A family’s decision to conduct a burial independently, potentially exposing dozens more to the virus, highlights a significant obstacle in controlling the latest deadly outbreak in the Democratic Republic of Congo (DRC). As of June 3, the outbreak had infected 381 people and claimed 64 lives.
For Marie Roseline Belizaire, Director of WHO Africa Region’s Emergency Preparedness and Response, the challenges often extend beyond the virus itself. Her team frequently encounters difficulties such as engaging with families who believe the disease is caused by witchcraft, persuading traditional healers to collaborate with health teams, or regaining the trust of communities where health workers return daily facing threats.
“We are not trying to override their culture. We are trying to integrate science into their beliefs,” Belizaire stated.
Progress, Not Yet Control
The outbreak, caused by a rare strain of the Bundibugyo Ebola virus with no known cure or vaccine, continues to spread in the eastern DRC, with cases also reported across the border in Uganda.
Belizaire informed UN News from Bunia, Ituri province, that response efforts have made significant gains in recent weeks, particularly in testing capacity. At the start of the outbreak, laboratories could process around 40 tests per day. This capacity has now increased to 800 tests daily, allowing for much faster confirmation or exclusion of suspected cases.
“All the tests we receive, we do them within the same day. The waiting period for results has decreased. We get results within twenty-four, at most 48 hours,” she added. Community alerts are first investigated on the ground, and those matching the outbreak’s case definition are tested and either excluded or confirmed, enabling suspected cases to be processed more rapidly than at the outbreak’s inception.
Closer Tracking
While contact tracing rates have risen from approximately 25% to 45%, this remains significantly below the 90% to 95% coverage needed for effective transmission control.
“We still face many challenges,” Belizaire acknowledged, adding that the regional dimensions of the outbreak remain a concern. Uganda has recorded 15 confirmed and one probable case linked to the outbreak. One Congolese national also traveled via the United Arab Emirates before arriving in Uganda, illustrating how quickly infectious diseases can cross borders.
“Whenever there is an outbreak and there is mobility, it is always a concern,” Belizaire said, though she emphasized that mechanisms like the WHO’s International Health Regulations help countries share information rapidly and coordinate responses.
Trust in Public Health
One of the most complex tasks for WHO teams on the ground is building trust. Many communities in affected areas have endured years of conflict and insecurity. Cultural beliefs and misinformation can also shape how people interpret illness and death.
“The symptoms of the disease are very similar to malaria symptoms in the community,” Belizaire explained. Some families attribute deaths to witchcraft or poisoning rather than infection.
Health workers are therefore focusing on coexistence rather than confrontation.
“We are not stopping them from believing in witchcraft, from believing in other things in their culture. We just want them to also believe in the existence of the disease,” Belizaire said.
Old and New
Traditional healers are also being included as partners, rather than being excluded.
“We don’t stop them from going to traditional healers. We ask the healers, if they see someone with those symptoms, to also refer them to us,” Belizaire said. This approach reflects lessons learned from past Ebola outbreaks, where mistrust could be as dangerous as the virus itself.
WHO Director-General Tedros Adhanom Ghebreyesus, who recently visited the epicenter of the outbreak, warned, “Misinformation is as dangerous as the virus and spreads as fast as the virus.”
Reasons for Hope
Despite the challenges, there are encouraging signs. Seven people have recovered from Ebola, including six health workers. Most received early treatment and intensive supportive care, such as rehydration and symptom management, while their immune systems fought the infection.
“They recovered because they went to the hospital early,” Belizaire said.
‘No Country Faces Ebola Alone’
WHO and the Africa Centres for Disease Control and Prevention (Africa CDC) launched a joint continental preparedness and response plan on Friday to combat the Bundibugyo Ebola outbreak and strengthen preparedness across the continent. The six-month plan aims to mobilize $518 million under a “One Response” approach, bringing together governments, UN agencies, humanitarian partners, and communities. It supports existing national response plans in the DRC and Uganda while strengthening preparedness in neighboring countries at risk of cross-border transmission. The plan focuses on emergency coordination, clinical care, research, surveillance and testing, infection prevention and control, community engagement, and logistics.
“The only way to defeat this outbreak is in close partnership… no country faces Ebola alone,” Tedros said. Africa CDC Director Jean Kaseya emphasized the urgency of the response, stating, “Ebola moves fast. Africa must move faster.”
Candidate Vaccines Under Development
Currently, there is no licensed vaccine or approved treatment for the Bundibugyo strain, but candidate vaccines are in development. However, Belizaire stressed that even a vaccine would not eliminate the need for early diagnosis and treatment. “The key is to go to the health center immediately when you have symptoms,” she said.
A Survivor’s Resolve
One of the encounters that most resonated with Belizaire involved a female health worker who contracted Ebola while caring for a patient but later recovered. The health worker expressed her intention to continue serving others rather than abandon her profession.
“She said she wasn’t going to stop. She said she was born to take care of others and she would continue to do so,” Belizaire recalled. This story reflects the resilience of the health workers and communities confronting the outbreak daily.
