The World Health Organisation (WHO) has reaffirmed that the Ebola outbreak in the Democratic Republic of the Congo (DRC) remains a public health emergency of international concern (PHEIC), as the epidemic surpasses 5,021 confirmed cases and 2,378 deaths across 55 health zones in six provinces. The outbreak, caused by the Bundibugyo ebolavirus, is now the second-largest Ebola epidemic ever recorded and is spreading faster than all previous outbreaks, WHO chief Tedros Adhanom Ghebreyesus warned at an emergency committee meeting.

Scale of the Crisis

As of Sunday, 19 August, the case fatality rate stood at 47.4 per cent, according to the latest WHO tally. The Africa Centers for Disease Control and Prevention (Africa CDC) stated on Monday that the outbreak is currently killing roughly one person every 30 minutes and risks becoming the deadliest Ebola epidemic ever recorded globally if its trajectory is not urgently reversed.

The epidemic has already surpassed the 2018-2020 Ebola outbreak in eastern DRC, previously the country's deadliest. During the first 95 days of reporting, the seven-day moving average rose to more than 90 confirmed cases a day — substantially higher than at the same stage of both the 2014-2016 West Africa epidemic and the DRC's 2018-2020 outbreak, according to a WHO situation report.

Why the Virus Is Spreading So Fast

The eastern province of Ituri remains the epicentre, accounting for 84.8 per cent of cumulative cases, but infections are accelerating in neighbouring provinces. DRC Health Minister Roger Kamba said the outbreak had spread unusually fast despite a 'very rapid and very vigorous' response, attributing the speed partly to Bundibugyo's less distinctive early symptoms, which allow infected individuals to remain in their communities longer before seeking care.

WHO Director-General Tedros Adhanom Ghebreyesus cautioned that population movement 'along roads, rivers and mining routes,' combined with insecurity and displacement, was fuelling the epidemic. The WHO warned that high mortality, deaths outside treatment facilities, a growing surveillance workload, and uneven response capacity indicate that current containment measures are insufficient to interrupt transmission.

'We must be frank: the epidemic is far from being under control,' Tedros said. 'It had a big head start, and we are still playing catch-up.'

Experimental Vaccines and Treatments Under Trial

With no approved vaccine or treatment specifically targeting the Bundibugyo virus, authorities are turning to experimental and repurposed medical tools. Two vaccines designed specifically against Bundibugyo virus have entered human trials, Tedros confirmed. A WHO-sponsored PARTNERS treatment trial is evaluating antiviral remdesivir, the experimental monoclonal antibody MBP134, and their combination. Preliminary results could be available in 'about three to four weeks,' according to Health Minister Kamba.

Researchers are also studying oral antiviral obeldesivir as post-exposure prophylaxis. Separately, authorities are examining whether Ervebo — the licensed vaccine against Zaire ebolavirus — could offer cross-protection against Bundibugyo virus. Kamba said observations among vaccinated health workers and laboratory studies had suggested possible cross-protection, while stressing that this remains unconfirmed. The Africa CDC on Monday backed a DRC request for controlled expanded use of Ervebo among high-risk frontline workers, alongside a Phase III trial to assess its efficacy against Bundibugyo virus.

Cross-Border Spread Risk Remains Elevated

Tshopo province and its capital Kisangani are of particular concern due to their road, river, and air links, which could facilitate longer-distance transmission toward Kinshasa, the national capital. Kamba confirmed that no cases from the current outbreak have been confirmed in Kinshasa. Authorities have stepped up screening along river routes to the capital.

The WHO has identified Uganda, South Sudan, and the Central African Republic as being at particularly high risk of imported cases, given their proximity to affected areas and frequent cross-border population movements. The risk of further spread within the DRC is assessed as 'very high.'

What Comes Next

The WHO's emergency committee meeting signals that the international response is being intensified, but health authorities acknowledge they are still catching up to the outbreak's pace. Preliminary results from the PARTNERS treatment trial are expected within weeks, which could determine whether existing antivirals can meaningfully reduce the fatality rate. The trajectory of the epidemic over the coming month will be critical in determining whether the worst-case scenario — the deadliest Ebola outbreak in history — can be averted.