The Democratic Republic of Congo (DRC) is once again confronting the deadly Ebola virus, marking its seventeenth confirmed outbreak. On May 15, 2026, health authorities in Ituri province declared the new crisis. In a concerningly short time, the number of reported cases has soared past 900, with the virus now detected across borders in Uganda and in the DRC's volatile North and South Kivu provinces, areas under the control of the Rwanda-backed M23 armed group. Early indications suggest the virus may have been circulating for weeks before detection, catching local health systems unprepared for a rapid response. This new outbreak triggers urgent international concern, especially as conditions on the ground appear even more complex and challenging than during the last major Ebola epidemic that devastated the region from 2018 to 2020. The ongoing conflict, combined with a unique strain of Ebola for which no vaccine currently exists, and a strained global health support system, means that the approach taken by international aid groups must be drastically different to succeed. ## Understanding Ebola Virus Disease: The Silent Threat Ebola Virus Disease (EVD) is a severe, often fatal illness in humans. It's caused by the Ebola virus, which belongs to the Filoviridae family. The virus is transmitted to people from wild animals and then spreads through the human population through direct contact with blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g., bedding, clothing) contaminated with these fluids. Symptoms typically appear suddenly, including fever, intense weakness, muscle pain, headache, and a sore throat. These are followed by vomiting, diarrhea, a rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. The incubation period—the time from infection to the onset of symptoms—ranges from 2 to 21 days. Without prompt and effective medical care, Ebola carries a high fatality rate, making rapid containment and compassionate treatment absolutely critical. ## Navigating a Challenging Environment in Eastern DRC The current Ebola outbreak is unfolding against a backdrop of severe instability. Eastern DRC is a region plagued by decades of conflict, with numerous armed groups, including the M23, vying for control. This constant unrest disrupts communities, displaces populations, and makes it incredibly difficult for health workers to reach those in need safely. Goma, a vital logistical hub in the east, is occupied by an armed group, further complicating humanitarian access and aid delivery. Adding to these local challenges, the international response capacity is also under pressure. The United Nations peacekeeping mission in the DRC (MONUSCO) has been reducing its presence, now largely confined to Ituri and North Kivu. Furthermore, the global health architecture itself faces significant strain, exacerbated by a recent withdrawal from the World Health Organization (WHO) by a major donor and a growing shortfall in funding allocated to address health emergencies worldwide. These factors underscore the urgent need for a well-thought-out, deeply informed strategy. ## Echoes of the Past: Lessons from the 2018 Outbreak The 2018–2020 Ebola outbreak in eastern DRC was described by the WHO as a “perfect storm” – a highly infectious disease spreading through an active conflict zone. During that period, the Congolese population, particularly in the east, largely viewed their government with distrust. Many lived in overcrowded areas with poor healthcare facilities, close to porous international borders, facilitating rapid virus spread. In response, the international community, led by the WHO, launched a massive health and humanitarian operation guided by a “no regrets” principle, meaning it was deemed better to overreact than to act too late. While well-intentioned, this approach often led to the WHO acting directly with limited consultation with other UN bodies. Many decisions made then had unintended and devastating consequences. They inadvertently empowered local officials and security forces known for human rights abuses, and even spawned an “Ebola Business”—a local war economy that paradoxically benefited from the crisis’s continuation. This intertwining of the Ebola response with the conflict fostered widespread community resistance and even violence against health workers, which severely hampered containment efforts and accelerated transmission. By the time that outbreak ended in 2020, over 3,400 people had been infected, and some 2,200 had tragically died. ## Crucial Adjustments for a Smarter Response To avoid repeating the failures of 2018, current international responders must integrate critical lessons from the past. Three key areas demand immediate attention: ### Prioritize Conflict and Political Analysis from the Outset During the 2018 outbreak, the WHO often deployed without first consulting MONUSCO’s comprehensive analysis of the security and political environment. This oversight led to detrimental decisions, such as engaging personnel from the Agence Nationale de Renseignements, a state security service notorious for human rights abuses, as “community liaisons.” Such actions, documented by groups like the Congo Research Group, securitized the health response in the eyes of the public, creating perverse incentives and severely eroding trust. For the current outbreak, deep conflict and political economy analysis must guide every deployment decision, not follow it. ### Separate Health and Security Roles Distinctly There is a crucial difference between security forces creating a safe environment for health activities and directly participating in them. Using uniformed personnel to escort vehicles, guard clinics, or cordon off facilities fundamentally alters how communities perceive humanitarian aid. The 2018-2020 experience demonstrated how quickly the close proximity of security actors to health responses led to the latter being associated with them, sparking hostility. While MONUSCO and national security services may play a role in overall security, they must maintain a clear distance from direct humanitarian and health operations to preserve trust and neutrality. ### Balance Urgency with Authentic Community Engagement While the “no regrets” approach emphasized speed, it often overlooked the vital need for community trust and participation. Public health measures can only succeed if affected populations believe in them and are willing to engage. Securitized responses that treat communities as obstacles rather than essential partners are ultimately counterproductive. This means accepting potentially slower initial progress in exchange for methods that are acceptable to local communities—for example, utilizing local responders instead of teams flown in from Kinshasa, using motorcycles instead of large vehicles, and negotiating culturally sensitive burial practices with families rather than imposing them. ## WHO's Global Health and Peace Initiative: A Step Forward? Recognizing the challenges from past outbreaks, the WHO developed its Global Health and Peace Initiative (GHPI). This initiative is built on two main pillars: first, ensuring health programs are “conflict-sensitive” by applying the “do no harm” principle to operations; and second, making them “peace-responsive” where possible, by designing health interventions to actively foster peace outcomes like social cohesion and dialogue. This framework is expected to guide the WHO’s strategy for the current crisis. However, the GHPI also presents its own complexities in violent conflict zones. For instance, questions remain about how the WHO and its partners will reconcile conflict sensitivity with humanitarian impartiality when these principles diverge. An intervention might exacerbate conflict dynamics (e.g., by negotiating with a non-state armed group), yet humanitarian principles might compel its delivery. The GHPI currently lacks a clear framework for managing such trade-offs. Furthermore, the GHPI emphasizes that programming “must be led at national level.” While promoting national ownership is crucial, especially after criticisms of bypassing national institutions during the 2014-2016 West Africa Ebola crisis, this principle becomes problematic when the national government itself is a party to the conflict or widely mistrusted. In eastern DRC, many view state institutions with deep suspicion. Unqualified deference to national ownership risks empowering predatory actors and reproducing the legitimacy issues that fueled community resistance in 2018. A more localized, nuanced approach is needed to define the role of national actors, firmly grounded in thorough conflict analysis. ## Charting a Course for Success in the DRC The success or failure of the international response to this latest Ebola outbreak in eastern DRC will depend entirely on its ability to implement emergency public health measures within the region's long-standing social, political, and security quagmire. This demands deliberate actions from the very beginning: First, joint conflict and political-economy analysis must shape deployment decisions, rather than being an afterthought. Second, a security posture focusing on less proximate protection, combined with carefully negotiated community-level access, is essential. Third, the response must be built on localized approaches that engage existing community structures and carefully calibrate the involvement of national actors. Many difficult choices will undoubtedly emerge, including navigating the inherent dilemmas within the GHPI. However, the initial decisions made by international responders in the coming weeks will have profound implications for both regional stability and global public health, making a thoughtful, community-centered approach non-negotiable.