Geneva/Kinshasa, 20 August 2026 — The Bundibugyo virus disease (BVD) outbreak in the Democratic Republic of the Congo (DRC) has become the largest Ebola outbreak ever recorded in the country, with 4,665 confirmed cases and 2,184 deaths reported as of 12 August 2026. The World Health Organization and Africa CDC welcomed the allocation of 70,000 doses of Ervebo vaccine from the global stockpile on 20 August, marking a critical escalation in the international response to a public health emergency of international concern declared on 17 May 2026.
Outbreak Scale and Geographic Spread
The outbreak, caused by the Bundibugyo ebolavirus (BDBV) — a species distinct from the Zaire ebolavirus responsible for most previous major Ebola epidemics — was first reported in the Mongbwalu health zone of Ituri Province on 14 May 2026. Within three months, it has expanded to 54 health zones across six provinces: Ituri, North Kivu, South Kivu, Haut-Uélé, Tshopo, and Bas-Uélé.
Ituri Province remains the epicentre, accounting for 85% of all confirmed cases (3,979 of 4,665) and 79% of deaths (1,726 of 2,184) nationwide. The most recently affected province, Bas-Uélé, recorded its first confirmed case on 4 August in a patient with travel history to Haut-Uélé, underscoring the outbreak's continued geographic expansion.
A Virus Without a Licensed Vaccine
The Bundibugyo virus presents a unique challenge: unlike the Zaire ebolavirus, for which the Ervebo vaccine is licensed and recommended, no approved vaccine or specific treatment exists for BDBV. Previous Bundibugyo outbreaks were small — the 2007 Uganda outbreak had a case fatality ratio of 30%, and the 2012 DRC outbreak had a ratio of 50%.
On 7 August 2026, the WHO Technical Advisory Group on candidate vaccine prioritisation recommended that Ervebo be prioritised for inclusion in a randomised clinical trial. The International Coordinating Group (ICG) on Vaccine Provision subsequently allocated 70,000 doses to the DRC on 20 August.
Vaccine Allocation: Trial and Frontline Protection
The 70,000-dose allocation is divided into two streams:
| Allocation | Doses | Purpose |
|---|---|---|
| Phase 3 clinical trial | 20,000 | Generate evidence on Ervebo's effectiveness against Bundibugyo virus |
| Frontline and health workers | 50,000 | Protect those at highest occupational risk, per SAGE recommendations |
Gavi, the Vaccine Alliance, is providing $7 million to fund vaccine shipment and an additional $6 million to assist with vaccination efforts and broader immunisation services in high-risk areas.
WHO has emphasised that informed consent is paramount: all individuals offered the vaccine must receive clear information about the risks, potential benefits, and limitations, given that Ervebo's efficacy against the Bundibugyo strain remains under investigation.
Treatment Trial Underway
In parallel with the vaccine deployment, WHO is sponsoring the PARTNERS trial — the first clinical trial to identify effective treatments specifically for Bundibugyo virus disease. Enrollment began on 2 July 2026 across three clinical management facilities in Ituri Province, and over 100 confirmed cases have already been enrolled.
Health Worker Infections and Insecurity
As of 9 August, at least 155 confirmed infections among health workers have been recorded, including 45 deaths (CFR: 29%) and 68 recoveries. These infections highlight persistent challenges in implementing infection prevention and control measures in health-care facilities outside designated Ebola treatment centres.
The outbreak is unfolding amid a severe humanitarian crisis. Since the PHEIC declaration on 17 May 2026, 12 attacks on health care have been recorded, with additional reports under verification. Insecurity and attacks on health facilities have curtailed access for response teams, discouraged patients from seeking care, and disrupted surveillance activities.
Cross-Border Spread and Regional Risk
The outbreak has not been confined to the DRC. Uganda has recorded 20 confirmed cases and two deaths, with the final patient discharged on 16 July. Ugandan health authorities declared their outbreak over on 28 July after 42 days without new locally transmitted cases. France reported a single imported case detected on 24 June, with no secondary transmission recorded.
WHO's risk assessment places the risk in the DRC as very high, in Uganda as high, and in countries sharing land borders with BDBV-affected nations as high due to sustained population mobility linked to cross-border trade and mining activities.
Response Scale-Up
WHO's Director-General and Regional Director for Africa, alongside the Director General of Africa CDC, conducted missions to the DRC and identified surveillance activities and closer community engagement as priority areas. A continental preparedness and response plan — a strategic six-month framework running from June to November 2026 — guides coordinated efforts across emergency coordination, disease surveillance, laboratory testing, infection prevention and control, clinical care, community engagement, and research.
Expanding the number of treatment centres across more areas is underway, along with training for health and care workers to staff them. As of 12 August, 84.2% of contacts (17,460 of 20,740) were followed up within the previous 24 hours.
Sources
- World Health Organization, Disease Outbreak News: Ebola disease caused by Bundibugyo virus — Democratic Republic of the Congo, 14 August 2026.
- World Health Organization, News release: WHO and Africa CDC welcome the allocation of Ebola vaccines to the Democratic Republic of the Congo, 20 August 2026.
- WHO Regional Office for Africa: Ongoing outbreak in the DRC.
- ECDC: Ebola outbreak in the Democratic Republic of the Congo and Uganda.
- International Rescue Committee: Ebola outbreak in DRC and Uganda.
FIRAT Editorial Board
Institutional Research Desk · Foresight Institute of Research and Translation
The collective editorial and research translation board of FIRAT, synthesising peer-reviewed evidence, policy briefs, and division milestones across our seven foundational research pillars.
