An outbreak of Bundibugyo virus — a member of the Ebola family — has now killed nearly 3,500 people in the Democratic Republic of Congo, with the WHO warning that the epidemic continues to spread exponentially across the country's northeast. More than four months since it began, the outbreak has produced over 7,200 confirmed cases nationally, and experts fear it could become the deadliest Ebola epidemic on record. The WHO describes the epidemiological situation as "heterogeneous", with cases distributed unevenly but continuing to rise.

The epicentre is Ituri, a province of roughly four million people in northeastern DRC, which borders South Sudan, Uganda, Rwanda, and Burundi — a region long shaped by cross-border migration, ethnic conflict, and the aftermath of the 1994 Rwandan genocide and two Congo Wars. Of all confirmed cases, 5,615 originated in Ituri, a province studded with artisanal and semi-industrial gold mines. The town of Mongwalu, where the outbreak began, sits at the heart of a mining network where workers move frequently between mine sites and home villages — a pattern of mobility that has accelerated viral spread. The Bundibugyo strain's relatively mild early symptoms, unlike the dramatic haemorrhagic fever associated with the more common Ebola virus, delayed local laboratory identification, and a cold-chain failure that degraded samples sent to the capital Kinshasa for sequencing cost critical weeks at the outset.

Deep distrust of authorities has compounded the medical challenge. Many communities in Ituri, bearing historical trauma from government repression, foreign mining companies, and the opacity of international aid organisations, have come to view Ebola containment as a conspiratorial project — a belief that the virus is fabricated to lure healthy people into hospitals for organ harvesting or to depopulate resource-rich areas. Medical anthropologists studying the region describe the perception that "Ebola is a business" as one of the foremost obstacles to containment. Violent resistance has been widespread: isolation facilities were burned in Mongwalu in late May, ambulances have been destroyed, burial teams attacked, and on a single day in September, 42 bodies could not be sampled because families physically blocked health workers.

The response has also been hollowed out financially. When the Trump administration dismantled the United States Agency for International Development (USAID) in early 2025, it eliminated funding that had historically covered 30 to 40 percent of emergency Ebola response costs. Disease surveillance programmes and NGO-run treatment networks shrank accordingly. A US$1.4 billion emergency package proposed by the Trump administration was tied to an Iran war funding bill and stalled in Congress; only US$512 million from the State Department has been confirmed for the outbreak zone. The African Union's Africa CDC has called for US$1.4 billion in total, and the DRC health ministry and WHO jointly published a 180-day response plan in September seeking US$1.3 billion. The EU announced US$580 million at the G7 summit in June, and the United Kingdom added £50 million in September, bringing British contributions to roughly US$100 million. China, which has significant mining interests in the region, has so far dispatched three five-person expert teams and pledged approximately US$4.5 million — a substantially smaller commitment than Beijing made during the 2014 West African epidemic.

Health workers on the ground have staged repeated strikes over unpaid wages, with some teams in Ituri going three months without salaries or hazard pay. Authorities have moved to address the problem by switching to biometric direct payments, but the disruptions have further strained a response system already operating well below capacity. The combination of community resistance, funding shortfalls, and logistical breakdowns has left international health officials racing to close gaps before the outbreak — already unprecedented in scale — grows further beyond control.