11.06.2026

Illustration of safe burial practice: the virus can survive for days within body fluids

Immunising the world

Some experts are saying the latest outbreak could be at least as bad as 2014. But, says James Linney, Ebola could be eradicated with sufficient resources and basic disease management

It has been six weeks since the first death that alerted authorities to the current outbreak of Ebola Virus Disease (EVD), which continues to spread alarmingly through the Democratic Republic of the Congo and Uganda.

On April 24, in Bunia, the capital of Ituri province in northeastern Congo, a health worker became unwell with a severe infectious disease, with symptoms highly suggestive of Ebola, including severe bleeding. He died on April 27 and soon his close contacts started developing similar symptoms. The local health clinic only had access to diagnostic tests for the more common Zaire strain of Ebola and the tests all came back negative. It took another two weeks and the samples being sent off to the DRC’s capital city, Kinshasa, where more extensive testing was available, before health authorities established that the rarer Bundibugyo species of Ebola was responsible for the death.

By this time many more people in the region had become unwell and on May 11 there was a confirmed case affecting a Congolese man in Kampala, the capital of neighbouring Uganda; worryingly he had travelled the 434 miles from Ituri overland, infecting an unknown number of people on the way.

At the time of writing there have been 550 cases and 101 deaths in the DRC, and 19 cases and two deaths in Uganda, but these are only the laboratory-confirmed cases: there are likely thousands more. The outbreak may no longer be leading the headlines, but the situation, which the World Health Organisation is calling “a public health emergency of international concern”, is still extremely dangerous. It is likely that, when this outbreak finally gets under control (which may take many more months), thousands more people will have died.

Six species

The current outbreak is already the third worst recorded since the disease was first recognised in 1976. Since then six distinct species of the Ebola genus (the Filoviridae family) have been identified. Four of these are known to cause Ebola Virus Disease in humans: the Zaire species (this is the most common and the one responsible for the outbreak in 2014 in Guinea, Liberia and Sierra Leone, which led to 11,308 reported deaths), plus the Sudan, Taï Forest and Bundibugyo viruses.

I will make no bones about it: Ebola is a truly terrible infection to contract. Symptoms start innocuously, with body aches, fatigue, fever and headaches, but within a few days they can progress to severe diarrhoea and vomiting. The virus attacks and kills cells, causing multi-organ failure. As it progresses, it causes damage to the endothelial cells that line the blood vessels - hence at the end stage of the illness people commonly experience bleeding both internally and externally, which is why it is known as haemorrhagic fever. The mortality rates of all species are devastatingly high, the Zaire virus being the highest, killing as many as 90% of those infected, while the Bundibugyo virus, which is responsible for the current outbreak, has a mortality rate of around 30%-50%.

There are a couple of things about Ebola that we can be thankful for. Firstly, it is passed from one person to another through contact with bodily fluids (blood, sweat, vomit, saliva or semen) rather than the much more contagious infections, like flu or Covid, that are airborne. Secondly, again unlike, for instance, flu, Ebola is not infectious during its two-week incubation period, so can only be passed on once a carrier develops symptoms. It tends to be less contagious in the first few days after symptoms develop, but much more so towards the end of the illness and there is an especially high risk of spread by coming into contact with the dead bodies of victims. This is why traditional funeral practices in the Congo region, which involve close contact with and washing of the body by family members, can cause huge spreading.

As of yet there are no known specific treatments for EVD, although early and intensive hospital treatment can make a difference between survival and death. Since 2014 there is now an effective vaccine for the Zaire species, found to provide 84% protection.¹ Sadly, however, this vaccine does not give protection against the Bundibugyo species. There are some candidate vaccines for this species currently in development, but these are unlikely to be ready for several months. However, treating patients is only one part of controlling Ebola. Understanding where the virus comes from and what drives its spread is equally important if future outbreaks are to be prevented.

Ebola is zoonotic - meaning it is transmitted to humans from other animals which act as host reservoirs. It can infect other mammals, including primates (Ebola has possibly killed as many as a third of Africa’s gorillas²), but it is believed to be transmitted to humans when the virus ‘spills over’ from bat carriers. The world’s largest fruit bat population is located in the tropical rainforests and savannahs of central and west Africa, making these Ebola hotspots.

There has been a definite increase in these ‘spillover events’ in the past couple of decades, with an Ebola outbreak at least every couple of years, as well as other zoonotic viruses, such as Avian influenza, Mpox, Nipah, Marburg, Hantavirus - and, of course, Covid-19. It is thought the process of human geographic expansion, urbanisation and deforestation is the driver behind these increasing events, as dense human populations come into closer contact with wild animals.

Natural resources

This process is accelerating in areas like the DRC because of the rush by foreign players for its natural resources; the Congo has vast deposits of so-called ‘conflict minerals’, 70% of the world’s cobalt reserves and massive deposits of copper, coltan and lithium. These minerals are foundational to the global energy transition, smart phones, laptops and lithium-ion batteries that power electric vehicles and consumer electronics. The likes of Apple, Dell, Google, Microsoft and Tesla have vested interests in the mining industry here. Workers face abysmal conditions and children as young as six are routinely employed.³ The strategic importance of these resources means that economic interests in the region extend far beyond mining companies alone.

The US and China are engaged in competition for influence in the DRC and neighbouring states. At stake is access to vast mineral reserves and the political influence that comes with controlling supply chains so critical to the global economy. To get one over on China, towards the end of last year, Trump hosted DRC and Rwanda leaders for a ‘peace deal’ - soon after which, by coincidence, US-based Virtus Minerals finalised a $700 million acquisition of the Congolese mining company, Chemaf, including the Etoile and Mutoshi mines in Katanga, southern DRC, which together account for roughly 5% of global cobalt production.⁴

As its natural resources continue to be exploited and shipped abroad for the benefit of global capitalists, to the score of trillions of dollars, the DRC’s people live in dire poverty, often lacking clean water and basic sanitation. Access to healthcare and hospitals is scattered and severely lacking - almost non-existent in more remote areas - allowing infectious diseases such as Ebola to spread unchecked long before being identified. The WHO recently confirmed that the first infections in the current outbreak are likely to have been back in January.⁵

The DRC’s extreme inequality, poverty, corruption and ongoing warfare is a legacy of centuries of colonial interference and exploitation, from the slave trading of the 15th-18th centuries to the territorial conquests of the 19th century, Africa in general was plundered and its people killed or kept impoverished. During the ‘scramble for Africa’ the people of the Congo fared even worse than most African regions, being subjected to Belgium’s King Leopold II, when he established the Congo Free State at the Berlin Conference in 1885. His barbaric reign over the region represented colonialism in its most racist and vicious form. The Congo’s rubber and ivory enriched the Belgian bourgeoisie, whilst the population were en masse exploited, tortured and mutilated, with an estimated 10 million people murdered.⁶

Horrible history

Not surprisingly, when Belgium hastily granted independence to the Congo in 1960, the country was left in a dire, chaotic state - the kind of economic and political chaos that allows a strongman dictator to exploit. In this case it was army chief Joseph-Désiré Mobutu who seized power in a coup in 1965. Mobutu changed the country’s name to Zaire and ruled until he was overthrown in 1997 by a rebel coalition led by Laurent-Désiré Kabila, who was being backed by Rwanda and Uganda. 1997-2003 saw a period of continuous devastating warfare and, although in 2006 the country held its first free elections, the modern political reality continues to be dominated by corruption, civil war and conflict. Currently the DRC government is in armed conflict with the M23 rebel group, which holds power in areas where the Ebola outbreak is live, making attempts to arrest the spread and treat those infected even more hazardous.

One consequence of the colonial past, and the years of war and corruption since, is the lack of trust the people of the DRC have for any authority - particularly foreign agencies who often swoop in at times of infectious disease outbreaks and just as quickly abandon them when the outbreak subsides. During recent Ebola outbreaks there have not surprisingly been some friction and clashes between the local population and medical teams - both native and foreign NGOs, who turn up to try and limit the virus.

This is made worse by the fact that those infected by Ebola are often placed in ‘field hospitals’, which, due to the lack of resources for the basic support treatment mentioned earlier, act basically as quarantine holding pens. Whilst quarantine is a fundamental part of managing an Ebola crisis, from the local population’s point of view their loved ones are being taken from them to die in excruciating pain all alone. Of course, mistrust is not unique to outbreaks in Africa: similar ill-informed conspiracy theories and government mistrust was rife in the UK during the Covid pandemic, while idiotic anti-vaccine misinformation persists today.

Dealing with an Ebola outbreak is an expensive undertaking, severely hampered by the fact that, each time there is an outbreak, the local health infrastructure is so inadequate that health workers are starting from scratch. EVD management requires specialised separate hospitals that can effectively quarantine and care for those infected humanely, whilst providing adequate personal protective equipment to protect health workers, who are at especially high risk from Ebola. PPE in the case of Ebola means more than just face masks, aprons and gloves: the virus is considered a ‘class 4’ (the highest class of risk) hazardous infection, requiring the most stringent biocontainment measures, such as airtight positive-pressure suits, independent air supplies, negative-pressure environments, strict air filtration and complete chemical decontamination upon exit. Also essential are adequate on-site diagnostics, human resources to contact-trace, support for families of those infected, education, public health campaigns, etc.

There are, however, less funds available than ever for managing this crisis. Since within days of taking office, Donald Trump had issued a series of executive orders that included an immediate freeze on all US foreign assistance and the cancelling of 80% of its foreign aid projects worldwide. The majority of the staff at the United States Agency for International Development (USAID) were laid off and America simultaneously withdrew from the WHO. US aid was never an altruistic act: it always came with strings, such as the receiving country having to agree to hosting US military bases, allowing US companies market expansion or access to natural resources. But the lack of previously available US money and personnel is currently leading to further suffering and deaths.

One solution

How and when this current outbreak will end is hard to predict. Some health experts are saying it could be at least as bad as the 2014 outbreak.⁷ Trump’s dismantling of the USAID did not cause the Ebola outbreak: the virus has been around infecting animals before homo sapiens ever existed. But it is absolutely certain that the withholding of funds and support has led to the current outbreak being able to go undetected for longer and to spread more widely. People have died in appalling ways as a direct effect.

But, as we have seen, the historical role of colonialism and the ongoing influence of imperialism is perpetuating corruption, warfare, poverty and suffering and this will without doubt lead to many more such outbreaks of Ebola and other infectious diseases - diseases which are within our current capabilities to at least effectively contain, if not completely eradicate. It would have been fairly straightforward for medical science to have previously produced vaccines to all species of Ebola, but the major pharmaceutical companies are not interested, because they would not provide big enough profit incentives.

Such future outbreaks are not guaranteed to be regional or containable. Ebola is a ribonucleic acid (RNA) virus, which replicates quickly and often with errors, meaning it has a high propensity towards mutation. If, for example, one of these mutations leads to Ebola becoming able to spread via air droplets, it would lead to a global pandemic that would make Covid-19 look tame.