DR Congo: Engage Communities In Ebola Response, HRW Says
The Congolese government and international partners should prioritize community engagement and limit the role of security forces in responding to the Ebola outbreak in eastern Democratic Republic of Congo, Human Rights Watch said Thursday.
“The Congolese government and its partners need to overcome years of conflict, abuse, and neglect that have strained healthcare systems and eroded trust and that risk complicating the Ebola response,” said Ida Sawyer, Crisis and Conflict director at Human Rights Watch. “That means taking all necessary steps to minimize the role of security forces and closely engaging with affected communities.”
Human Rights Watch in May and June 2026 interviewed nine humanitarian workers and public health experts involved in the current and previous Ebola outbreaks.
The World Health Organization (WHO) on May 17 declared the Ebola outbreak a “public health emergency of international concern.” The Bundibugyo Ebola virus, a strain with no vaccine or approved treatment and a fatality rate of up to 50 percent, had been spreading undetected for months. The Trump administration’s dismantling of the US Agency for International Development (USAID) in 2025, compounded by years of underfunding of the humanitarian response in eastern Congo, may have contributed to the delay in detection of the virus and response systems.
As of June 6, the WHO reported 515 confirmed cases in Congo, including 91 deaths, and 19 confirmed cases and 2 deaths in neighboring Uganda.
Ebola spreads through contact with the bodily fluids, causing fever, severe headaches, muscle pain, vomiting, diarrhea, hemorrhaging, and death. Women face disproportionate risks of exposure due to their roles as caregivers and health workers. The ritual washing of bodies before burial can contribute to transmission and requires careful, culturally informed, public health outreach about safe practices. Inadequate personal protective equipment has put health workers at risk and can drive transmission.
The 2018-2020 outbreak killed 2,299 people. Hostilities prevented effective disease surveillance, tracing, and treatment, which are crucial for treating this type of outbreak and created what the WHO called a “perfect storm.”
The involvement of Congolese security personnel during the 2018-2020 outbreak hindered the health response, politicized care, and deepened mistrust among affected communities, Human Rights Watch said. Armed groups also capitalized on the influx of funding, creating what local communities described as “Ebola business.” The Congo Research Group, an independent organization, reported in 2021 that parties to the conflict exploited the outbreak for material gain, creating incentives to impede the healthcare response.
The current outbreak is concentrated in Ituri province, where mass displacement and a healthcare system degraded by years of conflict have created high-risk conditions for the rapid spread of Ebola. Armed groups and government security forces previously targeted hospitals, clinics, and healthcare workers, and looted medical supplies. A May 2026 report by the Safeguarding Health in Conflict Coalition, an international group of nongovernmental and academic organizations,found that there were 325 reported attacks on health in Congo in 2025—mostly in the east—nearly triple the 2024 total.
In May 2026, humanitarian organizations in Ituri warned that persistent insecurity was impairing the delivery of aid and the provision of health services. Attacks by residents on Ebola care facilities in the towns of Rwampara and Mongbwalu in Ituri on May 21 and 22 reflected local distrust in the public health response.
Armed groups in Ituri have repeatedly committed mass killings of civilians and other abuses with impunity. In a long-running intercommunal conflict over land and resources, the Coopérative pour le développement du Congo (Cooperative for the Development of Congo, or CODECO), has attacked civilians, primarily the Hema ethnic group. Just weeks before the outbreak was announced, CODECO forces reportedly killed 50 civilians near Pimbo in Ituri’s Djugu territory. The Islamic State-affiliated Allied Democratic Forces (ADF) have also killed numerous civilians, including up to 60 people in southern Ituri in early 2026.
The Congolese armed forces have been responsible for serious abuses, which Human Rights Watch has documented. Both the UN Group of Experts on the Democratic Republic of Congo and International Peace Information Service reported that the Congolese government is involved in unlawful gold trafficking in the region in collaboration with armed groups.
The urgent need for increased funding and other assistance—trained personnel, medical supplies, and expanded testing capacity—needs to incorporate transparency about resource allocation and distribution and effective communications with affected communities. It is important for the UN peacekeeping mission in Congo, MONUSCO, to maintain its civilian protection role and for the WHO to coordinate closely with the mission.
Evidence from past outbreaks shows that community engagement and social support measures such as food aid and home-based care can be more effective than coercive containment measures and can help build the trust needed for an effective response. As of November 2025, emergency levels of acute malnutrition had been recorded in parts of Ituri and North Kivu, and nearly 25 million people faced high levels of food insecurity between September and December 2025, with conditions expected to worsen in 2026. People are more likely to comply with voluntary quarantine if they have adequate food. When treatment centers cannot provide basic sustenance, family members risk exposure by bringing food themselves.
The US government on May 28 announced US$112 million in emergency assistance to Congo, but it is going into a system that was dismantled in recent years by aid cuts by multiple donors. The US government cut emergency response aid to Congo by more than half between 2024 and 2025, from $805 million to $373 million. One local doctor told Physicians for Human Rights that they were “no longer truly able to carry out proper epidemiological surveillance because of the disruption in USAID funding.” A former senior USAID official who oversaw the agency’s response to past infectious disease outbreaks told Human Rights Watch that previously “USAID invested in making sure you had the people, logistics, and operational support to activate when outbreaks occur. Those investments are no longer there, so the systems were not positioned to be activated.”
Grace Tran, who worked on Ebola preparedness with USAID during the 2018 outbreak, said that the cuts eliminated many of the community outreach programs critical in a conflict setting: “A lot of the trust that we built disappeared.”
The US withdrawal from the WHO in January compounded the damage, severing real-time data-sharing and compelling the WHO to cut nearly a quarter of its staff. The United States was absent from the WHO’s World Health Assembly in Geneva in May, where world leaders discussed a global response to the outbreak. On the withdrawal from the WHO, the former senior USAID official told Human Rights Watch: “Lack of coordination causes death. And our failure to coordinate is killing people.”
“The Ebola outbreak in a region ravaged by atrocities and years of neglect, compounded by major cuts to global health funding, has created a humanitarian catastrophe,” Sawyer said. “Donor countries and international organizations should urgently respond to the outbreak and ensure funds are spent effectively and accountably.”
