Congo Ebola outbreak passes 1,100 cases as US seeks $1.4 billion and WHO readies trials

Outbreak origins and scale

The rare Bundibugyo strain of Ebola, first detected in the gold-mining town of Mongbwalu earlier this year, was officially declared an outbreak on May 15 after the virus had already been circulating for months. Since then, infections have accelerated sharply. As of June 23, Congo's health ministry reported 1,118 confirmed cases and 291 deaths, though other tallies place the toll slightly lower, at 1,048 infections and 277 deaths. Neighbouring Uganda has recorded 20 cases.

Africa CDC Director-General Jean Kaseya warned on June 16 that the outbreak could eclipse the 2014–2016 West Africa epidemic that killed more than 11,000 people. He said tens of thousands of contacts remain untraced.

If we don't stop the outbreak very soon it will be worse than what we had in West Africa and eastern DRC.

Response and funding

On June 24, a Trump administration official told Reuters the White House would ask Congress for more than $1.4 billion to counter the outbreak. The request includes $800 million for humanitarian crisis responses, such as a quarantine centre in Kenya for exposed Americans, supplies, treatment, contact tracing and infection control. Another $500 million would go to global health security measures (disease surveillance, laboratory capacity, cross-border coordination) and $90 million to diplomatic efforts, including evacuation and transport of US citizens with the virus.

The US has already banned non-citizens who have travelled to Congo, Uganda or South Sudan. A doctor who recently returned to France from a humanitarian mission in Congo tested positive, marking France's first confirmed case linked to the outbreak.

Security and community challenges

Health workers face severe risks. The WHO reported seven incidents in which they were targeted for abduction or crime. Deep mistrust of officials and outsiders, fuelled by decades of conflict, has led locals to attack treatment sites and prevent safe burials. On June 15, armed assailants with bladed weapons stormed a clinic near Butembo, North Kivu, and removed a woman and her six-year-old daughter, who had tested positive for Ebola.

We are making a solemn appeal for them to go as soon as possible to an Ebola treatment centre, as their return to the community risks worsening their health and, above all, infecting their relatives.

Ituri province accounts for more than 90% of cases, but the mining-driven population mobility makes contact tracing exceptionally difficult. Congo's daily testing capacity has been ramped up from 30 to roughly 2,000.

International efforts and trials

With no approved vaccines or treatments for Bundibugyo, the WHO announced on June 24 that clinical trials of the monoclonal antibody MBP134 and the antiviral remdesivir would begin the following week in Ituri. The agency thanked the US and Gilead Sciences for providing doses. Advocacy groups had urged Washington just days earlier to make MBP134 available for trials and emergency use in affected countries.

Outlook

WHO Director-General Tedros Adhanom Ghebreyesus acknowledged progress but stressed that the outbreak continues to outpace the response. As the virus spreads to new areas and security incidents persist, the window to prevent a wider catastrophe is narrowing.

Despite the good progress we have made, we still face major challenges, and the outbreak is continuing to outpace the response.