Hope rises in Bulape as DRC mounts swift Ebola response

Swift action, strong partnerships, and early signs of recovery are fueling optimism in Kasai Province as Congo confronts a new outbreak

NEWS ANALYSIS | RONALD MUSOKE | When the Democratic Republic of the Congo (DRC) confirmed a new outbreak of Ebola on Sept.4, memories of past outbreaks came rushing back. Fear spread quickly in Kasai Province, where the virus was detected.

But just two weeks later, the mood appears to have shifted, thanks to rapid action by the Congolese government, strong support from international partners, and bravery from local health workers.

Amid the grief of lives lost, new signs of hope are emerging, as first survivors walk out of the Bulape treatment centre alive. “We’re witnessing important improvements in the response, but these are still the early days,” said Dr. Mohamed Janabi, the World Health Organization (WHO) Regional Director for Africa.  “Determined action is vital to consolidate these positive steps, gain ground against the virus, end its spread, and protect the population.”

Swift action saves time

One reason the response feels different this time is speed. Within 24 hours of the first confirmed case, the Congolese government declared an outbreak, adhering to international health regulations. That move triggered a cascade of rapid deployments.

WHO and partners including Médecins Sans Frontières (MSF), UNICEF, the Alliance for International Medical Action (ALIMA), the World Food Programme (WFP), the International Organization for Migration (IOM), and the UN peacekeeping mission in Congo (MONUSCO) mobilized planes, medical teams, vaccines, and supplies to Bulape, the outbreak’s epicenter.

“Special thanks go to the WFP and MONUSCO,” said Dr. Patrick Otim, the Programme Area Manager for Emergency Response at the WHO Regional Office for Africa, during a virtual press briefing on Sept.18.

“Their support in providing aircraft has been crucial in getting teams and essential supplies in and out of Bulape quickly.” What once took days by road — vaccines and lab samples bouncing across poor roads for nearly a week—now takes hours by air. That time saved is saving lives.

Tracking the virus

Two weeks into the outbreak, the progress is striking. Over 90% of people who came into contact with confirmed Ebola cases are now being monitored daily, up from just 19% at the start.

In Bulape health zone alone, nearly 950 contacts are under watch. Medical teams check in with them morning and evening, ready to act if symptoms appear. This vigilance is crucial; it means new cases are detected earlier, isolated faster, and treated before they can spread the virus further.

Dr Otim says the outbreak remains confined to 14 localities in Bulape, with no spread yet to other health zones of Kasai Province. As of Sept. 17, there were 48 cases (38 confirmed, 10 probable) and 31 deaths. Though each life lost is a tragedy, experts note that without the early surge in surveillance and contact tracing, those numbers could be far higher.

“Our aim is to disrupt the transmission chain by intensifying disease surveillance, alert management, and contact tracing,” said Dr. Patrick Okumu Abok, the Acting Regional Emergency Director at the WHO Regional Office for Africa.

A centre of healing in Bulape

The newly built Ebola Treatment Centre in Bulape—a 34-bed facility staffed by national health workers alongside international experts—is at the heart of the quick response. Fifteen patients are currently receiving care there. On Sept. 15, two of those patients were declared free of Ebola and discharged. Their recovery was a powerful moment for a community weary of loss.

The centre offers not only isolation but also cutting-edge care. Patients receive fluids, treatment for co-infections, nutritional support, and access to promising therapeutics. Monoclonal antibody treatments such as mAb114—first discovered in the DRC itself—and Inmazeb (from Regeneron) are now part of the standard of care.

“For Ebola, survival depends on how early treatment is initiated,” explained Dr. Janet Victoria Diaz, the Head of Safe and Scalable Care at WHO. “That’s why surveillance and rapid isolation are so critical. When patients get optimized care early, their chances of survival rise dramatically.”

“The patients are getting fluid resuscitation as well as treatment for co-infections and monitoring. And we are now working with all the partners to support the Ministry of Health and the setup and establishment of another treatment centre that has all the innovative techniques that we’ve been developing over the years,” she said.

Behind the scenes, infection prevention systems—from strict “donning and doffing” (putting on and taking off protective gear) procedures to carefully designed patient flow circuits—protect health workers from exposure. Their courage, working long hours in sweltering protective suits, is the backbone of the response.

Vaccines bring protection and reassurance

Perhaps the most hopeful development is the rollout of vaccines. Thanks to pre-positioned doses in the country, vaccinations began on Sept. 13, just nine days after the outbreak was declared. Health workers and contacts of patients were first in line.

So far, more than 590 people, including over 280 frontline health staff and more than 300 contacts, have been vaccinated in Bulape and nearby Mweka. Six vaccination teams are working daily, with more doses arriving.

An additional 45,000 doses of the Ervebo vaccine have been approved for the DRC. The first shipments arrived in Kinshasa on Sept. 19, with more to follow in days.

The challenge has been logistics. Ervebo requires ultra-cold storage at minus 80 degrees Celsius. Initially, vaccines had to be shuttled in small batches from Kinshasa to Bulape and used within 14 days. Now, an ultra-cold chain facility is being set up in Bulape itself, which will allow for faster, larger-scale rollout.

“We’re very grateful to have a pre-qualified vaccine available from the start of this outbreak,” said Dr. Sheila Nsasiirwe, WHO’s Health Emergencies Officer for Immunization. “This was not the case in earlier epidemics. Vaccines are giving protection to health workers and reassurance to the community.”

More importantly, there has been no significant vaccine hesitancy so far. Community engagement teams — working with religious and local leaders — have explained the safety and effectiveness of the vaccine, and people are stepping forward willingly.

Communities at the centre

Unlike some past outbreaks in the DRC, this time community cooperation has been strong. There have been no recorded acts of hostility against health workers. At first, some families hesitated to send sick relatives to the treatment centre. But engagement teams quickly stepped in, listening to concerns and explaining what care would be provided. In each case, families agreed, and patients received treatment.

“We always say that communities are at the centre of any outbreak control, and getting their support and collaboration with all the response interventions is critical,” said Dr. Otim.

“I would like to state that in this particular response, we have not recorded what we call acts of hostility from the community.  Understandably, there have been some few instances of hesitance, for instance, to be admitted to the treatment centre, but these have been resolved by the community engagement teams.”

“There have been three of these instances but these have been quickly resolved once the community engagement teams and the experts have gone and explained to the family why it is important for this person to be taken to the isolation centre, and what is going to happen there in terms of the care that is going to be provided. They have responded positively,” Dr. Otim said.

He explained that considering the fact that the outbreak in Kasai has happened after almost two decades of the last outbreak in the province, many people in the affected area do not have very good memory of this particular disease.

“That’s why we are not taking the issue of community engagement and risk communication lightly.  There have been massive efforts to try to map out the community leaders, the religious leaders, to engage, to pass messages, to address their concerns, and ensure that we are responding in a way that is sensitive to the culture of the population, but also that mitigates the risk of transmission,” he said.

A regional shield

Kasai Province which is found in the South-Central region of DRC borders Angola and this has naturally raised fears of cross-border spread. Although nine neighbouring countries have been assessed for preparedness, Angola has been prioritized for extra support, with WHO providing risk assessments, contingency planning, and training.

“Diseases don’t need permission to cross borders,” noted Dr. Patrick Njuguna Kuria of WHO Regional Office for Africa during the press briefing. “That’s why we’re working closely with Angola and other countries to strengthen points of entry and readiness.”

He said simulation exercises are already testing those contingency plans. “When we look at the picture, the readiness in those countries is around moderate, what you would call a moderate level in terms of capacities in 11 important pillars. It’s currently about 57 percent,” Dr Njuguna said.

“There are some pillars that are very strong, some pillars that are not that much strong, but those readiness assessments help the countries now to be able to develop their contingency plans and be able to see what are the key priorities.”

The regional shield being built is designed not just to contain this outbreak but to strengthen systems against future ones, Dr. Njuguna said.

Challenges ahead

Despite the progress, officials stress there is no room for complacency because Ebola is unpredictable. One unsafe burial, for example, could trigger dozens of new cases. Infrastructure challenges remain, and reaching remote communities is still difficult.

Women, who often serve as caregivers in families, have been disproportionately affected, making up 55% of cases so far. And while no spread has been recorded beyond Bulape health zone, the virus remains a constant threat in a region with fragile health systems.

Food security is also a concern. Contact tracing requires families to stay home for 21 days, but many depend on daily labour for survival. To address this, WFP has begun planning general food distributions to affected households and is supplying meals for patients in treatment centres.

Beyond the immediate fight, experts are clear that every outbreak is also an opportunity to strengthen health systems for the future. That means more than vaccines and treatment centres. It means investment in infrastructure, training local staff, expanding laboratory networks, and embedding community trust.

“Outbreak response must go hand-in-hand with long-term investment in resilience,” said Dr. Otim. “Communities must be better protected not only against this outbreak but also against future health threats.”

Signs of hope

Asked by The Independent for a prognosis of the current outbreak, Dr Otim offered a cautious response.

“It is too early but we have seen significant progress in terms of the improvement in contact tracing that we are seeing 94 percent of the contacts that we have, being followed up. We have seen an improvement in terms of the testing turnaround time and the fact that we are not getting many confirmed cases than it was at the beginning,” he said.

“So, it’s a very good progress that we want to build upon and we are quite certain that if we continue in this trajectory along with the rollout of the vaccination then we should be able to control this outbreak as soon as possible but the factors have to be all put into consideration,” Dr Otim told The Independent during the press briefing.