By Esther Olaoluwa |
The Africa Centres for Disease Control and Prevention (Africa CDC) has backed the Democratic Republic of Congo (DRC)’s decision to scale up measures to contain the rapidly spreading Bundibugyo virus disease outbreak, including a community-led response and expanded vaccination under strict safety and monitoring protocols.
The agency commended President Félix-Antoine Tshisekedi Tshilombo for providing political leadership and guidance for the response, as well as the Minister of Public Health, Hygiene and Social Welfare, Dr Samuel Roger Kamba, for supporting implementation.
According to Africa CDC, DRC government data showed that 4,120 confirmed cases and 1,887 deaths had been recorded by August 7, 2026. The outbreak had also spread from 11 health zones in Ituri Province on May 15 to 53 health zones across five provinces.
The affected provinces are Ituri, North Kivu, South Kivu, Haut-Uele and Tshopo.
Africa CDC said the scale and speed of transmission required a shift from conventional response operations to a stronger community-centred approach.
Community-led response
Under the new strategy, affected villages will select trusted community health workers (CHWs) to serve as direct links between communities and response teams.
The workers will be trained, equipped, supervised and paid to identify suspected cases, support contact follow-up, promote early referrals, explain vaccination, support safe and dignified burials and communicate community concerns to response authorities.
The agency said CHWs would also be connected through available mobile or satellite networks to report alerts, contacts, referrals, vaccinations and shortages of essential supplies in real time.
Africa CDC said the approach was necessary because only about 10 per cent of expected contacts had been listed, while around 70 per cent of those listed were being followed. This remains below the 95 per cent operational target.
Recent reports also indicate that about four in five new infections are occurring outside known transmission chains, while more than 60 per cent of deaths are occurring in communities.
The agency said these figures suggested that undetected transmission may have occurred for months before the outbreak was identified.
Expanded vaccination plan
The DRC government also plans to use the licensed Ervebo vaccine in priority areas once national authorisations and International Coordinating Group (ICG) allocation are secured.
Vaccination would initially focus on eligible contacts and contacts of contacts, frontline health workers and people in areas experiencing high transmission. It could later be expanded based on safety information, operational readiness, outbreak trends and emerging evidence of effectiveness.
Africa CDC stressed that Ervebo is licensed for protection against disease caused by Zaire ebolavirus, not Bundibugyo virus. Its proposed use against the current outbreak is based on evidence suggesting possible cross-protection, although the agency acknowledged that the evidence is not yet conclusive.
The agency said the expanded use must therefore be conducted under an approved protocol, with active monitoring of safety and effectiveness.
The evidence includes laboratory studies, animal studies and early observations from the current outbreak. However, Africa CDC said these studies have limitations and that randomised clinical trials are still needed to determine how effective the vaccine is against Bundibugyo virus.
Free healthcare and support for workers
The response plan also calls for temporary removal of user fees for essential primary healthcare services in affected areas.
The government is expected to ensure predictable payment for health workers, maintain supplies of protective equipment, diagnostic materials, medicines, water and sanitation materials, and keep health facilities functioning.
Africa CDC said improving access to basic healthcare could encourage people to seek treatment earlier, reduce hidden transmission and ensure that routine health services continue during the outbreak.
Treatment and post-exposure measures will also be expanded under approved protocols.
Patients with laboratory-confirmed Bundibugyo virus disease may receive optimised supportive care and remdesivir under national guidance for compassionate use, while eligible high-risk contacts may receive obeldesivir post-exposure prophylaxis under the approved protocol.
Schools and humanitarian support
The response will also incorporate humanitarian assistance, including food, water, protection, psychosocial support and other essential services for affected communities.
Schools are expected to reopen in September following local risk assessments.
The plan includes handwashing facilities, trained teachers, rapid reporting of suspected cases and referral procedures. Community health workers will also help connect schools, families and response teams.
Africa CDC said the measures are intended to protect children, prevent stigma and allow education to continue safely.
Funding and accountability
The agency also called for stronger coordination and financial accountability across the response.
It said more than US$450 million had already been mobilised for the Ebola response, excluding funds for the wider humanitarian response. Africa CDC also acknowledged US$242 million in new funding announced by the United States Government on August 5.
The agency called on international partners to provide additional resources to close remaining funding gaps.
At the request of the DRC government, Africa CDC and the World Health Organization (WHO) are working on unified financial tracking to ensure resources are aligned with national priorities and reach frontline operations.
Each partner is expected to disclose the amount received and how funds are allocated.
Vaccine request to be submitted
Africa CDC said the DRC plans to submit its formal request for Ervebo vaccines to the ICG on August 12, following the required national ethics and regulatory approvals.
The agency urged the ICG to review the request urgently and authorise the quantity required under the approved vaccination strategy.
It also welcomed Gavi’s commitment to support operational costs and noted that Gavi had announced up to US$40 million to accelerate vaccine access, alongside an additional US$10 million for outbreak response and continuity of routine immunisation.
Africa CDC said preparations for vaccination were already underway, with its experts working alongside WHO, UNICEF and DRC health authorities on national and local plans covering priority areas, target populations, vaccine distribution, cold-chain logistics, safety monitoring, data collection, security and community engagement.
Evidence and monitoring
Africa CDC said vaccination would be accompanied by active safety monitoring and data collection to determine whether the vaccine provides meaningful protection against the Bundibugyo virus.
Medical history, vaccination status, exposure, clinical condition and serious adverse events will be recorded through secure systems, while epidemiological data will be linked with genomic surveillance where appropriate.
The agency said independent oversight and transparent reporting would be essential. If evidence shows that the intervention is beneficial, access could be expanded, while evidence of harm or lack of benefit could lead to the strategy being paused, stopped or modified.
WHO Director-General Dr Tedros Adhanom Ghebreyesus said the outbreak could ultimately be stopped only by putting affected communities at the centre of the response.
Africa CDC Director-General Dr Jean Kaseya similarly stressed that trusted information, early reporting and access to care would be critical to breaking transmission.
Africa CDC said it would continue working with the DRC government, WHO, UNICEF, MSF and other partners to implement the response, strengthen regional preparedness and mobilise resources needed to contain the outbreak.
The agency also maintained that countries should avoid unnecessary restrictions on travel and trade, instead strengthening surveillance, laboratory capacity, preparedness and cross-border coordination.
The latest figures cited by Africa CDC are consistent with the DRC’s reported 4,120 confirmed cases as of August 7.
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