The first patients have been enrolled in a clinical trial testing new treatments for the Ebola outbreak ravaging the Democratic Republic of Congo's Ituri province, in what scientists describe as a record-breaking pace of research mobilisation. Just six weeks after the World Health Organization declared the outbreak a public health emergency of international concern on 17 May, the Partners trial has opened with two experimental drugs: remdesivir, an antiviral made by Gilead Sciences, and MBP134, a monoclonal antibody developed by Mapp Biopharmaceutical containing engineered immune proteins designed to recognise and neutralise the virus. Patients will be randomly assigned to receive one drug, both in combination, or standard supportive care alone.

The outbreak, caused by the Bundibugyo strain of Ebola — for which there is no approved vaccine or treatment — has recorded 1,792 confirmed cases and at least 625 deaths as of 9 July, and remains in what the WHO describes as its "expansion phase." Health workers account for 112 of those confirmed cases, and 35 have died. The Bundibugyo strain typically kills around one in three of those infected, a lower fatality rate than the better-known Zaire strain, but still devastating. Both drugs have shown strong efficacy against Bundibugyo in animal models. "They showed great efficacy, but now we need to test it in humans — basically, what we want to see is if they indeed can lower mortality," said Professor Laurens Liesenborghs of the Institute of Tropical Medicine in Antwerp, who is working on the trial in Ituri.

The response is unfolding against a backdrop of severe challenges. Ituri is a province in northeastern DRC marked by extreme poverty, the presence of multiple armed groups, and deep mistrust of authorities. Safe burial teams — whose work is critical because the bodies of Ebola victims remain highly contagious — have faced community hostility, with some workers reporting physical attacks. Frontline staff have also protested over unpaid wages and shortages of protective equipment. "Since we started working on 15 May, with all the insults we've had to put up with, we haven't seen a single penny," said Bahati John, head of one burial team in Rwampara, a mining town in Ituri. A second treatment trial, testing whether obeldesivir can prevent disease in people exposed to the virus, is also due to begin imminently, though it still requires significant additional funding.

To prepare health workers for conditions on the ground, Doctors Without Borders (MSF) has established a simulation training centre on the outskirts of Nairobi, Kenya. Equipped with beds, mannequins, a mock laboratory, and full protective gear, the centre trains around 100 people per month and will run through August and potentially beyond. Trainees practice not only clinical procedures but also community engagement and safe funeral protocols. "Once you're in PPE, it's a different story," said Cisse Papa Ndiaga, a Senegalese MSF health worker preparing for deployment to DRC. The centre also trains Kenyan Ministry of Health officials and staff from other NGOs, reflecting the regional stakes of an outbreak African health officials describe as the fastest-growing ever recorded.

Researchers and public health officials are cautiously optimistic that accelerated trials could help turn the tide. Enough doses of both drugs have been donated for up to 1,200 patients to be enrolled, and the trial's design allows new treatments to be added if they become available. A statistically meaningful result will likely require between 700 and 1,000 enrolled patients. "What limits an outbreak is our capacity to provide care, our surveillance capacity, and our ability to isolate people," said Professor Yap Boum of Africa CDC, the continent's public health watchdog. "These trials will enable us to access treatment, and when we treat people, it also sends a message to the community."