Three Months Into Fast-Spreading Ebola Epidemic, Direct Relief’s Response Spans Three Nations

Three months after the World Health Organization declared the Ebola outbreak in eastern Democratic Republic of Congo a global health emergency, the epidemic’s rapid growth rate puts it on track to become the deadliest Ebola outbreak in history, WHO Director-General Tedros Adhanom Ghebreyesus warned Wednesday.

“At its current pace, it is on track to eclipse the West African Ebola outbreak of 2014 to 2016,” which killed more than 11,000 people, Tedros said at a WHO media briefing. “The outbreak had a big head start; it is still way ahead of us, and we are playing catch-up.”

Three months after the World Health Organization declared the Ebola outbreak in eastern Democratic Republic of Congo a global health emergency, the epidemic is growing so rapidly that it is likely to become the deadliest Ebola outbreak in history, WHO Director-General Tedros Adhanom Ghebreyesus warned Wednesday.

“At its current pace, it is on track to eclipse the West African Ebola outbreak of 2014 to 2016,” which killed more than 11,000 people, Tedros said at a WHO media briefing. “The outbreak had a big head start; it is still way ahead of us, and we are playing catch-up.”

More than 4,400 cases have been confirmed in DRC, and more than 2,000 people have died, a case fatality rate of roughly 46%, according to data through Aug. 11 compiled by the European Centre for Disease Prevention and Control – and the WHO estimates the true count is likely two to four times the official figures. The WHO said Monday that genomic sequencing shows the virus had been circulating since February – months before the outbreak was declared – with early cases wrongly attributed to malaria and typhoid.

For Direct Relief, the three-month mark is a moment to take stock. The organization has delivered 19.5 tons of PPE, essential medicines and supplies, valued at $11.3 million, to partners across DRC, Uganda and South Sudan since May, with additional emergency shipments en route. As public health leaders say the Ebola fight must move from treatment centers into villages and homes, Direct Relief continues to deepen its ongoing support for the community-level organizations best positioned to help slow the epidemic.

“Frankly, this moment is the one I’ve been so worried about, where we’re not seeing the curve bending the way you would expect or hope at this point,” said Craig Redmond, Direct Relief’s Chief Operating Officer. “There’s an uphill battle around community trust. It’s essential that local community-led organizations are leading the way on this. Our job is to make sure our partners have the resources they need for this extraordinary lift.”

The Global Response Pivots to the Community Level

Direct Relief’s long-standing focus on community partners aligns with a pivot in the international response. Most people dying of Ebola in this outbreak are dying in their communities rather than in treatment units – roughly two-thirds of deaths, according to the WHO. The Africa Centres for Disease Control and Prevention says more than 70% of new infections are found among people who weren’t being monitored through contact tracing, and its Director-General, Dr. Jean Kaseya, told reporters that an outbreak this size would normally generate 160,000 to 200,000 contacts to trace – against roughly 17,000 currently listed, Bloomberg News reported.

On Aug. 5, DRC adopted a village-centered response run through community health workers chosen by village leaders, according to Africa CDC, which, along with the WHO, called last week for “an urgent scale-up of the community-led Ebola response.” Africa CDC and its partners are shifting from conventional contact tracing to door-to-door case finding in the hardest-hit areas. More than 21,000 community health workers have been trained so far, Tedros said Wednesday, and contact tracing now reaches about 80% of known contacts – still short of the 95% target the WHO says is needed to interrupt transmission.

Most transmission happens when people with late-stage disease are not in treatment, or when bodies are handled after death, Tedros said, making early clinical care and safe and dignified burials critical to stopping the outbreak. “And both depend on the trust of affected communities, which means community engagement and community ownership are essential. There is no other way.”

“Containing and ultimately stopping this outbreak will come from communities,” Africa CDC’s Kaseya said. “When people have information they trust, can report symptoms early and seek care without fear, we can break every chain of transmission.”

“You can’t fight this outbreak from treatment centers alone when so many patients never reach them,” said Dr. Jeffrey Samuel, Direct Relief’s regional director for Africa. “The response has to reach people where they are – through the community health workers and local organizations their neighbors already trust.

Direct Relief’s Community Engagement Work

Direct Relief’s support for community-level engagement spans multiple organizations working where trust is the scarcest resource.

In DRC’s Ituri, Haut-Uélé and Tshopo provinces, VillageReach has supported DRC’s Ministry of Health in training more than 1,000 community health workers to bring Ebola information to the region’s diverse communities, while strengthening lab sample transport. Direct Relief has supplied VillageReach with two large shipments of PPE and other medical supplies, including more than a quarter million N95 respirators delivered to Bunia, the outbreak’s epicenter. VillageReach in turn distributed much of the material to frontline Ebola responders in the region.

Another shipment with nearly five tons of supplies for VillageReach is awaiting final DRC import documentation, including 341 cases of 3M protective coveralls, eye protection, intravenous fluids and water purification products.

In Beni Health Zone in North Kivu, Direct Relief is providing material and financial support to a new Ebola response project by Humanitarian Action for Africa. HAA’s approach centers on building trust and encouraging early reporting, with community dialogues covering Ebola symptoms, early alerting, safe and dignified burials, hand hygiene, the risks of home-based care for suspected cases, rumor management, and support for Ebola survivors. A shipment of essential medicine, PPE and oral rehydration salts valued at $1.9 million bound for HAA is packed and ready for transportation.

And along South Sudan’s border with DRC, the International Organization for Migration – supported by two large Direct Relief donations of PPE, medicine, infection-prevention supplies and oral rehydration salts – has screened hundreds of thousands of travelers and reached nearly half a million people with Ebola awareness messaging.

“People are getting sick at home. They’re staying at home, and that’s the killer,” Redmond said. “We’re in close contact with our partners, really picking their brains about how we can help as we enter this next frightening phase of this emergency.”

Ebola Vigil in Uganda

The outbreak’s one clear success story so far is Uganda, which stamped out its outbreak of 20 confirmed cases and two deaths, declaring itself Ebola-free on July 28. But vigilance there remains essential – and Direct Relief is helping sustain it.

Mulago National Referral Hospital, the largest public hospital in Uganda and a long-time Direct Relief partner, served as a primary response center for Ebola, with a dedicated isolation center.

“Whereas at the moment we’re Ebola-free, we still must remain prepared to identify, isolate, test, and manage suspected or confirmed cases, while also maintaining essential medical services to other patients,” said Dr. Vicky Nyombi, principal pharmacist at Mulago. “We have a lot of significant cross-border movements, and we have to remain prepared continuously. Being declared Ebola-free right now is an achievement, but does not mean that the risk has completely disappeared.”

Direct Relief is preparing to ship a large batch of PPE and medicine to Mulago, along with an ultra-low-temperature pharmaceutical freezer for histopathology work requiring long-term stable storage of medical samples. The shipment is packed and awaiting air transport. While the hospital has enough gloves, Dr. Nyombi said, “we critically need” N95 respirators, coveralls, and sterile gowns – and the hospital is short of body bags, a dangerous gap because Ebola can spread through contact with the bodily fluids of a deceased person.

The incoming shipment includes a large supply of N95 respirators with a long shelf-life. “We shall be getting stock that expires in 2030, so that’s quite exciting for us – and in very large quantities that we have never seen, not even during Covid,” Dr. Nyombi said.

Three Months of Response – and the Road Ahead

Direct Relief’s strategy works on two fronts: containing the spread of Ebola and maintaining continuity of primary care – because in an Ebola outbreak, deaths from disrupted routine care can rival deaths from the virus itself. During the 2014–16 West Africa outbreak, researchers estimated that reduced access to treatment for malaria, HIV/AIDS and tuberculosis caused more than 10,000 additional deaths – nearly matching Ebola’s direct toll.

Beyond the community engagement partnerships, Direct Relief’s shipments since May also include PPE, oral rehydration salts, chronic-disease medications, antibiotics and diagnostics to Jericho Road’s Wellness Clinic in Goma, and insulin and clinic medications to the Association des Diabétiques du Congo, preserving diabetes care through the crisis.

The road ahead is long – and underfunded: of the $518 million required for the continental Ebola preparedness and response plan, just over half has been disbursed, Tedros said Wednesday.

“There is still a long road ahead as cases continue to rise,” Dr. Samuel said. “But it has been encouraging to see Uganda contain its outbreak and South Sudan strengthen its preparedness. More funding now could expand the community-level response, protect frontline health workers, and keep health facilities functioning. I think that is what it will take to bring transmission under control in eastern DRC.”

Direct Relief will remain engaged for the long term, working with partners across all three nations as the fight moves to the community level, where it will ultimately be won or lost.