The World Health Organization says Congo’s Ebola outbreak remains uncontrolled, with cases rising in some areas even as they fall in others. A shortage of health workers is limiting the response: beds being added at treatment centers do not help patients if facilities lack teams to run them.
In an update published Friday, Sept. 25, WHO reported 7,890 confirmed cases and 3,799 deaths in the Democratic Republic of the Congo as of Sept. 23. The outbreak had reached 63 health zones across seven provinces. WHO describes it as the largest Ebola outbreak recorded in the country, regardless of virus species.
Three figures illustrate the outbreak’s uneven course:
- 7,890 confirmed cases: WHO counted 1,133 additional confirmed cases and 532 additional confirmed deaths between updates issued Sept. 11 and Sept. 25.
- 63 health zones: The outbreak had spread across seven provinces, according to WHO’s latest update.
- 73%: Cases in North Kivu rose by that amount over three weeks, according to WHO figures reported by PBS News. From Aug. 31 to Sept. 20, reported cases fell 26% in Ituri and 15% in Haut-Uele.
The declines in Ituri and Haut-Uele do not mean the outbreak is under control. WHO said cases had increased in some locations even as the seven-day average fell during the latest reporting days. The national total masks very different conditions across affected communities.
What does the health worker shortage mean for patients?
WHO representative in Congo Anne Ancia said one Ebola treatment center needs about 300 health professionals. PBS reported that beds were being added, but some facilities and partners did not have enough workers to operate them. A bed without a care team cannot provide treatment to someone who needs it.
Catherine Smallwood, WHO’s Ebola incident manager, told PBS News, “The human resources gap is one of the biggest gaps.” Ancia also emphasized the need to pay workers, telling PBS, “Those health workers must be paid.”
Frontline workers in Ituri previously went on strike over unpaid wages, PBS reported. Some reportedly received none of the arrears officials had promised, while others received only part. Those accounts point to a practical problem for the response: staffing depends not only on recruiting people, but also on paying workers for their work.
In July, Health Minister Roger Kamba said the government was checking payroll lists after names of people not involved in the response had been added, according to PBS. The reporting does not establish who was responsible. Verifying payrolls may help direct funds to the right people, but the promised arrears still need to reach workers who are owed them.
The consequences extend beyond treatment centers. WHO said deaths were occurring in communities, including among people who were not on known-contact lists. That points to transmission chains response teams had not identified, making community-based detection and access to care essential alongside beds and formal facilities.
What has international support delivered?
Congo’s government and response partners launched a revised 180-day plan on Sept. 4. It sets out work on surveillance, contact tracing, patient care, community engagement and logistics. WHO estimated the plan would require $1.3 billion for full implementation.
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On Wednesday, Sept. 23, the United States announced an additional $267 million pledge, bringing its stated commitment to $886 million, Reuters reported. U.S. officials were also seeking pledges from other countries toward a $2 billion target for the disease response, mainly in Congo. The pledge and target are not evidence that the money has been disbursed or reached local health workers and facilities.
WHO’s Contingency Fund for Emergencies lists a $3.4 million allocation, dated May 19, for the response in Congo and Uganda. The allocation covers activities including workforce surge support and emergency staffing, but the listing does not show how much has reached particular health zones or whether it has filled staffing gaps there.
These figures have different scopes: the $1.3 billion is the estimated cost of a six-month plan, the U.S. figure is a stated commitment, and the $2 billion figure is a wider fundraising target. The available reporting does not establish how much of the new pledge has been paid out or reached frontline workers. WHO’s plan announcement and funding records show the size of the response sought, not whether every local need is covered.
Why is containment still difficult?
WHO’s Sept. 1 briefing pointed to deaths in communities among people not listed as known contacts, a sign that teams had missed some chains of transmission. Insecurity, displacement, movement between communities and a fragile health system further complicate the response, according to WHO and PBS. These conditions can make it harder to find cases, trace contacts and sustain care where people live.
Children under five face particular risks. WHO’s Marie Roseline Belizaire reported a case fatality rate above 60% for children in that age group, compared with about 40% among adults. Smallwood told PBS that identifying Ebola in young children can be difficult because they may not be able to describe their symptoms.
WHO has said response operations need to continue and strengthen over many months. The test for the new commitments is whether they translate into paid teams and accessible services in affected areas. The available figures do not show how many pledged dollars have reached those workers or communities.