The First 100 Days
One hundred days ago, the government of the Democratic Republic of the Congo declared the country's 17th Ebola outbreak, following confirmation of the Bundibugyo virus. The World Health Organization (WHO) subsequently declared a Public Health Emergency of International Concern, and Africa CDC declared a Public Health Emergency of Continental Security. As of August 21, the DRC has reported 5,290 confirmed cases and 2,516 deaths across 56 health zones, making this the second-largest Ebola outbreak ever recorded and one moving faster than any previous one.
The outbreak is being fuelled by insecurity caused by decades of armed conflict that have undermined law, order, and social services, and displaced more than a million people. But as WHO Director-General Tedros Adhanom Ghebreyesus, WHO African Region Regional Director Mohamed Yakub Janabi, and Africa CDC Director-General Jean Kaseya write in a joint appeal published by Al Jazeera and AllAfrica, the first 100 days have made the priorities clear.
Community at the Heart
The appeal opens with a scene from Bunia, where the authors met dozens of community representatives: survivors, women, young people, local organisations, health workers, and leaders from affected areas. Their message, the authors report, was direct: involve us. "We know our communities. We know where families seek care, how information moves and why trust is breaking down," the representatives said, urging that they be given the means to help drive the response.
The authors argue that communities hold the knowledge required to stop Ebola. They can identify illness early, alert health teams, help trace contacts, challenge dangerous rumours, and support families through access to treatment and safe, dignified burials. "Communities are not just part of the response. They are at its heart," the appeal quotes Tedros as saying. The response, the authors write, always moves faster when communities lead alongside national authorities and health workers.
The Toll on Frontline Workers
At the centre of the response are the people who show up every day: health workers caring for patients, laboratory teams identifying the virus, contact tracers following its path, community health workers building trust where fear and misinformation have taken hold, and burial teams helping families honour their loved ones safely. These workers are under extraordinary pressure, often in insecure and hard-to-reach areas, and the toll has been severe. As of August 20, 158 health workers have been infected and 45 have died.
Scaling Up the Response
The authors argue that the response must be scaled by two to three times current capacities to reach every affected area. They warn that delayed financing costs lives and that fragmented financing leaves gaps. Priorities, they say, are clear: reach every affected area, protect frontline workers, and turn commitments into action.
Signs of Progress
There are signs that the course of the outbreak can be turned. Neighbouring Uganda has interrupted locally acquired transmission of the virus, and several health zones in northern Ituri and South Kivu provinces in the DRC have also interrupted transmission. These successes, the authors write, show how rapid detection, decisive action, and close cooperation with communities can change the trajectory of the outbreak.
Coordination Across Borders
The appeal stresses that cross-border coordination must remain strong. Closing borders or imposing blanket travel restrictions can disrupt the response and livelihoods without stopping transmission, the authors argue. Instead, they call for continued collaboration between the DRC, neighbouring countries, communities, and international partners.
The Path Forward
WHO and Africa CDC say they will continue working with the DRC, neighbouring countries, communities, and partners to deliver on these priorities. The first 100 days have demonstrated both the scale of the challenge and the path forward. As the authors put it, "We must rise to this challenge, together."