Congo: Attacks on Ebola Clinics Complicate Efforts to Stop a Regional Outbreak

3 MINS READMar 6, 2019 | 17:30 GMT
The Big Picture

The Ebola outbreak in the eastern Democratic Republic of the Congo so far remains a localized concern. Given the isolated nature of the outbreak, it is unlikely to have a global impact, though it poses a regional threat.

Editor's Note: This snapshot is part of a series of analyses supporting Stratfor's upcoming 2019 Second-Quarter Forecast. These assessments are designed to provide more context and in-depth analysis on key developments over the next quarter.

What Happened

The effort to contain an outbreak of the Ebola virus in the Democratic Republic of the Congo encountered a major setback when unknown assailants violently attacked two Doctors Without Borders (known by its French abbreviation, MSF) clinics the night of Feb. 24 in Katwa and Feb. 27 in Butembo, forcing staff to evacuate. The facility in Butembo reportedly reopened March 2, but without MSF participation.

Why It Matters

Though the World Health Organization (WHO) and UNICEF are reportedly aiding the Congolese health ministry in running the facility, even with international aid, it is unclear if the effectiveness of the facilities can be maintained. On March 5, Mai-Mai rebels attacked a military facility in Butembo, creating further disruptions in the outbreak area. Heightened security threats will make controlling the outbreak more difficult.

As of Feb. 26, the number of new Ebola cases reported weekly by the WHO had been declining since the end of January. But in the WHO's Feb. 28 disease outbreak update, it noted a high proportion of deaths outside a hospital setting, and a failure to track people with whom infected persons are known to have had contact. Making matters worse, more violence in the outbreak area is possible, whether by militant groups or locals. Rebel groups in the area have complicated matters even further by actively spreading misinformation about disease prevention efforts. Together, these factors suggest an uptick in Ebola cases will likely occur.

Even with a regional spread, the nature of the disease means the threat to the world at large remains very small.

Congolese and international health workers will continue to struggle to end the outbreak, and the situation will test new President Felix Tshisekedi in his first months in office. Given this outbreak is concentrated in the northeastern Democratic Republic of the Congo, where informal economic and cultural ties are often closer with neighboring countries, there is a significant risk that the disease will cross over into adjacent countries — especially Uganda and, to a lesser degree, Rwanda. Were this to occur, these countries and international organizations could be expected to mount a cooperative effort to limit the spread of the disease from reaching more populated city centers. But even with a regional spread, the nature of the disease means the threat to the world at large remains very small.


The 10th Ebola outbreak to strike the Democratic Republic of the Congo in three decades began in August 2018. Confirmed and probable cases had hit 900 as of March 4, with deaths exceeding 560 — making this the second-largest outbreak in African history. International relief workers immediately feared that the site of the outbreak, which is located in the restive and remote far northeast of the Democratic Republic of the Congo, would make stamping it out challenging. Still, heavy international involvement and a large vaccine campaign made progress possible, and the disease has so far been contained to the Democratic Republic of the Congo.

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