.
Authorities are combining contact tracing with active case finding, particularly in areas where transmission remains intense. Community health workers are being deployed to identify people with Ebola-like symptoms, trace contacts and strengthen surveillance at community level.
More than 1,100 healthcare workers and frontline responders have reportedly received Ebola vaccines in affected areas, including Goma, Bukavu and Kinshasa. Officials said vaccination is being used alongside surveillance, infection prevention and control, case management and other response measures.
The response is also moving toward clinical trials of vaccines and therapeutics. Officials said one planned trial is expected to recruit about 500 participants, with an initial group of roughly 100 expected to provide early indications of safety and efficacy.
Researchers cautioned, however, that the long-term effectiveness of currently available vaccines against the circulating Ebola strain has not yet been established. Evidence is still being gathered through vaccination campaigns, laboratory investigations and clinical research.
Authorities are also working with vaccine manufacturers and research partners, including an Egyptian pharmaceutical company, to assess additional vaccine options and their potential effectiveness against the current strain.
Despite encouraging epidemiological trends, insecurity remains one of the biggest obstacles to the response.
Officials said some affected health zones are difficult or impossible for response teams to reach because of insecurity, particularly in remote and forested areas. The lack of access is hampering case detection, contact tracing, community engagement and the rapid deployment of response teams.
Health authorities are therefore using population-mobility data and risk mapping to identify areas most likely to report infections in the coming weeks. The aim is to deploy resources before cases emerge rather than waiting until transmission is established.
Border surveillance has also been strengthened, particularly following the declaration of an Ebola outbreak in Uganda. Screening and community-based surveillance are being reinforced at points of entry and in communities near the border to detect imported cases quickly.
Response leaders said community engagement remains central to controlling the outbreak. They acknowledged that mistrust is not solely an Ebola-related issue but is influenced by wider political, security and humanitarian conditions.
In some communities, residents remain suspicious of outsiders and international responders because of past experiences and allegations of misconduct.
Africa CDC officials said the response is increasingly involving local leaders, young people, teachers, faith leaders, community organisations and other trusted figures.
The DRC’s recently adopted national preparedness and response plan also places greater emphasis on community leadership and participation, with the aim of improving trust and ensuring that surveillance and response activities reflect local realities.
Officials said schools also face protection challenges as they reopen, raising concerns about the potential for Ebola transmission.
Africa CDC officials said schools require adequate water, sanitation and hygiene facilities, as well as strong infection-prevention measures.
Remote learning through radio and other technologies has been considered, but access to those technologies remains limited for many families.
At the same time, officials said schools and students could serve as important channels for community surveillance by helping identify health concerns and sharing information between schools, households and communities.
Financial support for the response has increased, with partners reporting approximately US$1.69 billion in pledges, of which slightly more than US$1 billion has been released.
Major contributors include the United States, the World Bank, the European Commission, the Pandemic Fund and CEPI, with some funding supporting medical countermeasures and clinical trials.
Officials acknowledged, however, that it remains difficult to track exactly which implementing partners receive funds and how resources are distributed among different response pillars.
A more comprehensive financial-tracking update is expected to provide greater transparency on how the money is being allocated.
The funding needs have also risen sharply as the outbreak has persisted. Officials said the estimated monthly cost of controlling the outbreak has increased dramatically, illustrating how delays in financing and implementation can make an outbreak increasingly expensive to contain.
Officials repeatedly urged caution over the recent plateau in cases, warning against declaring victory too soon.
The response has previously experienced periods of apparent stabilisation followed by increases in infections. Authorities therefore want to see a sustained decline over several weeks before drawing stronger conclusions about the trajectory of the outbreak.
Among the indicators being monitored are daily case numbers, deaths, the proportion of contacts successfully traced and followed, infection-prevention standards in health facilities, treatment capacity and the geographical spread of transmission.
With continued surveillance, stronger community involvement, improved access to affected areas, adequate funding and successful clinical trials, health authorities believe the outbreak can eventually be brought under control.
Until transmission is completely interrupted, however, response leaders say the effort must continue at full intensity.
