Public Health Emergency of International Concern: WHO Sounds the Alarm Over the Ebola Epidemic in the DRC

The world has just received one of the most serious health alerts in recent years. In the early hours of Sunday, May 17, 2026, the World Health Organization (WHO) declared a Public Health Emergency of International Concern (PHEIC) in response to the Ebola epidemic devastating the province of Ituri, in northeastern Democratic Republic of Congo (DRC), which has already claimed a victim in neighbouring Uganda. The announcement, made by WHO Director-General Tedros Adhanom Ghebreyesus, places the international community before a major challenge: containing a strain of Ebola for which there is no vaccine and no specific treatment, in one of the most unstable and least accessible regions of the African continent.

What Is a PHEIC?

Before delving into the details of the epidemic itself, it is important to understand what this declaration means on an institutional level. A Public Health Emergency of International Concern is defined under the International Health Regulations (IHR) — a legally binding framework to which WHO member states are party — as an extraordinary event that constitutes a risk to public health in other states through the international spread of disease, and which may require a coordinated international response.

The PHEIC was formerly the highest level of alert available to the WHO. However, amendments adopted in June 2024 introduced an additional tier: that of a "pandemic emergency." The PHEIC thus becomes the second most serious alert level in the current global alert system architecture. In his statement, Tedros Adhanom Ghebreyesus was precise: the virus "constitutes a Public Health Emergency of International Concern, but does not meet the criteria for a pandemic emergency." This is an important distinction, but it in no way diminishes the gravity of the situation on the ground.

The Origin of the Outbreak: A Nurse in Bunia

It all began on April 24, 2026. A nurse presented at a medical facility in Bunia, the provincial capital of Ituri, with characteristic symptoms of an Ebola infection: high fever, haemorrhaging, and vomiting. This is the official patient zero of the 17th Ebola epidemic in the DRC since the disease was first identified in the country in 1976, when it was still named Zaire.

Since that first case, the spread has been rapid and alarming. As of May 16, 2026, the WHO had laboratory-confirmed eight cases, while the Africa CDC — the African Union's health agency — was recording 336 suspected cases and 88 deaths likely attributable to the virus. The WHO, for its part, reported 246 suspected cases and 80 suspected deaths in Ituri province alone. These figures are likely underestimates: the epicentre of the outbreak is located in areas that are difficult to access, few samples have been able to be transported to laboratories, and the majority of tallies still rely on clinical suspicion cases.

The Bundibugyo Variant: A Rare and Formidable Strain

What makes this epidemic particularly worrying is the very nature of the virus involved. This is not the Zaire strain — the most well-known — against which effective vaccines have existed for several years. This is the Bundibugyo variant, a distinct strain of Ebola against which no approved vaccine exists and no specific treatment is available.

The epidemiological history of this variant is relatively short: it had only caused two outbreaks in the world before the 2026 one. The first occurred in 2007 in Uganda, in the Bundibugyo district from which the strain takes its name, causing 42 deaths out of 131 confirmed cases. The second occurred in 2012 in the DRC, with 13 deaths out of 38 confirmed cases. These precedents indicate a historical case fatality rate of between 25% and 40%. But Congolese Health Minister Samuel-Roger Kamba warned that the lethality of this variant can reach as high as 50% under current conditions, and that early symptoms — often limited to a simple fever — make early detection particularly difficult.

The Ebola virus is transmitted through direct contact with the bodily fluids of an infected person, whether living or deceased. The incubation period can last up to 21 days. Those infected only become contagious once symptoms appear. It is precisely in this context that traditional funeral rites involving the handling of deceased bodies represent a major transmission vector that is particularly difficult to control.

Ituri: A Crisis Zone With Multiple Dimensions

Ituri province alone concentrates several aggravating factors that make this epidemic a logistical nightmare for health teams. This gold-rich region of northeastern DRC, bordering Uganda and South Sudan, is the scene of intense population movements related to mining activity, which greatly facilitates the circulation of the virus. It is also plagued by chronic armed violence that has persisted for decades, making access to certain areas dangerous or entirely impossible for humanitarian actors.

The testimony of Isaac Nyakulinda, a civil society representative in Rwampara in Ituri, gathered by AFP, brutally summarises the reality experienced by the population: "We have been watching people die for two weeks. There is no place to isolate the sick. They die at home and their bodies are handled by family members." This situation — sick patients not isolated, bodies handled without protection, no treatment centres available — constitutes a chain transmission vector that is particularly difficult to interrupt.

The health zones of Mongbwalu and Rwampara, each with approximately 150,000 inhabitants, are currently the hardest hit. Cases have also been recorded in Bunia, a city of around 300,000 inhabitants serving as the province's main hub. The appearance of a confirmed case in Kinshasa — the DRC's capital, a megacity of more than 17 million people — and a death in Kampala, Uganda's capital, among travellers who had recently returned from Ituri, has transformed what might have remained a local crisis into a regional and potentially international emergency.

The Health Response: Limited Means Facing a Colossal Challenge

The response to this epidemic comes up against a fundamental reality that Jean Kaseya, director of the Africa CDC, summarised without mincing words: "We do not have a vaccine, which means we are essentially relying on public health measures." These measures include barrier gestures, movement restrictions, contact tracing, isolation of suspected cases, and community awareness about safe burial practices.

The WHO announced the airlifting of five tonnes of medical equipment from Kinshasa to Ituri province, and released $500,000 from its Emergency Fund to support the initial response. Medical supplies and personal protective equipment intended for infection prevention and control were sent to Bunia, the provincial capital.

Médecins Sans Frontières (MSF), which already has teams in Ituri, announced that it is preparing "a large-scale response in the region as quickly as possible." MSF representative Trish Newport nonetheless warned: in this region, "many people already struggle to access healthcare and live in permanent insecurity," making "a rapid response essential to prevent the epidemic from worsening further." The WHO's PHEIC declaration formally calls for international coordination and mobilises additional resources from the donor community and UN agencies.

A Context of Chronic Vulnerability

This epidemic does not arise in a vacuum. The DRC had already experienced an Ebola outbreak between August and December 2025 — barely five months before this one — which killed at least 43 people in the centre of the country. The most deadly epidemic in the country's history, between 2018 and 2020, killed nearly 2,300 people out of 3,500 infected, in a similar context of armed violence and restricted humanitarian access in the east of the country. In total, the Ebola virus has killed more than 15,000 people in Africa over the past 50 years.

The DRC is also grappling with other overlapping health crises: measles, cholera, and more recently mpox have severely strained a healthcare system that is chronically underfunded and weakened by decades of armed conflict. The eruption of an Ebola epidemic involving an unprecedented strain, with no available vaccine, in the country's most unstable region, coming directly on the heels of a previous outbreak barely extinguished, represents one of the most challenging scenarios global public health can face.

What This Means for the Rest of the World

The spread of a confirmed case all the way to Kinshasa and the death of a traveller in Kampala demonstrate that this virus is not confined to Ituri. In a world of intense human mobility — cross-border trade, mining activity, migration, air transport — early detection at the entry points of neighbouring countries becomes crucial. Uganda, South Sudan, and the Central African Republic, which all share a border with the affected areas, are on heightened alert.

The WHO's PHEIC declaration is a signal sent to all member states: it is time to strengthen epidemiological surveillance at borders, prepare isolation and care capacities, and contribute to collective response efforts. It also calls on the international scientific community to accelerate research into a vaccine and specific treatment against the Bundibugyo strain — a glaring gap that this epidemic now makes impossible to ignore.

Sources

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