“Act now or pay a much higher price later.”
The Ebola outbreak in the eastern Democratic Republic of the Congo (DRC) has yet to reach its peak, but treatment centres are already at saturation point, with health officials warning that far greater urgency is needed to contain the virus.
Since the outbreak was first declared in May, there have been more than 1,700 confirmed cases and 580 deaths from the Bundibugyo variant of the virus – for which there is not yet a dedicated treatment (although trials are underway) or a vaccine. Neighbouring Uganda has had 20 confirmed cases and two deaths.
In the DRC, contact-tracing coverage stands at around 60% of cases, leaving thousands of contacts undiscovered. That makes breaking the transmission chain all the harder, deepening fear and stigma.
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The emergence of Ebola in areas marked by active conflict, displacement, and overstretched health services complicates the humanitarian response. But funding is also an issue. The Africa Centres for Disease Control and Prevention (Africa CDC) has launched a six-month, $518 million regional plan, yet less than half of that amount has been secured.
In this Question and Answer, Dr Jean Kaseya, the director-general of Africa CDC, insists the outbreak can be stopped and communities protected – but only if the response is urgently scaled up.
The New Humanitarian: Did the current outbreak begin far earlier than May, and what does that say about the potential impact of USAID funding cuts and the threat of emerging pandemics more broadly?
Jean Kaseya: Yes, we are concerned that transmission started before the outbreak was officially confirmed. That is exactly why early detection, local surveillance, and community alerts are so important. When funding is cut from surveillance, laboratories, community health workers, rapid response teams, and local health systems, outbreaks are detected late. Late detection costs lives. It also costs far more money.
This outbreak is a warning. The next pandemic threat will not start in a boardroom or a conference hall. It will start in a community, a health facility, a market, a border area, or a conflict-affected zone. If those places are not protected, no country is protected.
The New Humanitarian: The worst-case scenario projects 66,000 confirmed cases by September – is that sensationalist or a real possibility?
Kaseya: It is a worst-case scenario. It is not the future we want, and it is not the future we should accept. But nobody should dismiss it. Ebola grows when we move too slowly. It grows when cases are missed, when contacts are not followed, when treatment centres are overwhelmed, when communities lose trust, and when money arrives late.
The point of that projection is simple: act now or pay a much higher price later. We can still stop this outbreak. But the response must surge now.
The New Humanitarian: What would an outbreak of that magnitude look like for DRC and the region, bearing in mind that the West Africa outbreak – the worst on record – infected under 29,000 people over a two-year span?
Kaseya: It would be catastrophic. DRC would face overwhelmed treatment centres, exhausted health workers, more community deaths, interrupted routine health services, and deep economic and social disruption. Children would miss school. Families would avoid clinics. Pregnant women, malaria patients, and children needing vaccines would also suffer.
For the region, the risk would rise sharply. Uganda and other neighbouring countries would face repeated alerts, border pressure, laboratory pressure, and fear-driven disruption to movement and trade.
The West Africa outbreak taught the world one lesson: Once Ebola reaches a certain scale, every delay becomes deadly. We are not there yet. That is why we must move faster now.
The New Humanitarian: Contact tracing is a key gap in the response. Latest reports suggest as many as 300 cases are unaccounted for. Why is there such a problem and what support do contact tracers need?
Kaseya: Contact tracing is difficult in any Ebola outbreak. In this outbreak, it is even harder because of insecurity, displacement, fear, stigma, weak transport, delayed payments, and limited access to some communities.
Some people move because they are afraid. Some move because of conflict. Some move for work, food, trade or family reasons. In that environment, one missed contact can become a new chain of transmission.
Contact tracers need practical support: pay on time, transport, phones, data tools, protective equipment, supervisors, security arrangements, and community leaders who can open doors. They also need local trust. The best contact tracers are often people already known by the community.
We need to find the missing contacts quickly. Ebola spreads in the gaps.
The New Humanitarian: How does the absence of an approved vaccine or specific treatment handicap the response? What does it mean for patients, families and health workers?
Kaseya: It makes the response much harder. For Ebola Zaire, we have vaccines and approved treatments. For Bundibugyo Ebola, we do not yet have an approved vaccine or a specific approved treatment. That leaves us with early detection, isolation, supportive care, infection prevention and control, safe burials, and strong community engagement.
For patients, early care becomes even more important. For families, delays are dangerous. For health workers, the risk is higher and the margin for error is smaller.
The start of treatment trials is important. Work on diagnostics is also important. But science must move together with field operations. People need protection today.
The New Humanitarian: What has been funded so far, what remains unfunded, and which gaps are the most critical?
Kaseya: We have seen important pledges from African countries and international partners. We welcome that.
But pledges do not stop Ebola. Money in the field stops Ebola. Paid contact tracers stop Ebola. Functioning laboratories stop Ebola. Treatment centres with beds and supplies stop Ebola. Trusted community workers stop Ebola.
The most urgent gaps are contact tracing, case management, diagnostics, infection prevention and control, safe and dignified burials, community engagement, health worker protection, logistics, and readiness in neighbouring countries.
Our message to partners is direct: disburse now. The response cannot wait for slow paperwork while the virus is moving.
The New Humanitarian: All the evidence suggests communities should guide the response, unlike the top-down approach that did so much harm during the 2018-2020 outbreak. What does “listening to the local population” look like? What does it take to rebuild trust?
Kaseya: Listening means putting communities inside the response, not speaking to them from outside.
It means women, youth, survivors, health workers, faith leaders, traditional leaders, local authorities and community groups help shape decisions. It means rumours are taken seriously. It means people can ask questions and challenge the response without being treated as a problem.
Trust comes from behaviour. Pay local workers on time. Treat families with dignity. Explain decisions. Use local languages. Make treatment centres safe and humane. Protect women and children. Support survivors. Show where resources are going.
People cooperate when they feel respected, protected and informed.
Ebola outbreak: A crisis of history, not misinformation
Distrust of the humanitarian intervention is not irrational – it’s grounded in the realities of neglect, abuse, and exploitation.
The New Humanitarian: The New Humanitarian exposed a massive sexual abuse scandal involving WHO staff during the 2018-2020 epidemic. What measures have been taken to ensure such abuses don’t happen again? Have you sought reassurances from WHO and are you satisfied with their processes this time around?
Kaseya: What happened during the 2018-2020 outbreak was unacceptable. Women and girls were harmed by people who were supposed to help protect them. That failure must never be repeated.
Africa CDC’s position is firm. Safeguarding must be part of the response from day one. Every responder must follow a code of conduct. Communities must have safe reporting channels. Women and girls must know where to report abuse. Complaints must be investigated quickly. Survivors must receive support. Perpetrators must be removed and held accountable.
We have raised this with partners, including WHO. We expect prevention, accountability and field-level follow-up.
I will not say we are “satisfied” because policies on paper are not enough. We need proof in the field. Safeguarding must be visible to communities every day.
EXCLUSIVE: More than 50 women accuse aid workers of sex abuse in Congo Ebola crisis
Not one woman said she knew of a hotline, email address, or person to contact to report the incident.
The New Humanitarian: A pandemic response in a conflict zone is not politically neutral – it distributes resources and legitimises selected actors. Given access and funding constraints, can abusive authorities who are parties to the conflict be operationally kept at arm’s length?
Kaseya: In a conflict zone, public health must protect people without feeding the conflict. DRC leads the national response. Africa CDC supports national leadership. At the same time, lifesaving services must reach people based on need, not politics, armed control, ethnicity, or affiliation.
The safeguards are important: transparent financing, traceable supplies, independent monitoring, community feedback, protection principles, and strong coordination with humanitarian actors.
No armed actor should use Ebola for legitimacy, control, money or coercion. The virus already exploits conflict. The response must not add fuel.
The New Humanitarian: Does the US push for America First Global Health Strategy agreements undermine the Africa Health Security and Sovereignty Agenda?
Kaseya: Africa welcomes partners who strengthen African priorities. Every country can define its foreign policy. Africa will also define its own health security agenda. For us, the test is simple: does the agreement strengthen African institutions, African manufacturing, African surveillance, African regulatory systems, and African decision-making?
If support aligns with Africa’s priorities, it helps. If it fragments the response, bypasses continental institutions, or pushes countries to negotiate alone during emergencies, it weakens collective security.
Africa CDC is building African health sovereignty. We want partners who support that direction.
The New Humanitarian: How does Africa get fairer access to vaccines, diagnostics, and other countermeasures?
Kaseya: Africa must negotiate together, buy together, and manufacture more on the continent.
Fair access requires pooled procurement, predictable financing, stronger regulators, the African Medicines Agency, regional manufacturing, technology transfer, African-led clinical trials, and advance agreements before emergencies hit.
Africa does not seem to enjoy the same sense of urgency as other parts of the world. Africa cannot keep arriving last in every global health crisis. African health workers face the same risks. African communities deserve the same speed.
The answer is practical: finance early, regulate faster, manufacture closer to need, purchase collectively, and make equity a condition from the beginning.
The New Humanitarian: In the current Ebola outbreak, what worries you most, what gives you hope, and what should international partners do differently?
Kaseya: What worries me most is speed. The virus is moving faster than parts of the response. Contact tracing, financing, logistics, treatment capacity, and community engagement must catch up now.
I am also worried about health workers. They are carrying enormous pressure in extremely difficult conditions. What gives me hope is what I have seen in DRC: health workers showing up, communities organising, survivors helping the response, and local leaders trying to protect people. I have also seen African solidarity.
[DRC] President [Félix] Tshisekedi is leading the national response. South African President [Cyril] Ramaphosa’s visit to Kinshasa, convened with Africa CDC’s support, sent a strong continental signal: DRC is not alone.
International partners should do three things. First, disburse funding now. Second, align behind DRC leadership and Africa CDC’s continental coordination. Third, fund the front line: communities, contact tracers, laboratories, treatment centres, health workers, and neighbouring-country readiness.This outbreak can still be controlled. But the response has to move now.
Obi Anyadike, Senior editor, Africa