ADDIS ABABA, June 24 (Xinhua) -- As the Bundibugyo Ebola virus outbreak continues to spread in the Democratic Republic of the Congo (DRC) and Uganda, with cases already surpassing 1,000 and a rising death toll, complex operational challenges have raised fears of further transmission.
With a range of critical operational constraints, including insecurity, intense population movement and displacement, a lack of a licensed strain-specific vaccine, and funding shortfalls -- experts and health organizations are warning that containing this regional public health emergency demands immediate mobilization and coordinated solidarity from the African continent and the broader global community.
RAPID EXPANSION
In the DRC, the outbreak reached a critical threshold on Sunday, when health authorities reported 1,003 cases and 254 deaths. The latest figures released Tuesday show that cases have risen to 1,094 and deaths to 277, with 387 patients currently in isolation or receiving treatment and 115 having recovered.
Uganda, which borders the DRC's Ituri province, has reported 20 cases and two deaths, according to the Ugandan Health Ministry.
In addition to the two affected nations, 11 other countries across the continent have been classified as at high risk of being affected, namely South Sudan, Rwanda, Kenya, Zambia, the Central African Republic, Tanzania, Ethiopia, Angola, the Republic of the Congo, Burundi, and Somalia.
According to the Africa Centers for Disease Control and Prevention (Africa CDC), Ituri province in the eastern DRC remains the epicenter of the outbreak, accounting for more than 90 percent of the total disease burden. The surge in case numbers and geographic expansion are placing a heavy burden on clinical management capacity, as healthcare systems struggle to cope with the influx of patients.
The outbreak is further compounded by its impact on frontline medical personnel, such as healthcare-worker infections and attacks on health facilities, which the Africa CDC described as "an emergency within the emergency."
While rising case numbers present a grim reality, some technical aspects of the response have shown positive improvements. Africa CDC experts noted that laboratory testing capacity has expanded significantly, reducing previous sample backlogs from five to eight days down to a same-day, 24-hour turnaround.
CRITICAL CONSTRAINTS
However, critical operational challenges are fueling concerns that the outbreak could spiral out of control. In a recent interview with Xinhua, Africa CDC Director General Jean Kaseya said that a critical constraint is the absence of a licensed vaccine or therapeutic treatment for the Bundibugyo strain.
Unlike other Ebola strains, responders can not deploy ring vaccination strategies, forcing containment efforts to rely entirely on classic public health measures: early detection, rapid isolation, contact tracing, safe care, infection prevention and control, community trust, and strong coordination.
With only about 12 percent of expected contacts currently under active follow-up, Africa CDC official Wessam Mankoula said the contact-tracing gap is another critical operational constraint, compounded by intense cross-border movement and a financing gap.
Yap Boum II, head of the emergency preparedness and response division at Africa CDC, said that the Ebola outbreak is adding strain to the DRC's health system, which is already stretched by conflict, displacement and multiple disease emergencies.
"We are talking about an environment that is very complex, with over 900,000 displaced people and refugees. There was already a humanitarian challenge before Ebola arrived," Boum said, emphasizing the vital importance of integrating humanitarian and essential public health interventions.
The Africa CDC also expressed concern over inadequate safe burial capacity, with only 84 personnel currently available out of the minimum required 540 in the affected areas.
To contain the regional spread of the Bundibugyo strain, African and international stakeholders need to take urgent action to address these constraints, strengthen frontline security, and better mobilize resources for large-scale containment efforts.
GLOBAL SOLIDARITY URGENTLY NEEDED
Despite operational improvements, containing the outbreak requires stronger intra-African cooperation and sustained investment in national public health institutes, local emergency operations, genomic surveillance and community health systems to strengthen Africa's health security system.
"Africa's health security agenda must be led by African institutions and supported by partners who align with national priorities, move quickly, and invest in systems that remain after the emergency has passed," Kaseya said.
Calling for fast and aligned global action, the Africa CDC chief also underscored that global partners have a "critical role to play" in Africa's continued fight against the outbreak. "Africa needs timely financing, flexible emergency resources, diagnostic support, personal protective equipment, clinical care supplies, logistics, trained personnel, laboratory capacity, safe access, and support for communities and frontline health workers."
Earlier this month, the Africa CDC and the World Health Organization jointly launched a continental response and preparedness plan, aiming to raise 518 million U.S. dollars for a six-month period. However, a significant gap remains between political commitments and actual funding on the ground.
At an African Union-led high-level meeting on the outbreak held last week, donors pledged 910 million dollars to counter the disease. But the Africa CDC said only 90 million dollars of the total pledged amount had been officially released to the affected nations and operational response partners as of Thursday.
Highlighting that early financing represents the most cost-effective public health investment, the Africa CDC called for a rapid release of the financial commitments before the outbreak escalates into a much larger regional crisis.
Beyond funding, health officials and experts are calling for greater regional political solidarity to strengthen response and preparedness efforts across the two affected countries, 11 other high-risk countries, and beyond.
Enhanced regional coordination is vital to harmonize border screening, share epidemiological data, manage population movements, and protect shared health workers across borders, they said, advising international partners against "unscientific and counterproductive" travel or trade restrictions on African countries. ■