Ebola Crisis: Multilateral Response Across Health and Security
Since early May 2026, an outbreak of Ebola has been rapidly evolving in northeastern DRC into the second-largest outbreak recorded. Case mortality rates jumped from 15% to 48% in just a few weeks.
The multilateral health response, aided by a more integrated operation between the World Health Organization (WHO) and the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) than in the past, is unfolding against a complex security situation and humanitarian crisis, with ongoing armed conflict between government forces and armed groups throughout the area.
There are ongoing efforts to advance peace mediation efforts but the Security Council has not yet taken any action to address the wider impact of the Ebola outbreak.
As world leaders convene in New York for the annual high-level opening of the General Assembly and high-level meetings on health and Security Council meetings on MONUSCO; they should consider measures to respond to the deteriorating situation across health and security.
In early May 2026, an outbreak of Ebola was identified in the northeastern Democratic Republic of Congo (DRC). The WHO and African Center for Disease Control (African CDC) declared the outbreak a public health emergency of international and regional concern respectively. It is the 17th outbreak of Ebola in DRC, and the most deadly recorded in the country yet.
This note summarizes the current situation and factors that are causing this Ebola outbreak’s rapid spread, the multilateral health response, and the lack of a concerted effort to improve the security environment. As world leaders convene in New York for the annual high-level week of the General Assembly, the High-level Meeting on Pandemic Prevention, Preparedness and Response on 25 September and the regular briefing of the Security Council on the the United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO) on 29 September offer a timely high-profile opportunity to address the crisis from both the health and a security perspective, and to integrate these.
The largest, deadliest, and fastest-growing Ebola outbreak in DRC — and still growing
WHO reports, as of September 19, show 7,672 confirmed cases, and 3,699 deaths in the DRC. Exposure is a particular risk for young women who make up the majority of frontline healthcare workers and are frequently primary caregivers for sick family members. UN system experts warn that the situation is rapidly deteriorating, as can be seen through the daily situation reports issued by the DRC authorities. The case fatality rate in the DRC has been rapidly rising from 30.7% on July 1, to 38% on July 15, and 44.2% on August 1. Since the end of August, the rate has hovered just above 48%, which means that every second recorded infection is now fatal. The outbreak has increasingly spread geographically and now reached seven provinces, while Ituri province remains the epicenter with almost 80% of reported cases.
The deteriorating situation in DRC stands in contrast with the more successful response in neighboring Uganda, which declared itself ‘free of ebola’ on July 29. While exact figures are hard to verify independently, it appears that, even though the epicenter of the Ebola outbreak is located right on a porous border, a combination of a national surveillance infrastructure and rapid response capacity, a stable security environment, and border restriction and quarantine measures, enabled early detection and containment in Uganda (border restrictions, at the same time, also pose an obstacle for access into the DRC). Health infrastructure and response are intrinsically related with the security environment, and reinforce each other.
A health responses limited by insufficient health infrastructure, logistics, and insecurity
The current spread of the Ebola virus in the DRC is caused by a number of factors:
Health. There is no licensed vaccine or rapid diagnostic test for Bundibugyo ebolavirus, the strain of the current outbreak, although rapid research continues on that front. Contract tracing rates of 85% remain below the 90-95% coverage required to contain transmission, despite recent improvements. The absence of rapid diagnostic tests slows down contact tracing, undermines the accuracy of reported cases and hampers the ability to track transmission in real time. Ebola’s contagiousness demands a strict decontamination regime and a high-volume of personal protective equipment (PPE). Cuts to international aid have disrupted training programs and supply chains that frontline health workers depend on to safely manage Ebola cases, compounding existing gaps in access to treatment protocols and PPE. In particular, the dismantling of USAID and U.S. withdrawal from the WHO in 2025 weakened a structure that led the response in the previous crises (although vestiges of this structure continue to play an important role.)
Quarantine and logistical access. Restrictions on border crossings impede access for health workers as well as the delivery of goods and services. Moving staff and materials from the key logistics hub in Entebbe, Uganda is critical for the multilateral response effort. Quarantine requirements of up to 21 days for travelers entering Uganda from the DRC complicate operations.
Security. The multilateral response overlaps with an active conflict and humanitarian emergency. In the affected areas in the DRC, control is contested between the national government and a network of armed non-state actors. The lack of a ceasefire hinders effective surveillance and contact tracing operations, and the general lack of respect for international humanitarian law among armed groups increases risk for humanitarian and health personnel. The spread of mis- and disinformation complicates operations, as was seen during previous outbreaks.
Not enough, but the multilateral health response is surging
Operational arrangements. The multilateral response builds on the lessons learned from the 2014-2016 Ebola outbreak in West Africa, and the subsequent establishment of the WHO’s Health Emergencies Program (WHE). The WHE strengthened the organization’s operational capacities and updated standard operating procedures for health emergencies with improved internal procedures. While the emergency is still unfolding and it is too early for a comprehensive assessment, the view from within the leading agencies coordinating the response is that current mandates and structures are appropriate to surge capacity.
Resource mobilization. Funding appeals are ongoing, with about 35% of WHO’s response plan covered. On June 5, the WHO and the African CDC announced a six-month response plan and issued a call for $518 million. Approximately half ($240.3 million) will be directed to the response in the DRC, with the remainder to Uganda, preparedness in 11 neighboring countries, and to organizations supporting the overall response. On June 25, the call was revised upwards to $1.4 billion to reflect the scale of the outbreak and include support for humanitarian relief measures. OCHA committed up to $60 million from the Central Emergency Response Fund. In addition to contributions to their support toward humanitarian assistance in the DRC provided through OCHA, the U.S. contributes $270 million in direct Ebola response funding. In connection with the U.S. withdrawal from the WHO, contributions to the humanitarian response cannot directly fund the organization, which adds a layer of administrative complexity for an integrated operation.
Vaccine Development. The development of a vaccine against the Bundibugyo strain is being fast-tracked. The Coalition for Epidemic Preparedness Innovations (CEPI) committed $61.8 million to fast-track four candidate Bundibugyo vaccines in development by IAVI, Moderna, the University of Oxford/Serum Institute of India, and Public Health Vaccines. The U.S. committed $50 million to CEPI on June 10. On May 29, GAVI, the Vaccine Alliance, committed $50 million to addressing the outbreak, with $40 million to support vaccine development in partnership with CEPI. $10 million will support implementation of national response plans to protect routine immunization, protecting healthcare workers, and ensuring readiness for future outbreaks.
A push to improve the security environment is critical, yet missing
There has been no significant UN initiative to improve the security in the region in support of the health response. The relative success in containing the outbreak in neighboring Uganda points to the importance of a stable environment for an effective response to the health crisis. In the DRC, conflict continues between the national and rebel groups, including the M23 rebels that control large swaths of the North and South Kivu provinces. Local conflict hampers humanitarian access and individuals’ access to essential services. At the same time, the M23 reportedly has mounted an independent health response in territories controlled by them, and official numbers report a very low caseload in those areas (with only one reported case in Goma.)
The United Nations Organization Stabilization Mission in the Democratic Republic of the Congo (MONUSCO) provided logistical support, including vehicles and ambulances, to WHO, and established mobile operating bases to increase presence around health facilities to support the health response. There has been no significant action taken to mount a more robust response. In fact, compared to previous outbreaks in the region in 2018-2020, the Mission has a lower footprint and capacities to support a health effort as the Security Council has gradually downsized it for political and budgetary reasons over recent years.
At the political level, the UN system continues to cast the Ebola response as a public health matter, while seemingly minimizing the security elements involved. Pressed by a journalist, the UN Senior Ebola Coordinator Julien Harneis acknowledged on July 29that the security situation was a concern, but described the operations as a public health response in a “complicated environment.” He stressed that the majority of cases occurred in and around Bunia, the capital of Ituri province, which was a “safe environment” where people could seek care without concern.
The UN Security Council has not taken action specifically to the ongoing crisis, unlike during some previous outbreaks. The Ebola outbreak was highlighted by most Council members during the last regular briefing on the situation in the DRC on 26 June, mostly to acknowledge the efforts of the national government, the WHO in leading the response, and MONUSCO’s support to these efforts. Member States stressed the importance of humanitarian access and protection of health and humanitarian workers. The primary focus of Member States, however, was not Ebola, but the implementation of peace efforts, particularly the Doha Peace Framework and Washington Accords, as well as MONUSCO’s role in it. The DRC itself, as a current Council member did not reference the Ebola crisis in their national statement, beyond a joint declaration by the three African Council members.
No peak in sight, but leaders should use upcoming high-level meetings for action
With the current rate of acceleration, the health situation in the affected regions is likely to further deteriorate. It may not have reached the level of a pandemic, and is unlikely to do so, but the required response to an endemic, like the current Ebola outbreak, is quite similar. The upcoming High-level Meeting on Pandemic Prevention, Preparedness, and Response is an opportunity to raise awareness, announce commitments, and mobilize support for the multilateral emergency response to the outbreak, but also highlight the need for investment into prevention and preparation infrastructure and mechanisms in the region to enable better detection, tracing, and treatment of future outbreaks. A strong and locally-embedded primary health care system will also be more likely to build up trust with local communities and improve resilience against mis- and disinformation than health-workers flown in from other regions or internationally only for the duration of acute crises.
The complex security environment is hampering the national, bilateral, and multilateral health response. Against the background of a health emergency occurring in an area rich in gold and critical minerals, subject to strategic and competing interests by both the U.S. and China, growing attention is to be expected, as are calls for a more robust international engagement. The U.S. signed a Strategic Partnership Agreement with the DRC in December 2025 to secure supply chains, and will be interested in ensuring that the Ebola outbreak does not destabilize an already fragile region further at a time when global supply chains for critical minerals are already stretched thin. Their decision to host a ministerial meeting of the G20 on September 23 on the margins of the UN General Assembly is a concrete initiative underlining the urgency of the issue.
Expression of support for ongoing efforts may increasingly turn into pressure, in particular on the Security Council, to consider action. At the very least, pressure on the DRC, Uganda, and Rwanda might mount to remove administrative obstacles and leverage political influence on any (armed) actors in the region to facilitate a more effective operation of healthcare organizations on the ground. Recent progress in peace talks between the DRC government and the M23, including on ceasefire monitoring and verification, are encouraging signs. The spread of the Ebola outbreak, however, by far outpaces any gradual steps toward stabilization right now. The Security Council will be briefed, on September 29, on MONUSCO. The consultation will offer a key moment to highlight more explicitly, how the security environment interrelates with the health crisis and what the operational implications for the missions are, and how the Council could enable more robust support provided through the UN mission on the ground.
Failing to more effectively address the security components of the fast-spreading Ebola outbreak in DRC ultimately undermines the efficacy of the health response. The high-level platform at the UN General Assembly at the end of this month is a rare moment to bring together both health and security tracks for a more cohesive effort to contain the crisis. It should not be missed.
Photo Credit: UN Photos/Martine Perret