JONATHAN M. METSCH, Dr.P.H. – Tracking Emerging Public Health Challenges – September 24, 2026 – EBOLA
He was infected before anyone knew to look for him.
That is the story of this outbreak captured in one person’s travel history. It is one example of how this virus is showing signs of containment in some areas, while new cases are being recorded in provinces for the first time. The local and international responses over the last 4 months are working, even if they cannot predict where the virus will travel next.”
When the Response Names Its Own Obstacles
“Payroll and Compensation Failures: North Kivu reports unpaid security personnel guarding health facilities and delayed compensation for first responders.5 In Haut-Uélé, psychosocial support personnel face missing payments,6 while Ituri reports worker demotivation linked to unpaid arrears.5 At one checkpoint, workers went on strike over non-payment.6 The commitment to fix this is on record: an August 5 high-level meeting chaired by President Félix Tshisekedi listed prompt, transparent, and fair payment of salaries, hazard pay, and other entitlements owed to health workers and response staff among its 8 immediate priorities.8
Transport and Mobility Bottlenecks: Transportation shortages severely limit the ability of multiple provinces to deploy personnel and essential supplies to high-priority areas. Tshopo faces a critical shortfall of motorcycles, and a lack of transport forced the cancellation of scheduled vaccination sessions in the province.5 Similar mobility constraints prevent the deployment of provincial infection prevention and control (IPC) teams in North Kivu, as well as psychosocial support staff in Haut-Uélé,5. At the same time, impassable roads delay humanitarian responses in parts of Bas-Uélé.6
Supply Chain Breakdowns: Ituri reported a lack of personal protective equipment (PPE).6 Elsewhere in the province, a lack of testing supplies and personnel, combined with family refusal, prevented post-mortem Ebola testing on 10 deceased individuals.6 In Haut-Uélé, outreach teams have exhausted all communication materials across every affected health zone.5 Concurrently, Tshopo lacks a secure blood supply, while Bas-Uélé operates without a dedicated treatment center or patient transport ambulance.5
Institutional Vulnerabilities: Systemic weaknesses across field security, data infrastructure, community trust, and essential support services are severely restricting where and how the response operates. Security threats directly reduce response coverage across affected areas. These risks range from insecurity preventing the opening of a key checkpoint in Ituri to active intimidation of health workers in North Kivu.5 Simultaneously, network connectivity losses and hardware failures cripple real-time surveillance, leaving South Kivu with only 5 of its 9 expected reports submitted5 and 4 Haut-Uélé checkpoints fully off the grid.6
Together, these persistent barriers demonstrate that frontline teams are struggling against larger systemic constraints rather than temporary logistical delays.” (1)
“Catherine Smallwood, the WHO’s Ebola incident manager, said cases and deaths had begun declining in North Kivu after several weeks of increases. But although treatment beds are being added daily, facilities still lack enough staff and partners to operate them.
“The human resources gap is one of the biggest gaps,” Smallwood said.
WHO representative in Congo Anne Ancia said one Ebola treatment center requires about 300 health professionals, including anesthetists, hygienists, nurses and general practitioners.
“We are building Ebola treatment centers but do not always have the human resources needed to operate them,” Ancia said. “Those health workers must be paid.”
Frontline workers in Ituri previously went on strike over unpaid wages, worsening access to care. Health Minister Roger Kamba said in July that the government was verifying payroll lists after the names of people not involved in the response were added. Frontline workers said officials promised to pay the arrears, but some workers received nothing and others only part of what they were owed.” (2)
“G20+ countries pledged an additional $700 million this week to counter the Ebola outbreak in the Democratic Republic of Congo (DRC), Dr Jean Kaseya, Director-General of Africa Centres for Disease Control and Prevention, told a media briefing on Thursday.”
“The additional pledges mean that over $2.9 billion has been raised for the outbreak, which is growing at five times the rate of the previous biggest Ebola outbreak.
Describing the new money as “huge”, Kaseya thanked the US government, which is the biggest funder of the response, followed by the European Union.
“But pledges alone will not stop Ebola,” Kaseya added. “We must be able to trace every single dollar—from commitment to disbursement, from implementing partner to expenditure, and ultimately to the services delivered to affected communities. Transparency builds trust, accelerates delivery and saves lives.””
“The new money will go towards “new Ebola treatment units, additional safe and dignified burial teams, mass procurements of personal protective equipment, expanded surveillance, critical health commodities, and contact tracing through trusted implementers,” the US State Department said.” (3)
US pledges $267 million more to fight Ebola in central Africa, By Reuters, https://www.reuters.com/legal/litigation/us-pledges-267-million-more-fight-ebola-central-africa-2026-09-23/
DRC’s Ebola Lessons: Learned and Unlearned (Part I), by Mukesh Kapila, https://healthpolicy-watch.news/drcs-ebola-lessons-learned-and-unlearned-part-i/
DRC’s Ebola Outbreak: The Vast Mobilisation That Doesn’t Measure Itself (Part II), by Mukesh Kapila, https://healthpolicy-watch.news/drcs-ebola-outbreak-the-vast-mobilisation-that-doesnt-measure-itself-part-ii/
Why Has The Fastest-growing Ebola Outbreak Ever Been So Difficult To Contain?, https://www.yahoo.com/news/videos/why-fastest-growing-ebola-outbreak-120242102.html
The World Forgot About Ebola. The Organization Fighting It Has Never Been More Worried, https://www.wired.com/story/organization-fighting-ebola-never-more-worried/
1.When the Ebola Outbreak is Spreading Faster Than the Response Can Follow, by Brenna Doran, https://www.infectioncontroltoday.com/view/when-ebola-outbreak-is-spreading-faster-response-can-follow
2.Congo is running short of health workers as Ebola remains out of control, WHO says, By The Associated Press, https://www.kob.com/ap-top-news/congo-is-running-short-of-health-workers-as-ebola-remains-out-of-control-who-says/
3.Almost $3 billion Raised For DRC’s Ebola Outbreak, as Focus Shifts to Nord-Kivu, by Kerry Cullinan, https://healthpolicy-watch.news/almost-3-billion-raised-for-drcs-ebola-outbreak-as-focus-shifts-to-nord-kivu/
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai