分类： health

One month after the Democratic Republic of Congo formally declared an Ebola outbreak, the country is grappling with an unprecedented single-day spike in infections, as long-running systemic issues including insecurity, inadequate contact tracing, and critical funding shortfalls continue to derail containment efforts, Congolese health authorities have confirmed. In an update released Sunday, the Congolese Ministry of Health announced 72 new confirmed cases and 32 new confirmed deaths recorded over a 24-hour period. That surge pushes the total number of confirmed infections nationwide to 782, with the overall death toll now standing at 181. To date, 56 patients have successfully recovered from the virus, putting the current outbreak’s fatality rate at 23 percent.

Unlike the majority of past Ebola outbreaks in Congo, which were driven by the better-studied Zaire virus, this current event is caused by the rare Bundibugyo strain — a variant for which no approved vaccine or targeted treatment currently exists. Public health experts warn the true scale of the outbreak is almost certainly larger than official counts indicate. The virus was not formally confirmed until May 15, weeks after epidemiologists suspect community transmission first began, and contact tracing coverage has dropped sharply to just 56 percent, down from levels reported just one week prior.

Over 90 percent of all confirmed cases are concentrated in the country’s eastern Ituri Province, where long-running armed conflict has displaced nearly one million people according to the United Nations’ Office for the Coordination of Humanitarian Affairs. This mass displacement creates massive barriers to effective contact tracing: displaced populations often flee violent attacks or move frequently across the province, which is defined by dense rainforest, poorly maintained road infrastructure, and remote rural communities that can take multiple days to reach. Additional challenges come from the region’s large population of artisanal miners, who regularly travel between isolated mining sites across the mineral-rich area, making it nearly impossible to track and monitor potential exposures. While the outbreak is centered in Ituri, a small number of cases have also been recorded in neighboring North Kivu and South Kivu provinces, and transmission has already spilled across the international border into Uganda.

International and continental health bodies have moved to ramp up their response efforts in recent days. The World Health Organization announced Sunday it is expanding its work on testing, contact tracing, and patient care across affected regions. The Africa Centers for Disease Control and Prevention (Africa CDC) also announced it is deploying specialized technical teams to support local outbreak management, with a focus on strengthening laboratory capacity, accelerating active case searching, and improving community engagement to boost public compliance with containment measures. “We remain committed to supporting affected countries until transmission is stopped,” said Jean Kaseya, head of the Africa CDC. “We call on partners and donors to urgently mobilize resources to strengthen the response and save lives.” The appeal for emergency funding comes as authorities acknowledge ongoing funding gaps have left the response severely underresourced a full month into the public health emergency.

In a Sunday evening update posted to social platform X, the Democratic Republic of the Congo’s Ministry of Health has announced a sharp upward climb in confirmed cases of a rare Ebola outbreak, pushing the total to 782 documented infections and 181 confirmed deaths across the country. While these are the official numbers, public health officials warn the true scale of the epidemic is far larger than recorded. The outbreak was only formally detected on May 15, weeks after the first suspected infections emerged, and critical contact tracing efforts — a core strategy to halt Ebola spread — have dropped to just 56% coverage, a significant decline from rates reported the previous week.

This latest outbreak differs from most previous Ebola events in Congo in a key way: it is driven by the little-seen Bundibugyo virus, rather than the Zaire strain that caused the nation’s 16 prior outbreaks. Unlike Zaire, Bundibugyo has no globally approved vaccine or targeted treatment available to frontline health teams, limiting intervention options. As of the latest update, 56 infected patients have recovered, putting the current official fatality rate at 23% for the outbreak.

Nearly all confirmed cases — over 90% — are concentrated in eastern Congo’s volatile Ituri Province, with smaller clusters also detected in the neighboring North Kivu and South Kivu provinces. The virus has already crossed international boundaries, with cases confirmed in neighboring Uganda, raising regional public health alarm.

A web of long-standing crises has created major barriers to containing the spread, according to United Nations humanitarian officials. Ituri Province already hosts nearly one million people displaced by ongoing armed conflict, and constant population movement as communities flee violence makes tracking transmission chains nearly impossible. The province’s geography adds further obstacles: vast stretches of dense forest, poorly maintained road networks, and remote rural communities that can take multiple days to reach slow response teams.

Additional challenges come from the region’s large population of artisanal miners, thousands of whom move regularly between remote mineral extraction sites across the area, creating constant unmonitored movement that facilitates virus spread. Compounding these issues, attacks on frontline health workers by angry local residents, widespread misinformation and community skepticism about public health measures, and ongoing active armed conflict in transmission hotspots have all derailed containment efforts.

The outbreak has already sparked controversy beyond Congo’s borders. Last month, U.S. officials announced plans to construct a dedicated Ebola quarantine facility at Kenya’s Laikipia Air Base, with capacity for 50 beds, to treat Americans exposed to the virus in the region rather than repatriating them to the United States for care. The proposal sparked large public protests across Kenya, and the plan was ultimately halted by a court order.

In the heart of the latest Ebola outbreak in the Democratic Republic of the Congo, dozens of local motorcycle taxi drivers have launched a community-focused public awareness caravan to combat dangerous misinformation that has fueled violent attacks on frontline health workers. The initiative, held Tuesday, unfolded in Bunia and Rwampara, two urban centers in Ituri province — the epicenter of the current outbreak which accounts for over 90% of all confirmed cases nationwide.

Clad in crisp white T-shirts emblazoned with the slogan “Stop Ebola”, the drivers paraded through city streets, displaying illustrated public health guides that outline key preventive measures for the viral disease. As of late Tuesday, Congolese health authorities had confirmed at least 598 cases of Ebola across affected regions, with 115 recorded deaths. Cases have also been documented in neighboring North Kivu and South Kivu provinces, and a small number of infections have been detected across the international border in Uganda.

What makes this outbreak particularly challenging for global and local health authorities is the deep-seated skepticism and rampant misinformation that has taken root in many local communities. Many residents reject the existence of the outbreak entirely, while others fiercely oppose the strict burial protocols health workers implement to limit viral spread after an Ebola death. This resistance has erupted into open violence: Marie Roseline Darnycka Belizaire, the World Health Organization’s emergency director for Africa, confirms that more than 520 separate incidents have disrupted health worker operations, including at least three targeted attacks on health centers in Ituri alone, sparked by resident demands for the return of deceased patients’ bodies.

Organizers of the awareness caravan say that engaging local motorcycle taxi drivers is a strategic response to this violence. These drivers are embedded in daily community life, regularly transporting both sick and healthy residents across towns and rural areas, making them trusted messengers for accurate public health information. “Response teams have been attacked in some areas, and that is one reason why we chose to involve motorcycle taxi drivers,” explained Jacques Maliro, WHO’s Risk Communication and Community Engagement Officer and a lead organizer of the campaign. “They are an important group because they transport both sick and healthy people, so they too need to be informed and engaged.”

Misinformation has discouraged residents from following life-saving public health guidelines and seeking early medical care, officials say. At the start of the outbreak, some local churches even told congregations that Ebola is a hoax, and that divine faith eliminates the need for professional medical care. For Josue Mbabona, one of the motorcycle drivers participating in the caravan, the outbreak is a devastating personal reality: he has already lost three family members to the virus. “Those who do not believe in it need to understand that it is real,” Mbabona said.

The outbreak response has been hampered by multiple overlapping crises beyond community resistance. Decades of ongoing conflict involving dozens of separate rebel and militant groups — some linked to neighboring Rwanda and the extremist Islamic State — have left many rural communities completely cut off from outside aid, leaving frontline health workers unable to access at-risk populations. Frontline workers also face grueling conditions, laboring for long hours with little pay and almost no rest. Critical supply shortages further complicate response efforts: this week, local residents and officials in Bunia reported widespread shortages of clean water for the frequent handwashing public health officials recommend to slow viral transmission.

Complicating matters further, the current outbreak is caused by the rare Bundibugyo Ebola strain, which lacks any approved vaccine or targeted treatment — a key difference from the more common Zaire strain that has caused most of the 16 previous Ebola outbreaks recorded in Congo. Currently, three vaccine candidates are in active development, and Africa’s top public health agency announced last month that it aims to roll out approved vaccines and treatments for Bundibugyo virus by the end of 2024. For residents in affected areas, the urgent need for a vaccine is clear: “The vaccine needs to be available so that we can protect ourselves, move forward, and return to normal life,” said David Kasimwa, a student who joined the awareness caravan. “This disease has disrupted many activities: We are no longer able to travel freely because we are afraid,” he added.

The outbreak has already triggered international policy shifts: multiple countries have implemented new travel restrictions and enhanced entry screening for travelers arriving from affected regions, though the World Health Organization has repeatedly declined to recommend broad, region-wide travel bans. On Tuesday, U.S. Secretary of State Marco Rubio called on European nations to tighten their own entry restrictions for travelers from affected African countries, warning that failure to act could result in stricter U.S. entry requirements for all travelers arriving from Europe — even during the upcoming FIFA World Cup. There are very few direct daily flights between Africa and the United States, but more than 300 direct flights connect Europe and the U.S. on a daily basis.

As a fresh Ebola outbreak spreads across the Democratic Republic of the Congo and Uganda, the Trump administration has issued an urgent call for European nations to tighten entry restrictions for travelers arriving from the affected African regions, warning that inaction could trigger new U.S. travel rules that would impact transatlantic movement even during the upcoming men’s World Cup.

In a private conversation Tuesday, Secretary of State Marco Rubio raised U.S. concerns directly to European Commission President Ursula von der Leyen, with the two leaders discussing coordinated transatlantic responses to the unfolding public health emergency, a State Department official statement confirmed.

“Protecting the health of the American public and stopping the Ebola outbreak from reaching U.S. shores remains this department’s top priority,” the statement read.

Speaking on condition of anonymity to disclose details of the closed-door call, a senior State Department official struck a sharper tone, noting that the U.S. has already moved aggressively to contain the outbreak’s spread and that the broader global community must now match that effort. The official emphasized that concrete action is required immediately, and failure to act will have measurable consequences for travel between Europe and the United States.

The administration is pushing for two key actions from the EU: increased financial commitments to Ebola response efforts, and targeted, common-sense entry restrictions for travelers originating from the affected Central and East African region.

The 2026 World Cup, set to kick off this Thursday in Mexico, will run for nearly six weeks, with the majority of matches hosted across the United States, drawing hundreds of thousands of international visitors including many traveling through European hubs.

The U.S. has already implemented its own strict measures: a blanket entry ban for any traveler who has visited one of the Ebola-impacted countries in the prior 21 days, and mandatory quarantine protocols for U.S. citizens returning home from the affected regions.

Public health data puts the risk of direct importation in context: while there are only a handful of direct daily flights between the affected African nations and the U.S., more than 300 direct flights connect Europe and the United States every day, creating a far higher potential route for infected travelers to reach North America if European entry checks are insufficient.

Since the outbreak was first confirmed last month, the U.S. has committed over $200 million in emergency funding to contain the spread in the DRC and Uganda. Earlier the same day as Rubio’s call, the EU announced it would add an additional 16.5 million euros ($19 million) to its own Ebola response, on top of the 15 million euros ($17.3 million) it contributed to the effort just last month. The EU delegation to Washington has not yet issued a public comment on the call between Rubio and von der Leyen.

The administration’s response to the outbreak has already drawn political criticism. During last week’s congressional hearings, Democratic lawmakers pushed back against Rubio over the Trump administration’s earlier dismantling of the U.S. Agency for International Development, arguing that the restructuring may have weakened U.S. capacity to respond quickly to global health emergencies. Rubio countered that early detection programs previously run by USAID have been integrated into existing public health partnerships with African nations, and insisted the U.S. has mounted a swift, effective response to the outbreak.

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.