In the Democratic Republic of Congo, the Ebola epidemic has reached a fourth province, Haut-Uélé, health authorities confirm. The virus has infected 1,274 people and caused 360 deaths since the outbreak was officially declared in May. Ituri remains the epicentre, as health teams struggle to contain the spread amid severe access difficulties, ongoing armed violence, and deep mistrust among parts of the population.

Until now, three provinces were affected: Ituri (bordering Uganda and South Sudan), North Kivu, and South Kivu. Twenty cases, including two deaths, have also been recorded in neighbouring Uganda. Haut-Uélé, which borders Ituri, South Sudan, and the Central African Republic, is now the fourth Congolese province to report cases.

According to a source at the National Institute for Biomedical Research (INRB), an infected person travelled from Ituri to Haut-Uélé, carrying the virus into the new region. Health officials confirmed that the patient died. Teams are now working to trace the chain of transmission and identify potential contacts, as many infections have occurred during traditional funeral rites where mourners touch the body of the deceased, which remains highly contagious.

For weeks, humanitarian workers in the affected zones have been organising safe burials that comply with strict sanitary measures, despite significant resistance from local communities. In the DRC and across Africa, funeral ceremonies often last several days, and families traditionally handle the bodies of their loved ones. Recent incidents have been reported at several health centres, with angry community members demanding the remains of relatives.

Violence by armed groups compounds the crisis

Haut-Uélé shares the same characteristics as Ituri: both are remote border regions rich in gold, making them hubs of intense trade and transit that facilitate the virus’s spread. These areas are also plagued by violence from armed groups. In Ituri, massacres have occurred regularly for about a decade, carried out by community militias or the Allied Democratic Forces (ADF), a group affiliated with the Islamic State. The ADF have recently made incursions into Haut-Uélé, which is also troubled by armed groups from neighbouring countries.

This insecure environment makes it difficult to deploy an effective health response, which was already delayed. Humanitarian workers and scientists say health authorities were slow to detect the virus. Preliminary epidemiological investigations suggest the first suspected deaths may date back to January. While efforts in Ituri have recently been stepped up, health facilities—often under-resourced in one of the world’s poorest countries—still lack basic equipment such as protective kits and chlorine. Ebola treatment centres set up by the WHO and several NGOs are already overwhelmed, with occupancy rates exceeding 138%, according to the National Institute of Public Health (INSP). So far, 78 health workers have been infected, and 18 have died.

Dr Jean-Jacques Muyembe, a leading figure in the response, stated: “We will contain this epidemic, but it will take more time.” Experts and health authorities agree that more than six weeks after the official declaration, the peak has not yet been reached, and the crisis could last between six months and a year. Ebola, which spreads through contact with bodily fluids, has killed over 15,000 people in Africa in the last 50 years. The deadliest outbreak in the DRC, between 2018 and 2020, caused nearly 2,300 deaths out of 3,500 recorded cases.