On 15 May, health authorities in DRC officially declared an outbreak of Ebola disease caused by the Bundibugyo virus.

Days earlier, MSF had received alerts of unusual deaths linked to a suspected viral haemorrhagic fever in Mongbwalu health zone, northwest of Bunia in Ituri province. An assessment with the Ministry of Health found that 55 people had died in the area since the beginning of April.

By the declaration, authorities had reported hundreds of suspected cases and more than 80 deaths across Mongbwalu, Bunia and Rwampara health zones. A case had also been confirmed in neighbouring Uganda.

MSF began preparing a large-scale response, deploying specialised teams, medical supplies and protective equipment while expanding isolation and patient-care capacity.

By 28 May, confirmed and suspected cases had been reported across Ituri, North Kivu and South Kivu. Limited testing and difficulties reaching some areas meant the full scale of transmission remained unclear.

MSF rapidly expanded activities. A 65-bed Ebola treatment centre was under construction in Ituri, while temporary isolation structures were established in Mongbwalu and Fataki. Teams also reinforced infection prevention and treatment capacity in Bunia and several locations in North Kivu.

Yet hundreds of samples were awaiting laboratory processing, and isolation and treatment capacity remained insufficient.

One month after the declaration, MSF warned of major gaps in surveillance, diagnosis, contact tracing and community engagement.

Treatment centres in Ituri were under intense pressure, with many patients arriving only after becoming severely ill. Testing remained particularly limited in areas affected by insecurity, while access constraints prevented response teams from reaching some communities.

By the two-month mark, more than 2,000 confirmed Ebola cases and 750 deaths had been reported.

In less than five weeks, confirmed cases had approximately tripled. In Bunia, the 90-bed Elikya Ebola treatment centre was regularly operating close to capacity, and some people delayed seeking care because they feared no bed would be available.

MSF called for a broader response, including expanded testing, treatment capacity, surveillance, contact tracing, community engagement and survivor care.

As Ebola continued to spread, hundreds of thousands of people in eastern DRC were already living with the consequences of repeated displacement.

Displaced families may face overcrowding, reduced access to clean water, interrupted vaccination and difficulty reaching healthcare. Repeated movement can also make surveillance and contact tracing more difficult.

At Rho displacement camp near Drodro, Ituri, where nearly 50,000 people were living, community leaders worked with MSF to encourage early testing and treatment and strengthen infection prevention.

Their involvement showed that displaced communities are not simply recipients of emergency assistance. Their knowledge, participation and trust are essential to making the response effective.

As international attention focused on Ebola, MSF warned that other urgent health needs in eastern DRC could not be neglected.

Cholera, measles and malaria continued to affect communities in North Kivu and South Kivu, alongside conflict-related injuries and the health consequences of displacement and sexual violence.

From January to 19 July, official figures recorded more than 108,000 suspected measles cases and 1,394 deaths across DRC. More than 35,000 suspected cholera cases and over 1,000 deaths had also been reported.

For people living in eastern DRC, these emergencies overlap. A family displaced by violence may simultaneously need clean water, malaria treatment, childhood vaccination, maternity care or treatment for cholera or measles.

Fear of Ebola can also discourage people from visiting health facilities for other illnesses. Routine healthcare therefore needs to continue alongside the outbreak response. Stopping Ebola cannot mean allowing other urgent health needs to go untreated.

Nearly 100 days after the outbreak was declared, Ebola had become the largest and deadliest outbreak recorded in DRC’s history.

As of 16 August, national authorities had reported more than 5,000 confirmed cases and more than 2,400 deaths. MSF reported that more than 60 per cent of Ebola deaths had occurred outside treatment centres, often far from specialised facilities.

By August, more than 1,400 MSF staff were supporting the response across several affected provinces, operating treatment centres and isolation units while strengthening local health facilities and community-based activities.

The situation underscored the need to bring testing, isolation, referral and treatment closer to affected communities.