分类： health

MAIDUGURI, Nigeria – A rapidly spreading cholera outbreak that emerged in early May in northeastern Nigeria’s Borno State has already claimed 74 lives and sickened more than 7,000 people, international medical humanitarian organization Doctors Without Borders (MSF, by its French acronym) confirmed in a briefing Tuesday.

The public health crisis has been recorded across 14 of the state’s 27 local government areas, hitting communities already grappling with health systems gutted by nearly 20 years of violent insurgency led by extremist group Boko Haram. Decades of conflict have left basic infrastructure in the region decimated, leaving populations uniquely vulnerable to preventable waterborne diseases like cholera.

Cholera is a recurring endemic and seasonal health threat across Nigeria, a nation where systemic gaps in water access persist. Official 2020 Nigerian government data shows just 14% of the country’s 200+ million residents have access to reliably managed safe drinking water services. These gaps are far more severe in Borno State, both in the overcrowded state capital Maiduguri and in isolated rural communities. Many remote settlements sit far outside the effective reach of public health authorities, leaving them with virtually no functional sanitation or hygiene infrastructure.

MSF reports that it has already treated 7,439 cholera patients at its treatment facilities in the region, averaging 185 new patient admissions every day since the outbreak began. Last Friday alone, the organization recorded 500 new patients – the highest single-day caseload recorded since the outbreak started.

Jessie Kurnurkar, MSF project coordinator in Borno, told reporters multiple overlapping factors are fueling the outbreak’s rapid spread. “Open defecation is making it worse also, and there are fewer aid partners operating on the ground,” Kurnurkar explained. “By the time we receive word of cases in remote communities, local transmission has already occurred, and it becomes extremely difficult to contain the response – the spread has already gained too much traction.”

The Associated Press spoke with patients receiving care at MSF’s Maiduguri treatment center, who shared harrowing accounts of the disease’s rapid onset. Aisha Ibrahim, one of the cholera patients currently admitted to the facility, said she had experienced nonstop watery diarrhea since first falling ill, and has now been in care for more than four days. “When they initially discharged me, the vomiting stopped, but as soon as I got home, I started stooling again, and it became so severe I had to be rushed back to the center,” Ibrahim said.

In the South African township of Secunda, 19-year-old Olwam Plaatjie carries a personal motivation for embracing a revolutionary new tool in the global fight against HIV. Growing up surrounded by the havoc the virus wreaked on her family and neighbors—watching loved ones lose weight, battle repeated illness, and rely on daily antiretroviral pills to survive—she made the decision to start on pre-exposure prophylaxis three years ago, eager to avoid the same fate.

Today, Plaatjie is among the thousands of South Africans who participated in clinical trials for lenacapavir, a twice-yearly injectable HIV prevention medication that solves one of the biggest drawbacks of standard daily oral prevention pills: consistent adherence. Even after experiencing mild side effects including night sweats, she has continued her participation, and this month, her country made global health history as one of the first nations in the world to roll out the new drug broadly.

South Africa bears the world’s heaviest HIV burden, with more than 8 million people currently living with the virus and between 140,000 and 170,000 new infections recorded every year. At the official launch of the national rollout, President Cyril Ramaphosa told a stadium crowd that lenacapavir marks a long-awaited turning point for the country’s decades-long HIV public health response.

Developed by U.S. pharmaceutical firm Gilead Sciences, lenacapavir’s efficacy was validated through large-scale clinical trials conducted across South Africa and Uganda. A landmark study based in Johannesburg found that the six-monthly injection delivers 100% protection against HIV, a result senior clinician Dr. Nkosi Ndlovu of the Wits RHI research institute called “groundbreaking.”

Right now, the South African government has secured enough doses to treat 456,000 people for one full year, supported by a $29 million grant from the Global Fund. After this initial phase, Health Minister Aaron Motsoaledi confirmed the country plans to transition to independent domestic funding for the program, with continued backing from international donors. Ramaphosa has set an ambitious target to reach 3 million at-risk South Africans with the drug over the next three years, though he has not released detailed funding or implementation plans to meet that goal.

Despite the historic milestone, public health advocates and civil society organizations argue the current rollout is far too small to move the needle on national infection rates. Groups estimate South Africa needs at least 2 million doses annually to generate a meaningful reduction in new HIV cases. Advocates also point out that South Africa’s central role in developing the drug—from hosting trials to enrolling thousands of community participants and generating the critical efficacy data—should guarantee the country broader, faster access than it has received so far.

“Our communities participated in the research, our clinics hosted the trials and our scientists helped produce the data,” explained Tian Johnson, health strategist for Johannesburg-based advocacy group African Alliance. “Yet we are still waiting for Gilead to determine how much of the product we receive, when it arrives and how quickly access can expand.”

On the manufacturing front, progress is underway to expand access and lower costs for low- and middle-income nations. Gilead has already committed to granting a voluntary manufacturing license to a South African drugmaker, following six similar licenses issued to firms in other countries last year. Once a national committee selects the local manufacturer, lenacapavir will be produced domestically as a low-cost generic, priced at just $40 per person annually—a dramatic drop from the original list price of $28,000 per year.

For the initial rollout phase, South Africa is prioritizing distribution to six provinces with the country’s highest HIV prevalence, with the first batch of 37,920 doses already sent to 360 local health facilities. Doses are being directed first to the groups at highest risk of infection: people who inject drugs, sex workers, transgender people, adolescent women aged 15 to 24, and pregnant or nursing people.

Reaching these vulnerable key populations presents unique challenges, however. Years ago, sweeping cuts to U.S. global health aid under the Trump administration forced the closure of 12 specialized clinics that were the primary safe, confidential care sites for many at-risk groups. These groups often avoid standard public clinics due to stigma, long wait times, and negative interactions with staff, leaving many at risk of being left out of the new program.

“Key populations, sex workers, people who use drugs, they don’t normally use public clinics,” noted Bellinda Thibela, international policy and advocacy coordinator for the Health Global Access Project. “So it means that we’re going to lose them unless the government acts fast and ensures that they put the resources to reach those people.”

Minister Motsoaledi confirmed that patients from the closed U.S.-supported clinics have been transferred to existing public health facilities, and the government is currently working to train staff and create private, stigma-free spaces for vulnerable patients. Even so, he acknowledged that the unique safe environment the specialized clinics provided has not yet been fully replaced.

“What we have lost is that confidentiality, where they were going to these clinics that are very special to them, where they feel very safe,” Motsoaledi said. “So we are trying to train our doctors to take over.”

Leila Mansoor, a senior scientist at the University of KwaZulu-Natal’s Center for the AIDS Program of Research in South Africa, said equitable large-scale access to lenacapavir could reshape the country’s HIV epidemic. “If South Africa can deliver it equitably and at scale, it could make a meaningful contribution to reducing new HIV infections,” she said.

BUNIA, Democratic Republic of Congo – A devastating Ebola outbreak, declared less than a month ago in the eastern region of the country, has already claimed at least 100 lives, local health authorities confirmed. The crisis is being compounded by a series of interconnected obstacles that continue to hamper efforts to curb transmission and save lives. As of Monday evening, the latest official situation report documents 550 confirmed cases of the virus, with 101 recorded fatalities and only 19 people who have recovered so far. Public health officials warn that the true scope of the outbreak is likely far higher than documented, because the spread of the virus went undetected for weeks before the outbreak was formally declared. Complicating response efforts even further, the outbreak is being driven by the Bundibugyo strain of Ebola – an uncommon variant that, unlike the Zaire strain which caused most of Congo’s previous 16 Ebola outbreaks, has no currently approved vaccine or targeted treatment available. Local unrest has also become a major barrier: armed conflict is raging in key transmission hotspots, and angry resident attacks on frontline health workers have disrupted critical vaccination, testing and contact tracing operations. Widespread skepticism about the disease among local communities has further slowed public health interventions, creating additional gaps in efforts to contain the spread of the deadly virus.

In the bustling eastern Congolese border city of Beni, where trade routes connect the Democratic Republic of Congo to Uganda and Rwanda, the word “Ebola” still triggers sharp, traumatic memories for local survivors like Vianney Kambale Kombi. Kombi lived through the 2018–2020 Ebola epidemic, the second-largest in recorded history that infected more than 3,400 people and claimed over 2,200 lives. While that outbreak was ultimately contained through the rollout of experimental vaccines, Kombi says community denial, deep-rooted skepticism, and violence against frontline health workers accelerated the virus’s deadly spread. Back then, many residents in his community blamed the outbreak on supernatural forces, he recalls.

“We thought it was witchcraft,” Kombi explained. “The community had not accepted that this disease existed and it had not accepted that we could recover from it.”

Now, as Beni faces a new, emerging Ebola outbreak caused by the rare Bundibugyo strain, local residents and health workers fear the same damaging patterns of misinformation and distrust that fueled past tragedy could derail the response once again. Compounding these concerns is the absence of a widely approved, targeted vaccine for this specific strain of the virus. As of the latest update, 515 confirmed infections have been reported, with 91 people dead and only 12 confirmed recoveries.

Kombi, who survived the 2018 outbreak after contracting the virus, says misinformation took many forms during that crisis beyond the belief in witchcraft. Many residents dismissed Ebola as a Western conspiracy invented to draw international aid funding, while others framed it as a political tool amid national election campaigns. This widespread denial made life hard for survivors even after they recovered from the virus. “The community had not accepted that we could recover from this disease, that’s why reintegrating into the community at first was a bit difficult,” Kombi said.

Bienfait Wanzire, another 2018 Ebola survivor, echoed this account of community confusion. “When a pandemic hits here in Congo, we initially think it’s a political issue,” he said. “At first, we thought it was a spiritual illness. Then because there were election campaigns, we believed it was political.”

For frontline health workers, the legacy of that mistrust remains personal. Dr. Babah Mutuza Lusungu, a physician at Beni’s “Dieu Est Grand” Medical Center, lost his uncle and two colleagues to the 2018 outbreak, even as he worked tirelessly to convince local residents the virus was a real, treatable threat. “There was very strong resistance,” Lusungu recalled. “And so there was a climate of mistrust that took place between the population, the authorities, the partners too, right, and the health workers.”

Looking back at the failures of the 2018 response, Lusungu argues that local leaders made a critical mistake by excluding young people from public outreach and response efforts. He is now urging officials to partner directly with youth community leaders to spread accurate information about the new outbreak before the virus can gain further traction. “If we wait until they have so many declared cases to start making an effective response, we will have totally missed the target,” he warned.

Esperance Masinda, who worked for the United Nations children’s agency UNICEF in Beni during the 2018 outbreak, knows firsthand the dual toll of the virus and community stigma. She contracted Ebola while caring for her husband, a medical doctor who also caught the virus. Both survived, thanks in part to early access to experimental Ebola vaccines, but the treatment that saved their lives left them isolated from their own community.

“When we were in the community, we were told that you’re not going to make it even five years, you’re going to die with that medication that you took there,” Masinda recalled. Years later, however, that stigma has slowly faded. “And today, when they see us, these people no longer stigmatize us,” she said. “We are all humans, even though we have been victims of Ebola, all of us are humans.”

For Beni’s residents and public health experts, that hard-won lesson—of recognizing Ebola as a treatable, human disease rather than a curse or a plot—could make all the difference in containing the new outbreak before it repeats the scale of the 2018 crisis.

As a deadly Ebola outbreak spreads rapidly across the Democratic Republic of the Congo (DRC) and Uganda, pushing case counts past 490 and sparking global alarm, the World Health Organization (WHO) and Africa Centres for Disease Control and Prevention (Africa CDC) have issued an urgent call for coordinated international solidarity to contain the epidemic before it spills further across regional borders.

The current outbreak, caused by the less common Bundibugyo Ebola strain, has expanded at an alarming pace since it was first detected in mid-May. What began as a small cluster of infections in just three health zones across one eastern DRC province has grown to cover 25 health zones across three DRC provinces, with confirmed cases now reaching Uganda’s capital city of Kampala. As of early June 2026, official WHO data puts total confirmed cases at nearly 500, with Ituri Province in northeastern DRC remaining the crisis epicenter: the region accounts for 90 percent of all confirmed infections and 76 percent of recorded fatalities from the virus.

Health authorities confirm this outbreak is already the largest ever recorded for the Bundibugyo strain, outpacing previous outbreaks in Uganda in 2007 and the DRC in 2012. A key ongoing challenge, officials warn, is the absence of licensed vaccines or widely approved therapeutics specifically targeting this strain of the virus. While several promising candidate treatments and vaccines are currently in development, none have cleared regulatory approval for large-scale deployment to affected communities, leaving response teams without established preventive tools.

During a high-level emergency briefing held Friday, WHO Director-General Tedros Adhanom Ghebreyesus announced the launch of a joint six-month regional preparedness and response plan, developed alongside Africa CDC, to mount a unified fight against the outbreak. The plan, which runs from June through December 2026, carries an estimated price tag of $518 million and operates under the coordinating framework of “one plan, one budget, one team” to eliminate fragmentation in relief efforts. Core priorities outlined in the strategy include streamlined emergency coordination, expanded disease surveillance and contact tracing, scaled-up laboratory testing capacity, strict infection prevention protocols in healthcare settings, improved clinical care for infected patients, intentional community engagement, accelerated research into candidate treatments, logistics support for relief operations, and the preservation of routine essential health services that could otherwise be disrupted by the outbreak.

“The outbreak is moving fast and we are still playing catch-up,” Tedros said following a recent assessment trip to the DRC. “But my trip to the DRC also gave me real hope that together, under the government’s leadership, we can bring this outbreak under control. The only way to beat this outbreak is through close partnership, working together under the leadership of the affected countries in one coordinated effort.”

Africa CDC has already implemented a suite of urgent emergency measures to slow transmission, including high-level political engagement with regional heads of state and health ministers, deployment of multidisciplinary rapid response teams to affected zones, expansion of local laboratory testing capacity, and coordination of the delivery of more than 200 metric tons of critical medical supplies from global partners. Africa CDC Director-General Jean Kaseya highlighted China’s recent contribution to the response effort, noting that a multidisciplinary team of Chinese experts spanning epidemiology, clinical care, research, and traditional Chinese medicine arrived in Kinshasa last week to begin a three-month mission supporting capacity building for local Ebola response teams.

“China has joined a growing list of international partners supporting response efforts, highlighting the importance of global solidarity in tackling public health emergencies,” Kaseya said.

WHO’s Africa Regional Director Mohamed Yakub Janabi emphasized that building and maintaining community trust is a foundational pillar of any successful response. Misinformation spreading through affected communities, he warned, poses a threat nearly as dangerous as the virus itself, capable of undermining core public health measures.“Without community participation, contact tracing falters, safe care is delayed and transmission continues,” Janabi explained. “Misinformation is almost as dangerous as the virus itself and spreads just as fast.”

Global health leaders stress that immediate, coordinated international investment and partnership are critical to preventing the outbreak from becoming a sustained regional crisis that could spread to additional neighboring countries across central Africa.

In the gold-mining town of Mongbwalu, located in the eastern Democratic Republic of the Congo’s Ituri province, a devastating Ebola outbreak of the rare Bundibugyo strain has spread unchecked for weeks, overwhelming local healthcare workers who already face systemic challenges that threaten both their work and their lives. At the heart of the response is Mongbwalu General Referral Hospital, where medical director Dr. Richard Lokudu has spent every working hour treating a steady stream of infected patients — even responding to suspected case alerts in the dead of night — yet he has received almost no compensation for his frontline work.

This outbreak, which health authorities trace back to Mongbwalu’s bustling mining sector, caught regional officials completely off guard after spreading silently through communities for more than a month before detection. Today, it has become one of the deadliest Ebola events the country has faced in recent years, with Congolese health officials confirming 452 total cases and 82 deaths as of reporting. A single day this week saw 71 new infections, a marker that officials say confirms widespread active transmission across local communities.

Mongbwalu’s unique economic and living conditions have created the perfect environment for Ebola, which spreads through close contact with infected bodily fluids including blood, sweat, feces, and vomit, to multiply rapidly. Thousands of migrant gold miners flock to the town to work in dangerous, cramped pit and cave mines, then reside in overcrowded informal camps with limited access to clean water, sanitation, or basic health guidance. Compounding this risk is widespread community skepticism about the virus, with many residents distrusting medical authorities and avoiding care — a trend that has already cost the lives of multiple frontline health and response workers who were exposed while trying to contain the spread.

For the workers on the ground, the daily struggle extends far beyond the risk of infection. Many have gone months without pay or promised hazard allowances, even as they sacrifice all personal time to respond to the crisis. “During the first week, we did not even have time to go home and eat. The second week was the same. We only eat once a day, what amounts to breakfast in the evening,” explained Alice Bamuhinga, a nurse at the Mongbwalu hospital. Dr. Lokudu echoes the frustration of his colleagues, noting that frontline teams deserve fair compensation and regular pay for the risks they take. “It is one thing to be far away and hear statistics being reported, but what is happening on the ground is enormous. People are sacrificing their rest and comfort for this cause. There should be recognition that they deserve compensation,” he said. To date, the Congolese government has not responded to requests for comment on the delayed payments.

The outbreak is also being fought with almost no dedicated resources, years of underinvestment in the country’s public health system have left regional facilities ill-equipped to handle a large-scale infectious disease event. Unlike more common Ebola strains, the Bundibugyo variant has no approved vaccines or targeted treatments, leaving clinicians only able to manage patients’ symptoms as they wait for outcomes. When the outbreak was first officially confirmed by the Congolese Ministry of Health on May 15, local hospitals had no ability to test for the specific strain — a gap that allowed the virus to gain a critical foothold, according to World Health Organization Director-General Tedros Adhanom Ghebreyesus. International aid groups have scrambled to deploy support to the region, but critical supplies including personal protective equipment, masks, gloves, boots, and symptom-managing medications were in acute short supply in the critical early weeks of the response.

“There has been an erosion of the health system. There has not been investment in the health system, and this has been going on for years,” said Heather Kerr, country director for the International Rescue Committee in Congo.

Even as the outbreak worsens, frontline workers continue to navigate barriers that extend beyond resource gaps. Ongoing conflict between the Congolese government, the Rwanda-backed M23 rebel group, and Islamist militant factions has restricted movement into affected communities, leaving many response teams unable to reach remote areas to investigate new case alerts. “Despite the alerts we receive and the teams we have on site, we lack the means to travel into the field. As a result, there are alerts we are unable to investigate,” Dr. Lokudu explained.

For many local residents, the outbreak has already brought irreversible loss. Asero Jeanne, a 52-year-old Mongbwalu resident, lost two of her five children to Ebola within two weeks after community misinformation led her family to avoid hospital care at first. Neighbors told the family anyone who sought treatment at the hospital would die immediately, and the family initially mistook her daughter’s symptoms for malaria. After three weeks of shifting between home care and delayed hospital treatment, her daughter died, followed days later by her son. Jeanne ultimately contracted the virus herself but survived, one of at least five confirmed recoveries reported by the Congolese government. “I saw about 20 people die. I watched them being taken to the morgue, yet God is allowing me to leave here alive. I thank the doctors,” she said.

In response to the growing crisis, Tedros announced a $518 million international response plan Friday to contain the outbreak, noting that “containing Ebola depends on political commitment, sustained financing, and the trust and engagement of communities.” For frontline workers like Dr. Lokudu, however, the immediate need remains clear: fair pay, adequate resources, and the support required to stop an outbreak that is currently spreading faster than their existing capacity to treat it.