The deadly Ebola outbreak in the Democratic Republic of the Congo can be stopped, the World Health Organization (WHO) head, Tedros Adhanom Ghebreyesus, said as he arrived in Kinsasha.

Tedros landed in the DRC on Thursday evening and was due on Friday to travel to Ituri province in the north-east, where the epidemic is centred.

“That thing can be stopped,” Tedros said, adding that the WHO did not support travel bans to combat the outbreak because they “don’t help much”.

“Together, we will overcome this outbreak,” he said earlier, vowing to do “everything in my power to help you”.

The WHO has recorded 10 confirmed and 223 suspected Ebola deaths in the DRC since the outbreak was declared on 15 May, out of more than 1,000 confirmed and suspected cases, according to its figures up to 24 May, the latest available.

The true spread of the virus is likely much wider as it is thought to have circulated under the radar for some time, the WHO has warned.

This is the 17th recorded Ebola outbreak in the big central African country, which has a population of more than 100 million people.

Complicating medical relief efforts, the epidemic is centred in a mineral-rich region fought over by armed groups. “Conflict and displacement make everything harder,” Tedros said. “I am making a direct appeal to all warring parties in this region: please, declare a ceasefire.

“No cause, no conflict, no grievance is worth condemning innocent people to death from a preventable disease.”

No vaccine or treatment yet exists for the Bundibugyo strain of Ebola causing the current outbreak. The WHO said on Thursday that its advisory groups had recommended clinical trials for vaccines and treatments.

The head of the African Union’s health agency, Jean Kaseya, said on Thursday that a vaccine should be ready by the end of the year.

Neighbouring Uganda, with one recorded death from Ebola and six additional cases, announced it was shutting its border with the DRC with immediate effect.

The US said it would deny entry to anyone infected and was working to open a treatment facility for affected US citizens in Kenya. A Kenyan rights group has gone to court seeking to limit operations at any such facility, while health officials have warned it could burden Kenya’s stretched health system.

Ebola has killed more than 15,000 people in Africa over the past 50 years. The deadliest outbreak in the DRC claimed nearly 2,300 lives out of 3,500 cases between 2018 and 2020.

The WHO said it had received 4.6 tonnes of aid at the airport in Bunia, capital of Ituri province, while Unicef, the UN children’s agency, said it was sending 100 tonnes of aid to the DRC.

With Agence France-Presse

Ebola is spreading rapidly in parts of east Africa. The deadly disease, which kills around half of those it infects, is suspected to have claimed the lives of at least 240 people since the outbreak began in Ituri province in the Democratic Republic of the Congo earlier this month.

Public health officials are scrambling to contain the virus in one of the toughest environments: Ituri province, the centre of the crisis, is a mining hub where thousands of people work in close proximity every day, and a conflict zone, with ongoing fighting between rebel groups. Medical facilities are modest, while waves of displaced people are being forced into overcrowded camps to escape fighting, making it even harder to control transmission. The virus has already spread to other regions in eastern DRC and the Ugandan capital Kampala.

It is also the first major Ebola outbreak since the US, UK and other western countries made brutal cuts to humanitarian aid, which began with Donald Trump and Elon Musk’s gutting of USAID. The rapid response infrastructure from previous Ebola outbreaks has been stripped back so much of it is barely fit for purpose, hampering efforts to save lives, warn experts.

For today on First Edition, I spoke with Dr Papys Lame, the Ebola outbreak response coordinator in Ituri for the NGO Alima, and Selena Victor, senior director of policy and advocacy for Mercy Corps about efforts to contain the outbreak. But first, the headlines.

Five big stories

1. UK news | Britain risks a financial hit worth £125bn a year after a rise in the number of young people not in employment or education to more than 1 million.

2. US-Israel-Iran | Donald Trump has circulated a draft peace agreement for the war with Iran among allies including Israel as both sides try to prevent fresh breaches of the ceasefire escalating out of control.

3. UK politics | Andy Burnham has rolled back from his previous calls for ministers to scrap a restriction on immigrants claiming benefits as the Makerfield byelection places greater scrutiny on him.

4. Ukraine | A Russian drone that was part of an overnight attack on Ukraine crashed into an apartment building in eastern Romania, injuring two people, authorities said, in what an official statement condemned as an “irresponsible escalation” by Moscow.

5. Climate crisis | Abandoning net zero and drilling for more oil and gas would be a massive setback for the UK and would not help the economy, leading experts have said in response to Tony Blair.

In depth: ‘You must be brave if you work in this environment’

There is no current vaccine for Ebola. The virus, which is caught from wild animals and passed between humans through body fluids, was discovered in 1976 and is largely found in rainforest regions of western, central and eastern Africa. Between 2014 and 2016, the deadliest known outbreak killed 11,325 people in Guinea, Sierra Leone and Liberia. Frontline workers are desperately trying to prevent a repeat in eastern DRC and Uganda.

Lame says that Ebola was likely passing through the community for some time in and around Bunia, the capital of Ituri province, before the outbreak was formally declared on 15 May. Symptoms are similar to common illnesses like malaria and typhoid: fever, muscle pain, vomiting and diarrhoea. While Ebola is not spread as easily as a respiratory illness like Covid-19 or influenza, the lack of lab facilities for testing has made it hard to monitor. Many more cases are suspected than the official WHO figures, he says.

“We don’t have a specific treatment for Ebola right now but we can save people if they come very early. Then, their chance of being cured is higher. But if people come late, the case fatality rate is high,” says Lame, who is from Senegal. “Patients are afraid because they know that Ebola does not have a cure. Many have lost a member of their family or a colleague. And it also impacts frontline workers, too, who have lost colleagues.”

At least five doctors and nurses have died after treating patients at Bunia Evangelical medical centre, including 30-year-old Dr Vladimir Maduali who died on Sunday, and Dr Tibenderana Katho Blaise who died two days later. Other colleagues are believed to have contracted the virus.

“We have preventive measures that we are putting into place to protect our colleagues. They are working with some confidence because some have experienced previous Ebola outbreaks. You must be brave if you work in this environment,” says Lame.

Conspiracy abounds

Despite the immense bravery of medical staff, there is a fragile relationship with the local community, which is hampering the response. Some in Ituri province think that the virus does not exist or it has been brought in by humanitarian workers, fearing that they will die if they go to hospital, says Dr Lame.

There have also been attacks on healthcare facilities. The Ebola virus can spread from contact with cadavers, and authorities have implemented strict rules around burials which has sometimes angered families. In one case, a group of young men carried out an arson attack on an Ebola centre in the Rwampara region to try to retrieve a friend’s body.

Speaking about the attack on Alima facilities, Lame explains how the conditions around containment can exacerbate the sense of loss and anger: “The death of a young footballer from suspected Ebola shocked the community and his family. Young people came to ask for his body without treatment. Because it was a suspected Ebola death, we had to organise a safe burial so people got angry,” says Lame. “For us, this is not an attack against the organisation. It is anger and frustration against the loss of an important person in the community.”

USAID cuts dismantled the system

Maintaining cooperation with the community is vital to ending the outbreak as quickly as possible, say public health officials. On Wednesday, World Health Organization chief, Tedros Adhanom Ghebreyesus, appealed for a ceasefire in Ituri between rebel groups to help contain the outbreak.

But the effort to end the Ebola outbreak will probably take several months. The 2014 Ebola outbreak in west Africa took more than two years to end, and there was a major international effort to protect people from the disease. Enormous western cuts to humanitarian aid appear to have made the response much slower this time. US foreign assistance to the DRC has fallen from $1.4bn in 2024 to $21m so far this year, with health officials warning that the US appears to be doing little to stop the outbreak this time.

“Ebola is one of those truly terrifying, upsetting, horrific things that does happen intermittently. Since the 2014 outbreak, we had gotten much better at identifying it and responding to the virus. There was a major effort to train local epidemiologists and health workers. The USAID cuts were obviously devastating. The system took a long time to build but didn’t take very long to dismantle,” says Selena Victor, senior director of policy and advocacy for Mercy Corps.

Some countries, including the US, are providing more funding to help. But the amount is dwarfed by the resources used to contain previous Ebola outbreaks – and officials are warning that basic PPE supplies were already a concern. The world must do all it can to make sure medical staff have the resources to respond this time, she said.

“I’m blown away by people’s willingness and commitment to help in these situations. Please, let’s not have a situation where they don’t have gloves, masks and gowns. The very least we can do is make sure that they have everything they need to stay safe,” she says.

A global problem

Last week, University of Oxford scientists said they are working on an Ebola vaccine that could be ready for clinical trials within two months, as part of the effort to contain the virus. The WHO is treating the outbreak as a public health emergency of international concern. But in the era of extreme political polarisation, governments are not responding as they have done to previous outbreaks.

The US has banned people from entering the country who have been in the DRC, South Sudan and Uganda in the previous 21 days. The Trump administration is also building a quarantine and treatment centre in Kenya for Americans affected by the Ebola outbreak, instead of bringing them home, attracting widespread criticism.

Lame said it was vital that his team get the resources they needed to help save lives – adding that more resources are still needed from abroad. “The community response against Ebola is critical, and we need many resources for this. International staff who can come and help with community engagement, human resources, logistics, water sanitation. Hopefully we will have enough to do our work.”

What else we’ve been reading

• Argentina has a problematic self-image as “European” at the expense of African-Argentinian and Indigenous communities, as Tiago Rogero looks at what a recent spate of racist incidents says about race relations on the continent. Yassin El-Moudden, newsletters team

• Laura Barton has a great interview with Paul McCartney about his early life and the inspiration for his new album. Patrick

• Is Jamaica on the verge of becoming the region’s newest fossil-fuel producing state? Sarah Johnson takes stock of the debate triggered by news of a potential oil discovery. Yassin

• Steven Morris has a brilliant report on volunteers rechalking the enormous Cerne Giant in Dorset this year. Patrick

• Students in France are now able to say bon appétit over a three-course meal for no more than €1. Kim Willsher breaks bread with some of the beneficiaries of a student-led campaign that has borne fruit. Yassin

Sport

Tennis | Jannik Sinner’s bid for a maiden French Open title and career grand slam went up in smoke as he wilted in his second-round match against Juan Manuel Cerúndolo.

Cycling | Paul Magnier of Soudal Quick-Step completed a hat-trick of victories in this Giro d’Italia by winning a bunch sprint on stage 18 in Pieve di Soligo.

Athletics | Keely Hodgkinson has dangled the intriguing possibility that July’s ­London Diamond League ­meeting could be the day where she takes down Jarmila Kratochvilova’s 42-year-old 800m world record.

The front pages

“Labour plans welfare shake-up as scale of youth jobs crisis revealed”, is the Guardian’s front page today. The Times leads with “Burnham backs state control in blast at Blair” and the i Paper says “Burnham hits back at Blair and Starmer as he outlines plan to run Britain”.

The Telegraph says “Prostate screening set to be rationed” and the Mail, on the same topic, writes “Decision that will ‘condemn thousands’ to death”.

The FT’s splash is “Manifold clashed with BP’s company secretary before ousting over conduct”. The Express says “Jewish people don’t feel safe on British streets”. In the Mirror “Flags group ‘founder’ charged with murder” is the top story. The Sun goes with “It’s all kicking off” and finally Metro, on a drug gang who “loved the high life”, splashes “Behind spas!”.

Something for the weekend

Our critics’ roundup of the best things to watch, read, play and listen to right now

Film
Backrooms | ★★★★★
YouTuber Kane Parsons makes his feature directing debut with this icily brilliant and genuinely disturbing conceptual horror film based on his web series, and scripted by Will Soodik. There is something here of J-horror, the V/H/S found footage franchise, Dan Erickson’s Severance and Nathan Fielder’s The Rehearsal. It’s about people walled up in their own memories, imprisoned in endlessly remembered scenes from their past, or miserably perceived versions of their present existences in which they have become caricatures of themselves, gargoyle stars of their paralysed inner world of failure. Or perhaps the action of the film is not metaphorical in this or any other sense, and the “backrooms” of the title simply exist. Peter Bradshaw

Music
Iceage: For Love of Grace & the Hereafter | ★★★★★
Their sixth album, is billed as a return to punky first principles. It’s certainly less epic than its predecessor – but the barely contained chaos that Iceage once dealt in is conspicuously absent. Instead, the new album feels powerful, but streamlined in every sense, and the songwriting is extraordinarily tight and punchily melodic throughout. The songs have a sparkle to them: a curiously effective backing for Rønnenfelt’s lyrics, which still tend to the pugilistic, visceral and bleak, and make love sound like mortal combat. The result leaves you thinking that while the band’s constant development and diversity is striking, their consistency is more striking still. Alexis Petridis

TV
Spider-Noir | ★★★★☆
As the title suggests, Spider-Noir has been conceived as a homage to the hard-boiled films and fictions of the 1940s. The show is gloriously full of shadows and cigarette smoke, sassy secretaries and shady dames, as well as superheroes and supervillains. Plot twists are served up – and if none is brilliantly innovative, the whole is fast and fun enough to get away with it. Everything is shot with style and confidence, while the script contains just enough sharp dialogue and witty banter to keep it aligned with the templates of the past. And Nicolas Cage fans, of course, will have his turn as Ben Reilly to keep them going. Lucy Mangan

Theatre
Redcliffe, Southwark Playhouse Borough, London | ★★★★☆
Queer history is made up of bad news. The official documents record the raids, the arrests, the executions. The rest – all the raging love and snatches of joy – is largely left for us to imagine. In Jordan Luke Gage’s impressive Redcliffe, the writer-performer fills in the gaps of the lives of William Critchard and Richard Arnold, two men who collided in mid-18th-century Bristol. Inspired by true events romanticised into a musical, this is an open-hearted production. Kate Wyver

Today in Focus

Why are our homes and cities all so hot?

In the week when the hottest May days were recorded, the Guardian’s environment editor, Fiona Harvey, examines a new Climate Change Committee report on how the UK can better withstand extreme heat.

Cartoon of the day | Ben Jennings

The Upside

A bit of good news to remind you that the world’s not all bad

“That felt bonkers to me: they were creating the exact material we needed next to our site” says Joel de Mowbray, of the experience of watching trees felled near where he was working while he was having to source timber from miles away. He has now helped set up Tipping Point East, a hub set on a 20,000 sq metre industrial site in Newham, London, which promotes circular construction, where materials are reused instead of discarded. “We’re creating a regenerative supply chain for the city we love,” says De Mowbray. “Turning things that would otherwise go to waste into objects that have cultural potential”. The materials yard is full of neatly stacked glass panes, sinks and pipes that would otherwise have been thrown away which have now been certified to be re-used and donated to community builds or sold at very reasonable prices.

Sign up here for a weekly roundup of The Upside, sent to you every Sunday

Bored at work?

And finally, the Guardian’s puzzles are here to keep you entertained throughout the day. Until tomorrow.

• Quick crossword

• Cryptic crossword

• Wordiply

The deadly Ebola outbreak in the Democratic Republic of the Congo can be stopped, the World Health Organization (WHO) head, Tedros Adhanom Ghebreyesus, said as he arrived in Kinsasha.

Tedros landed in the DRC on Thursday evening and was due on Friday to travel to Ituri province in the north-east, where the epidemic is centred.

“That thing can be stopped,” Tedros said, adding that the WHO did not support travel bans to combat the outbreak because they “don’t help much”.

“Together, we will overcome this outbreak,” he said earlier, vowing to do “everything in my power to help you”.

The WHO has recorded 10 confirmed and 223 suspected Ebola deaths in the DRC since the outbreak was declared on 15 May, out of more than 1,000 confirmed and suspected cases, according to its figures up to 24 May, the latest available.

The true spread of the virus is likely much wider as it is thought to have circulated under the radar for some time, the WHO has warned.

This is the 17th recorded Ebola outbreak in the big central African country, which has a population of more than 100 million people.

Complicating medical relief efforts, the epidemic is centred in a mineral-rich region fought over by armed groups. “Conflict and displacement make everything harder,” Tedros said. “I am making a direct appeal to all warring parties in this region: please, declare a ceasefire.

“No cause, no conflict, no grievance is worth condemning innocent people to death from a preventable disease.”

No vaccine or treatment yet exists for the Bundibugyo strain of Ebola causing the current outbreak. The WHO said on Thursday that its advisory groups had recommended clinical trials for vaccines and treatments.

The head of the African Union’s health agency, Jean Kaseya, said on Thursday that a vaccine should be ready by the end of the year.

Neighbouring Uganda, with one recorded death from Ebola and six additional cases, announced it was shutting its border with the DRC with immediate effect.

The US said it would deny entry to anyone infected and was working to open a treatment facility for affected US citizens in Kenya. A Kenyan rights group has gone to court seeking to limit operations at any such facility, while health officials have warned it could burden Kenya’s stretched health system.

Ebola has killed more than 15,000 people in Africa over the past 50 years. The deadliest outbreak in the DRC claimed nearly 2,300 lives out of 3,500 cases between 2018 and 2020.

The WHO said it had received 4.6 tonnes of aid at the airport in Bunia, capital of Ituri province, while Unicef, the UN children’s agency, said it was sending 100 tonnes of aid to the DRC.

With Agence France-Presse

A fire that ripped through a dormitory at a girls’ school in Kenya overnight has killed at least 15 students, according to police, while dozens more were injured.

Gilgil police station said at least 15 girls died at Utumishi girls academy in Gilgil, Nakuru county, about 76 miles north-east of Nairobi, according to a police report seen by Reuters.

A police source told Agence France-Presse that 16 people had been killed, most of them children, while 73 were hospitalised. The cause of the fire in the dormitory, where about 220 girls were sleeping, has not yet been confirmed.

The tragedy is the latest fatal fire at a school in Kenya in recent years. In 2024, 21 boys were killed at a boarding school in central Kenya when a fire tore through their dormitory, while in 2017 nine girls died in a blaze at a school in Kibera, the largest slum in Nairobi.

In 2016, there were about 120 incidents of students setting fire to their sleeping quarters. A 2022 report by the country’s auditor general found that most state secondary schools were not prepared to deal with fires.

The Kenyan Red Cross said on X that the blaze in Gilgil was reported at about 3.30am on Thursday. “Several students have been evacuated and are receiving treatment in various hospitals,” it said. “A multi-agency response involving the county fire brigade, county disaster response teams, @PoliceKE and Kenya Red Cross remains ongoing.”

Masoud Mwinyi, an assistant to the deputy inspector general of Kenya’s police, told local media that officers were searching for pupils who may have escaped the fire but were still unaccounted for.

“We are combing the area because out of that shock and fear and anxiety, many people went out and it was at night,” he said.

Dozens of parents gathered at the school on Thursday morning, frantically searching for news of their children.

Wambui Nderitu told the BBC her niece had survived the fire but broken her leg. She added: “Some of those at the top floor had to jump out, that’s why they are injured.”

A fire that ripped through a dormitory at a girls’ school in Kenya overnight has killed at least 15 students, according to police, while dozens more were injured.

Gilgil police station said at least 15 girls died at Utumishi girls academy in Gilgil, Nakuru county, about 76 miles north-east of Nairobi, according to a police report seen by Reuters.

A police source told Agence France-Presse that 16 people had been killed, most of them children, while 73 were hospitalised. The cause of the fire in the dormitory, where about 220 girls were sleeping, has not yet been confirmed.

The tragedy is the latest fatal fire at a school in Kenya in recent years. In 2024, 21 boys were killed at a boarding school in central Kenya when a fire tore through their dormitory, while in 2017 nine girls died in a blaze at a school in Kibera, the largest slum in Nairobi.

In 2016, there were about 120 incidents of students setting fire to their sleeping quarters. A 2022 report by the country’s auditor general found that most state secondary schools were not prepared to deal with fires.

The Kenyan Red Cross said on X that the blaze in Gilgil was reported at about 3.30am on Thursday. “Several students have been evacuated and are receiving treatment in various hospitals,” it said. “A multi-agency response involving the county fire brigade, county disaster response teams, @PoliceKE and Kenya Red Cross remains ongoing.”

Masoud Mwinyi, an assistant to the deputy inspector general of Kenya’s police, told local media that officers were searching for pupils who may have escaped the fire but were still unaccounted for.

“We are combing the area because out of that shock and fear and anxiety, many people went out and it was at night,” he said.

Dozens of parents gathered at the school on Thursday morning, frantically searching for news of their children.

Wambui Nderitu told the BBC her niece had survived the fire but broken her leg. She added: “Some of those at the top floor had to jump out, that’s why they are injured.”

The Trump administration is building a quarantine and treatment center in Kenya for Americans affected by the Ebola outbreak, instead of bringing them home.

The White House on Wednesday confirmed that the US was setting up a facility in Kenya for Americans to quarantine after Ebola exposure in the Democratic Republic of the Congo (DRC).

“The facility is designed to provide access to high-quality care for Americans who would need to quickly get out of DRC and quarantine without the risks of a lengthy transport back to the US,” a White House official told the Guardian.

The center will also treat Americans who contract Ebola, the official said – “including critical care needs, though each case will be evaluated for forward transport for more advanced care as appropriate in order to maximize patient outcomes”.

The official did not clarify whether that further transport would be to the US or to Europe, where other Americans have been taken for quarantine and treatment. The official also did not clarify if Americans were allowed to return to the US if they did not want to go to Kenya.

The US has banned green card holders who recently travelled in DRC, Uganda and South Sudan from returning home, and other recent travellers to these three countries are also banned from entering the US.

“It is shocking to me that the administration is looking to prevent Americans from coming home to receive the proven world-class care that our taxpayer-funded biocontainment and treatment units are equipped to provide,” said Jennifer Nuzzo, an epidemiologist and director of the Pandemic Center at the Brown University School of Public Health.

“There are profound ethical concerns with this approach,” she added. “Without adequate plans for the safe quarantine of exposed individuals and prompt isolation of those who become infected, I fear these facilities could amplify the spread of the virus. The prospect of not being able to come home for safe and effective care may create disincentives for people to disclose having been exposed, which could drive cases underground, and cause the virus to spread even more.”

Americans responding to previous outbreaks – whether they were caring directly for patients or organizing the logistics of contact tracing and safe burial teams – knew that if they fell ill, they could return home to receive some of the best medical care in the world.

Without those assurances, and with the prospect of being indefinitely prevented from returning home to friends and family, US experts are much less likely to volunteer now.

“That’s basically telling any American health worker who might go and work on the effort to contain this outbreak that if they get sick, they can’t come home,” said Jeremy Konyndyk, president of Refugees International and former executive director of the USAID Covid-19 taskforce as well as a former leader in the 2014-2015 USAID Ebola response. “It disincentivizes people from going. In 2014, we faced this exact scenario – cases coming back to the United States – and we fought really hard not to put a travel ban in place because we knew that would ultimately be counterproductive to the goal of ending the outbreak.”

The risks of transportation are extremely low if a person is not symptomatic, and the US has extensive experience evacuating people who have been exposed to and test positive for Ebola or other contagious pathogens.

The head of the World Health Organization has called for an immediate ceasefire in the eastern Democratic Republic of the Congo to help tackle the Ebola outbreak there.

Tedros Adhanom Ghebreyesus posted on social media that the region was in the midst of a “catastrophic collision of disease and conflict with the Ebola outbreak in Ituri province outpacing the response”.

Tedros said on Monday that he would travel to the DRC this week.

As of Sunday there had been 900 suspected cases and 223 suspected Ebola deaths in the DRC and seven confirmed cases and one death in Uganda, WHO data shows.

The outbreak was confirmed on 15 May in Ituri, the DRC’s most north-eastern province, which borders South Sudan and Uganda.

Eastern DRC has a number of armed groups. Though the government still largely controls Ituri, insecurity had been worsening there before the Ebola outbreak. Almost 1 million people in the province have been displaced by conflict, according to the UN humanitarian office.

The outbreak has spread south to rebel-held areas of North Kivu and South Kivu provinces, where the Rwandan-backed M23 group controls large swathes of the region.

Tedros said: “Stopping this Ebola transmission depends entirely on humanitarian access. Yet ongoing clashes are driving mass displacement, pushing exposed contacts into overcrowded camps and severing critical containment corridors.

“Frontline workers are risking everything, while attacks on health facilities make tracking cases and their contacts nearly impossible. We cannot build community trust or isolate the sick while bombs are falling. We urge all warring parties to agree to an immediate ceasefire to contain this outbreak.”

The response to the outbreak has been complicated by the transient nature of many communities in Ituri, where goldmines attract migrant workers, as well as by international aid cuts.

Philippe Guiton, the DRC director of the aid organisation World Vision, said: “For children, the risks are especially acute. Years of conflict have weakened community systems, and acute malnutrition has left many young bodies too fragile to withstand a virus as aggressive as Ebola.”

The response has also been hindered by attacks on health facilities by people wanting authorities to release Ebola victims’ bodies for burial.

Traditionally, burials involve families washing and touching the body. However, the bodies of Ebola victims are highly contagious and have been a key vector for spreading the disease in previous outbreaks in the region.

On Saturday and Sunday, people attacked a hospital in Mongbwalu, in Ituri. Its medical director, Dr Richard Lokodu, told Reuters that 18 Ebola patients fled the facility on Saturday when “unidentified individuals” burned tents where patients were being isolated.

On Sunday, seven more patients fled and an individual suspected of having Ebola died haemorrhaging in the attempt, he said.

In Uganda, all seven confirmed cases were reported in Kampala, the WHO said. They included a driver who had transported another case; a Congolese woman who had travelled to Uganda for medical care; a Congolese health worker who worked with other Congolese people seeking healthcare in Uganda; and two Ugandan health workers who had cared for an Ebola patient.

The World Health Organization has warned that the Ebola outbreak is outpacing response efforts and countries neighbouring the Democratic Republic of Congo (DRC) are at high risk from the disease.

“We are urgently scaling up operations, but at the moment the epidemic is outpacing us,” said the WHO’s director-general, Dr Tedros Adhanom Ghebreyesus, as he urged neighbouring countries to take immediate action.

Addressing an online meeting of the African Union about the outbreak, he also announced there had been 220 suspected deaths so far in the current Ebola outbreak and that he would travel to the DRC on Tuesday with Chikwe Ihekweazu, executive director of WHO’s health emergencies programme.

Tedros’s announcement came as attacks by residents on health facilities in Ituri province, the centre of the outbreak, hampered the response.

First on Saturday and again on Sunday, residents of Mongbwalu town in the DRC attacked the Mongbwalu general referral hospital.

Dr Richard Lokodu, medical director of the facility, told Reuters that 18 Ebola patients had fled on Saturday after “unidentified individuals” burned tents, erected by Médecins Sans Frontières, where patients were being isolated.

The hospital came under four waves of attacks on Sunday, he added, by young people mobilised by relatives of a religious leader who died of Ebola. Seven other patients escaped and Congolese police and soldiers had to intervene to restore order.

A suspected patient who was in critical condition with haemorrhaging died in the second attack while trying to flee from his bed.

The perpetrators of the attacks had wanted the bodies of the Ebola victims released for burial, Lokodu added.

In a similar incident, a crowd on Thursday set fire to a treatment centre in Rwampara, near Bunia, after authorities refused to give them the body of a victim they wanted to bury themselves.

The burial of bodies, which can be highly contagious, is handled by authorities for containment of the disease, but some families prefer traditional burials, which involve washing and touching the body. In previous outbreaks that has been proved to be a key driver of the spread of the disease.

Earlier this month, Tedros declared the outbreak a “public health emergency of international concern” after more than 300 suspected cases and 88 deaths were reported in the DRC and two deaths in neighbouring Uganda.

On Monday, Uganda announced two more Ebola cases, taking the total number of confirmed cases in the country to seven. The new cases are both Ugandan health workers in a private health facility in the capital, Kampala, the country’s health ministry said in a statement.

The outbreak is caused by the rare Bundibugyo ebolavirus, which has no approved treatment or vaccine.

The hotspots are Rwampara, Mongbwalu, Nyankunde and Bunia areas in the north-east DRC province of Ituri, a commercial and migration hub and a gold-rich region where conflict between militias allied to the Hema and the Lendu ethnic groups, who are fighting over land and the mineral, has killed more than 50,000 people since 1999.

Cases have also been reported in Butembo and rebel-controlled Goma, both in North Kivu province, and Bukavu city, also rebel-held, in South Kivu province.

On Monday, Tedros said containing the outbreak was complicated by Ituri and North Kivu being insecure and the lack of an approved vaccine.

Reuters contributed to this report

Congolese authorities say that suspected Ebola cases have now passed 900 in the ongoing outbreak in the east of the country.

The Congolese ministry of communication, in a post on X on Sunday, said there were 904 suspected cases and 119 suspected deaths.

Authorities had previously announced more than 700 suspected Ebola cases, and more than 170 suspected deaths, mostly in Ituri province, where the outbreak is centred.

The World Health Organization has said the outbreak now poses a “very high” risk for the Democratic Republic of Congo, but that the risk of the disease spreading globally remains low.

Health authorities in the country are facing serious challenges as they try to stem the outbreak, which has been declared a global health emergency.

There have been arson attacks on Ebola treatment centres in the country’s east – two centres in two towns were hit last week, exposing the anger in a region beset by violence linked to armed rebel groups, the displacement of a large number of people, the failure of local government and international aid cuts that experts say have stripped health facilities in vulnerable communities.

Colin Thomas-Jensen, director of impact at the Aurora Humanitarian Initiative, said the attacks may reflect the “built-in skepticism and anger” of people in eastern Congo over how the region has been treated, with years of violence from foreign-linked rebel groups and a failure of their government and international peacekeepers to protect them.

Another source of anger has been the strict protocols around the burial of suspected victims of Ebola, which authorities are taking charge of wherever they can to prevent further spread of the disease during traditional burials – where families prepare the bodies and people gather for a funeral.

The first burning of an Ebola centre in Rwampara was by a group of young men trying to retrieve a friend’s body, according to witnesses and police. The witnesses said the crowd accused the foreign aid group operating there of lying about Ebola.

Authorities in north-eastern Congo have now banned funeral wakes and gatherings of more than 50 people, and armed soldiers and police are guarding some burials carried out by aid workers.

Eastern Congo has for years seen attacks by dozens of separate rebel and militant groups, some of them with links to foreign countries or the extremist Islamic State group.

The Rwanda-backed M23 rebels are in control of parts of the region. While the Congolese government still largely controls the north-eastern Ituri province, which is the centre of the Ebola outbreak, its control is tenuous. The Allied Democratic Forces, a Ugandan Islamist group linked to Islamic State, is one of the dominant rebel groups there and is responsible for violent attacks against civilian targets.

Before the outbreak, Doctors Without Borders said in an assessment that the insecurity in Ituri had worsened recently, causing doctors and nurses to flee, leaving overwhelmed health facilities and, in some parts, “catastrophic conditions”.

The UN humanitarian office says almost 1 million people have been displaced from their homes by conflict in Ituri.

It means the Ebola outbreak is “unfolding in communities already facing insecurity, displacement and fragile healthcare systems,” said Gabriela Arenas, a regional coordinator at the International Federation of Red Cross and Red Crescent Societies.

There are concerns the disease might spread to the large displacement camps near the city of Bunia, where the first cases were reported.

Health experts say international aid cuts last year by the US and other rich nations were devastating for eastern Congo because of its multiple problems.

The cuts “reduced the capacity to detect and respond to infectious disease outbreaks”, said Thomas McHale, public health director at Physicians for Human Rights. Congo has had more than a dozen previous Ebola outbreaks.

Aid groups fighting this outbreak on the ground say they don’t have the equipment they need, such as face shields and suits to protect health workers from infection, testing kits, and body bags and other materials needed to safely bury the bodies of those who have died, which can be highly contagious.

“We have made requests to different partners, but we have not yet really received anything,” said Julienne Lusenge, president of Women’s Solidarity for Inclusive Peace and Development, an aid group operating a small hospital near Bunia.

“We only have hand sanitiser and a few masks for the nurses,” she said.

The Bundibugyo type of Ebola virus responsible for the outbreak has no approved vaccine or treatment.

Bonolo Selelo was at Botswana’s national museum for a Gaborone Pride event when she spotted Tsholofelo Kumile and was struck by her good looks. The two initiated a conversation and when Kumile expressed anxiety about what a tarot reading at the event might hold, Selelo thought nothing of offering her a hug. The reading turned out positive but Kumile claimed her hug anyway and they talked for hours.

That was 1 October 2023. Two months later, they moved in together. Then, on a hike during the Easter holidays in 2024, Selelo proposed to Kumile. A year later, they visited a local government office to register their intent to marry and were told it wasn’t legal.

“It was kind of expected. But I don’t think they expected the response,” Kumile said. She looked affectionately at Selelo. “She does not back down.”

The couple launched a court case, claiming the right to marry. Hearings are scheduled for 14 and 15 July. If they succeed, Botswana would become the second African country to legalise same-sex marriage, after South Africa in 2006. However, the case is facing fierce opposition from the government and traditional and church groups.

“We did have a frank discussion about it,” said Selelo, sitting next to her fiancee in the office of her law firm, which Kumile also works for. “I said … I want us to get married, because I love you, but there’s also the practical part.”

As a lawyer, Selelo worried what would happen to Kumile if she died. “I feel that I would be able to withstand a lot of legal pressure, but I wouldn’t want her to be harassed if I am no longer there to offer that protection. And, for me, marriage would give her that added protection that no other institution would be able to give her.”

Botswana decriminalised same-sex relations in 2019 when the high court ruled that a British colonial-era ban was unconstitutional. The decision was upheld on appeal in 2021. The government is now defending its ban on same-sex marriage.

A spokesperson for Botswana’s Attorney General said: “The Attorney General’s position... is that the Marriage Act stipulates that a valid marriage is one between a bride and a bridegroom and or a husband and wife, connoting a bond between a man and woman in the conventional sense. The Marriage Act does not provide for same sex marriages.”

Selelo and Kumile argued that another law, the Interpretation Act, supports their case, due to the law stating: “In an enactment words importing the male sex include the female sex and words importing the female sex include males.”

Much of southern Africa and the continent’s island states are relatively liberal compared with the rest of Africa, where 32 of 54 countries criminalise consensual same-sex intimacy. Since 2012, Lesotho, Mozambique, Seychelles, Angola, Mauritius and Namibia have legalised same-sex relations.

However, some countries on the continent have passed harsher laws amid a global backlash against LGBTQ+ rights. Uganda in 2023 and Senegal this year increased the prison times for consensual gay sex and both criminalised the “promotion” of homosexuality.

Opinions in Botswana about LGBTQ+ people have become more negative since the 2019 decriminalisation ruling. In a 2021 survey conducted by the pan-African survey organisation Afrobarometer, half of Botswanans said they either would like or would not care about having gay people as neighbours, the joint fifth highest out of 34 countries surveyed. Three years later, the figure had fallen to 41%.

Legabibo, an LGBTQ+ rights campaign group, is running a campaign called “Lorato Ke Lorato” (Love Is Love) to try to change hearts and minds. “We want to show ourselves as ordinary citizens … We’re not asking for any special rights,” said Matlhongonolo Samsam, who is leading the campaign.

On the other side is the Dingwetsi Association, a traditional women’s group that promotes heterosexual marriage and is seeking to join the case. Grace Silver founded it in 2015, concerned at rates of divorce and family breakups. She said it now had about 2,000 members paying 20 pula (£1.10) a month.

Members often wear traditional headwraps and blue, white and black tartan blankets that signify they are married women. Several showed up wearing the attire to a hearing in March for Selelo and Kumile’s case. “This is our culture. We need to protect it,” Silver said.

Accompanying Silver was Moshe Morebodi, of the Botswana House of Prayer and Transformation. “Same-sex human rights are a subset of a satanic sect,” he said.

About 80% of Botswana’s population is Christian, according to the World Religion Database. Tshepo Ricki Kgositau runs the Ricki Kgositau Foundation to support transgender Botswanans and is also a member of an LGBTQ+ task team within the Methodist Church of Southern Africa. She said: “It has been really disappointing to see the very conservative and narrow interpretation by some conservative faith community members … If you do not know love, you cannot claim to know God.”

The lack of same-sex marriage in Botswana caused Kgositau her own difficulties. In 2017, she married her husband in South Africa. He was meant to come to Botswana for their traditional wedding but because she had not yet legally changed her gender (which requires a court ruling), he was barred from entering the country. They also lost the money they had spent planning the celebrations. “It was absolutely devastating,” she said.

For Brendon Tereki and his partner, Tashatha, the legal case brings hope. After connecting on Facebook two years ago, their first meeting at a popular bar in Gaborone was also Tereki’s first date with a man in public. By the end of the night, Tashatha had made him feel comfortable enough that they were able to kiss. “He has made me open up more than I ever thought,” Tereki said. “I really want to get married.”

Congolese authorities say that suspected Ebola cases have now passed 900 in the ongoing outbreak in the east of the country.

The Congolese ministry of communication, in a post on X on Sunday, said there were 904 suspected cases and 119 suspected deaths.

Authorities had previously announced more than 700 suspected Ebola cases, and more than 170 suspected deaths, mostly in Ituri province, where the outbreak is centred.

The World Health Organization has said the outbreak now poses a “very high” risk for the Democratic Republic of Congo, but that the risk of the disease spreading globally remains low.

Health authorities in the country are facing serious challenges as they try to stem the outbreak, which has been declared a global health emergency.

There have been arson attacks on Ebola treatment centres in the country’s east – two centres in two towns were hit last week, exposing the anger in a region beset by violence linked to armed rebel groups, the displacement of a large number of people, the failure of local government and international aid cuts that experts say have stripped health facilities in vulnerable communities.

Colin Thomas-Jensen, director of impact at the Aurora Humanitarian Initiative, said the attacks may reflect the “built-in skepticism and anger” of people in eastern Congo over how the region has been treated, with years of violence from foreign-linked rebel groups and a failure of their government and international peacekeepers to protect them.

Another source of anger has been the strict protocols around the burial of suspected victims of Ebola, which authorities are taking charge of wherever they can to prevent further spread of the disease during traditional burials – where families prepare the bodies and people gather for a funeral.

The first burning of an Ebola centre in Rwampara was by a group of young men trying to retrieve a friend’s body, according to witnesses and police. The witnesses said the crowd accused the foreign aid group operating there of lying about Ebola.

Authorities in north-eastern Congo have now banned funeral wakes and gatherings of more than 50 people, and armed soldiers and police are guarding some burials carried out by aid workers.

Eastern Congo has for years seen attacks by dozens of separate rebel and militant groups, some of them with links to foreign countries or the extremist Islamic State group.

The Rwanda-backed M23 rebels are in control of parts of the region. While the Congolese government still largely controls the north-eastern Ituri province, which is the centre of the Ebola outbreak, its control is tenuous. The Allied Democratic Forces, a Ugandan Islamist group linked to Islamic State, is one of the dominant rebel groups there and is responsible for violent attacks against civilian targets.

Before the outbreak, Doctors Without Borders said in an assessment that the insecurity in Ituri had worsened recently, causing doctors and nurses to flee, leaving overwhelmed health facilities and, in some parts, “catastrophic conditions”.

The UN humanitarian office says almost 1 million people have been displaced from their homes by conflict in Ituri.

It means the Ebola outbreak is “unfolding in communities already facing insecurity, displacement and fragile healthcare systems,” said Gabriela Arenas, a regional coordinator at the International Federation of Red Cross and Red Crescent Societies.

There are concerns the disease might spread to the large displacement camps near the city of Bunia, where the first cases were reported.

Health experts say international aid cuts last year by the US and other rich nations were devastating for eastern Congo because of its multiple problems.

The cuts “reduced the capacity to detect and respond to infectious disease outbreaks”, said Thomas McHale, public health director at Physicians for Human Rights. Congo has had more than a dozen previous Ebola outbreaks.

Aid groups fighting this outbreak on the ground say they don’t have the equipment they need, such as face shields and suits to protect health workers from infection, testing kits, and body bags and other materials needed to safely bury the bodies of those who have died, which can be highly contagious.

“We have made requests to different partners, but we have not yet really received anything,” said Julienne Lusenge, president of Women’s Solidarity for Inclusive Peace and Development, an aid group operating a small hospital near Bunia.

“We only have hand sanitiser and a few masks for the nurses,” she said.

The Bundibugyo type of Ebola virus responsible for the outbreak has no approved vaccine or treatment.

Hunger is being increasingly exploited as a weapon of war with more than 20,000 documented incidents of “food-related violence” in the past eight years, new analysis reveals.

Attacks include 1,261 strikes on markets used by families for daily groceries and 863 incidents in which food distribution systems were targeted and workers killed.

The analysis looked at the period since UN resolution 2417 unanimously condemned the deliberate starvation of civilians in 2018. It found starvation is being increasingly weaponised with the supply of food routinely targeted in Gaza, Sudan, Lebanon and Haiti among others.

Data compiled by Insecurity Insight uncovered 21,403 incidents in 15 countries where food supplies have been deliberately targeted since 2018, when the UN security council unanimously passed a resolution condemning the unlawful denial of humanitarian aid as a tactic of warfare.

Researchers discovered 1,909 military strikes on farmland, and another 563 on water infrastructure vital for crops, which affected food security in more than 42 countries and territories.

States with the highest recorded incidents are the occupied Palestinian Territory with 9,013 attacks, followed by Yemen – 1,863 incidents – and Sudan, where food was targeted in 1,605 strikes. One of the most recent attacks in Sudan occurred on Tuesday when a drone struck a busy market, killing 28 people.

Witnesses said the main market in the town of Ghubaysh, West Kordofan, appeared to have been deliberately targeted by the military while it was crowded with civilians.

Other countries that documented repeated attacks on food supplies include Syria, which saw 1,538 incidents, many attributed to government or Russian military forces before the fall of the Assad regime; and Mali, where 1,415 attacks were recorded as the ruling junta struggled to maintain its grip on power in the west African country.

The research, to be released on Monday to coincide with the anniversary of the UN resolution, describes a “marked increase” in attacks on markets, farmland and food distribution systems.

Giulia Contò, conflict and hunger advocacy manager at Action Against Hunger, said: “Famine in Gaza and Sudan has captured global headlines over the past two years, but most conflict-induced hunger never does. It unfolds daily, with relentless attacks on the systems communities depend on to survive: livestock looted, markets bombed, aid convoys blocked.”

Researchers also found that civilians were frequently targeted as they attempted to obtain food. Between October 2023 and the end of 2025, more than 10,300 people were killed or injured trying to access aid.

Christina Wille, director at Insecurity Insight, urged the international community to implement the UN resolution, saying that it had a responsibility “to act upon violations”.

She said: “It is not that resolution 2417 has failed, but that member states have failed to implement it, and to demonstrate the political will to prevent those very same actions that the international community claims to oppose.”

Wille said that women were disproportionately affected by the weaponisation of hunger.

“Women in particular are faced with some of the toughest choices: unreliable access to food might mean travelling longer distances, increasing risks to their safety in volatile contexts.

“Women who were primarily carers are forced to become breadwinners, often while reducing their food intake to prioritise their family members. Without enough food, children are unable to play, learn or grow, and the consequences on their development will last a lifetime.”

Conflict remains the primary driver of hunger, accounting for more than half of all people facing severe hunger.

Last month, UN agencies warned that a growing share of global hunger is becoming entrenched in a small group of conflict-hit countries, with two-thirds of people facing acute food insecurity concentrated in just 10 nations.

The Trump administration will temporarily pause the removal of refugees to the Democratic Republic of Congo (DRC) during a spiraling Ebola outbreak, according to reporting by Politico, but experts say the move won’t help prevent the spread of the disease.

At least one woman is now in limbo after officials moved her to Kinshasa, the capital of the DRC, and now say they won’t bring her back because of the Ebola travel ban – despite a judge’s order for her return.

Adriana Zapata, 55, fled Colombia to the US, but she was sent to Kinshasa over a month ago – even though the DRC said it could not care for her complex medical needs. A US judge ordered her return to the US, but American officials are saying they cannot bring her back because of the travel ban instituted on Monday.

“I’m just really worried about losing her,” Zapata’s lawyer, Lauren O’Neal, told the Gothamist. “I don’t want her to die before we can get her back here.”

Immigration agents could come into contact with the virus during the trips, and the virus could spread closer to the US because of Trump’s immigration tactics, unnamed officials told Politico. Yet they said the decision is at least partly motivated by legal concerns – that removal to a third country with an active Ebola outbreak could be used in an immigrant’s defense.

“By the government’s own logic, if it is not safe for people to come from there to here, it is equally unsafe to send people there,” said Jeremy Konyndyk, president of Refugees International and the top Ebola response official at the US Agency for International Development (USAID) during the 2014-15 outbreak.

As long as the US has a ban on travelers from the DRC, Uganda and South Sudan, “on what grounds could it possibly be safe to deport people there?” Konyndyk asked.

It’s not clear what happens next to refugees who were already moved against their will to countries affected by or near the outbreak. At least 37 people have been moved to these countries in recent months, according to Gillian Brockell, an independent journalist who tracks third-country removals by the US.

Brockell suspects US officials are using the travel ban as an excuse for not returning Zapata. Sending people in detention centers to African nations far from home is a common threat, Brockell said, “so to publicly take one of their main scare tactics off the table, they are only going to do that if it helps them in some way”.

The US government has evacuated people from Ebola-affected regions before – including patients with active Ebola cases. One of the world’s leading experts on high-risk medical evacuations, the former state department official William Walters, is now an Immigration and Customs Enforcement (ICE) contractor, Brockell pointed out.

“The Trump administration could absolutely return Adriana Zapata to the US; telling the judge it can’t be done just isn’t true,” she said.

ICE “follows all applicable health and safety guidelines, including those outlined in the US Department of State’s travel advisories, when conducting removal operations,” said a spokesperson for the US Department of Homeland Security (DHS). But the DHS did not respond to the Guardian’s questions about Zapata’s return and the agency’s third-country removal plans during the Ebola outbreak, including whether flights to Uganda, South Sudan and Rwanda would continue.

Sending immigrants against their will to other countries could risk violating international law, said Camille Mackler, an immigration lawyer. “Basically, the US can’t send people back to where they will be persecuted, so we’re exporting our immigration enforcement.”

There are no official numbers, but experts estimate that between 8,000 and 15,000 people have been flown to third countries.

“We’ve already seen that people who are being detained by immigration are not receiving adequate medical care,” Mackler said. “They’re taking no protections for them, and then not thinking about the ripple effect that can have.”

If the outbreak continues expanding, there’s a chance detainees in the affected areas could get sick themselves – and if they were then sent to their countries of origin, they would be bringing the virus to South and Central America, where countries have little experience battling the viral hemorrhagic fever.

The US Centers for Disease Control and Prevention (CDC) says it has plans in place to test and monitor passengers from the region. The US announced on Thursday that all passengers traveling from the DRC, Uganda and South Sudan would be diverted to the Washington-Dulles international airport for screening.

“The US is putting in place travel measures to limit risk,” said Satish Pillai, the CDC’s Ebola response lead.

Even passengers from places like Kinshasa, with no known Ebola cases, will be monitored because “the outbreak in the affected area continues to expand”, Pillai said at a press conference on Friday.

“That is why CDC has initiated entry screening processes, which is a part of an overall broader, layered public health approach, starting with exit screening, airline illness reporting and public health monitoring after arrival,” Pillai said.

Measures like these mean it’s very unlikely travelers – including Zapata – will bring Ebola into the United States, said Alexandra Phelan, an associate professor at the Johns Hopkins Bloomberg School of Public Health and senior scholar at the Johns Hopkins Center for Health Security.

The “proper and equitable process that also protects public health” would be to bring Zapata to the US, per the judge’s order, and have her undergo the same health protocols as returning US citizens and residents at Dulles, Phelan said. That could include quarantine if there has been any high-risk exposure – though that’s “unlikely if she has remained in Kinshasa, which is not a known active transmission location”, Phelan added.

“If the Trump administration is serious about countering the spread of Ebola, the US government should restore health-related humanitarian funding it gutted across Africa; designate temporary protected status for the Democratic Republic of Congo, Uganda and South Sudan; and halt all deportation flights to the region – including flights involving Latin Americans and other third country nationals,” said Yael Schacher, director for the Americas and Europe at Refugees International.

The Trump administration will temporarily pause the removal of refugees to the Democratic Republic of Congo (DRC) during a spiraling Ebola outbreak, according to reporting by Politico, but experts say the move won’t help prevent the spread of the disease.

At least one woman is now in limbo after officials moved her to Kinshasa, the capital of the DRC, and now say they won’t bring her back because of the Ebola travel ban – despite a judge’s order for her return.

Adriana Zapata, 55, fled Colombia to the US, but she was sent to Kinshasa over a month ago – even though the DRC said it could not care for her complex medical needs. A US judge ordered her return to the US, but American officials are saying they cannot bring her back because of the travel ban instituted on Monday.

“I’m just really worried about losing her,” Zapata’s lawyer, Lauren O’Neal, told the Gothamist. “I don’t want her to die before we can get her back here.”

Immigration agents could come into contact with the virus during the trips, and the virus could spread closer to the US because of Trump’s immigration tactics, unnamed officials told Politico. Yet they said the decision is at least partly motivated by legal concerns – that removal to a third country with an active Ebola outbreak could be used in an immigrant’s defense.

“By the government’s own logic, if it is not safe for people to come from there to here, it is equally unsafe to send people there,” said Jeremy Konyndyk, president of Refugees International and the top Ebola response official at the US Agency for International Development (USAID) during the 2014-15 outbreak.

As long as the US has a ban on travelers from the DRC, Uganda and South Sudan, “on what grounds could it possibly be safe to deport people there?” Konyndyk asked.

It’s not clear what happens next to refugees who were already moved against their will to countries affected by or near the outbreak. At least 37 people have been moved to these countries in recent months, according to Gillian Brockell, an independent journalist who tracks third-country removals by the US.

Brockell suspects US officials are using the travel ban as an excuse for not returning Zapata. Sending people in detention centers to African nations far from home is a common threat, Brockell said, “so to publicly take one of their main scare tactics off the table, they are only going to do that if it helps them in some way”.

The US government has evacuated people from Ebola-affected regions before – including patients with active Ebola cases. One of the world’s leading experts on high-risk medical evacuations, the former state department official William Walters, is now an Immigration and Customs Enforcement (ICE) contractor, Brockell pointed out.

“The Trump administration could absolutely return Adriana Zapata to the US; telling the judge it can’t be done just isn’t true,” she said.

ICE “follows all applicable health and safety guidelines, including those outlined in the US Department of State’s travel advisories, when conducting removal operations,” said a spokesperson for the US Department of Homeland Security (DHS). But the DHS did not respond to the Guardian’s questions about Zapata’s return and the agency’s third-country removal plans during the Ebola outbreak, including whether flights to Uganda, South Sudan and Rwanda would continue.

Sending immigrants against their will to other countries could risk violating international law, said Camille Mackler, an immigration lawyer. “Basically, the US can’t send people back to where they will be persecuted, so we’re exporting our immigration enforcement.”

There are no official numbers, but experts estimate that between 8,000 and 15,000 people have been flown to third countries.

“We’ve already seen that people who are being detained by immigration are not receiving adequate medical care,” Mackler said. “They’re taking no protections for them, and then not thinking about the ripple effect that can have.”

If the outbreak continues expanding, there’s a chance detainees in the affected areas could get sick themselves – and if they were then sent to their countries of origin, they would be bringing the virus to South and Central America, where countries have little experience battling the viral hemorrhagic fever.

The US Centers for Disease Control and Prevention (CDC) says it has plans in place to test and monitor passengers from the region. The US announced on Thursday that all passengers traveling from the DRC, Uganda and South Sudan would be diverted to the Washington-Dulles international airport for screening.

“The US is putting in place travel measures to limit risk,” said Satish Pillai, the CDC’s Ebola response lead.

Even passengers from places like Kinshasa, with no known Ebola cases, will be monitored because “the outbreak in the affected area continues to expand”, Pillai said at a press conference on Friday.

“That is why CDC has initiated entry screening processes, which is a part of an overall broader, layered public health approach, starting with exit screening, airline illness reporting and public health monitoring after arrival,” Pillai said.

Measures like these mean it’s very unlikely travelers – including Zapata – will bring Ebola into the United States, said Alexandra Phelan, an associate professor at the Johns Hopkins Bloomberg School of Public Health and senior scholar at the Johns Hopkins Center for Health Security.

The “proper and equitable process that also protects public health” would be to bring Zapata to the US, per the judge’s order, and have her undergo the same health protocols as returning US citizens and residents at Dulles, Phelan said. That could include quarantine if there has been any high-risk exposure – though that’s “unlikely if she has remained in Kinshasa, which is not a known active transmission location”, Phelan added.

“If the Trump administration is serious about countering the spread of Ebola, the US government should restore health-related humanitarian funding it gutted across Africa; designate temporary protected status for the Democratic Republic of Congo, Uganda and South Sudan; and halt all deportation flights to the region – including flights involving Latin Americans and other third country nationals,” said Yael Schacher, director for the Americas and Europe at Refugees International.

The warnings from aid groups and healthcare workers in the Democratic Republic of the Congo have been stark, their calls for coordinated international action impassioned.

As the country reels from the return of the Ebola virus, there is growing concern that its fragile healthcare system will struggle to cope with an outbreak that experts say goes well beyond the number of confirmed cases.

“The speed at which this Ebola outbreak is spreading is deeply worrying,” said Rose Tchwenko, the DRC country director at the NGO Mercy Corps. “The risk of wider spread is real, and more regional and global support is urgently needed.”

Hama Amado, a field coordinator in the city of Bunia for the Alima aid group, said the virus was gaining momentum and spreading in many areas. “Everyone must mobilise,” he told Associated Press on Thursday. “We are still far from saying that the situation is under control.”

It has been a week since the DRC reported its 17th outbreak of Ebola, a viral disease with a mortality rate of between 25% and 90% that is spread through body fluids or contaminated materials and causes organ damage, blood vessel impairment and sometimes severe internal and external bleeding.

Nearly 750 suspected cases and 177 suspected deaths have been recorded since the first known victim died in Bunia, the capital of Ituri province in north-western DRC, on 24 April. Mourners touched him during a funeral in the nearby town of Mongbwalu, contributing to the spread of the virus.

Hospitals and other healthcare facilities have quickly become overwhelmed. Trish Newport, an emergency programme manager at Médecins Sans Frontières, said a team had identified suspected cases over the weekend at Bunia’s Salama hospital but found no available isolation ward in the area. “Every health facility they called said: ‘We’re full of suspect cases. We don’t have any space,’” she said on social media. “This gives you a vision of how crazy it is right now.”

Several factors are impeding the aid response, including the strain of the virus, for which there is no approved treatment or vaccine; the remote and conflict-scarred location of the outbreak; and local funeral customs which are at odds with strict disease-control practice. All this is set against the backdrop of big shortfalls in aid budgets, driven largely by the Trump administration’s cuts to foreign aid.

According to a study by the International Committee of the Red Cross (ICRC) this year, more than half of health facilities surveyed in North and South Kivu provinces – where cases have also been reported – were damaged or destroyed, and nearly half had reported significant staff departures since January 2025 owing to conflict and insecurity.

Two incidents this week laid bare some of the aggravating factors. On Tuesday, at least 17 people were killed in an attack by the Allied Democratic Forces, a militant group operating in eastern DRC and parts of Uganda, on several villages near the town of Mambasa, in Ituri. “We are facing a double war: one of weapons and another of the disease outbreak,” said Zawadi Jeanne, a woman from the town who lost her brother and uncle in an ADF attack last month.

On Thursday, a crowd set fire to a treatment centre in Rwampara, near Bunia, after authorities refused to give them the body of a victim they wanted to bury themselves.

The burial of bodies, which can be highly contagious, is handled by authorities for containment of the disease, but some families prefer traditional burials, which involve washing and touching the body. In previous outbreaks this has proven to be a key driver of the disease’s spread.

Batakura Zamundu Mugeni, a customary chief who was at the scene in Rwampara, told Agence France-Presse that authorities were working with health officials to track down any patients who may have fled, as well as contact cases. He blamed the unrest on “young people who do not grasp the reality of the disease”.

On Friday, the province banned funeral wakes and said burials must be conducted only by specialised teams. It also prohibited the transport of dead bodies by non-medical vehicles and limited public gatherings to a maximum of 50 people.

Instructions to avoid physical contact more generally are hampered by a strong culture of expressing affection through touch. “We live in a society where shaking hands is on the menu every day,” said Jackson Lubula, who lives in Bunia. “With this disease, anything is possible. A small mistake can cost you dearly, so I decided to wash my hands with soap every time after each greeting.”

Reports from across the affected areas add to the impression that the virus has been spreading unnoticed. A rapid needs assessment by ActionAid in the Bunia, Nizi and Nyankunde areas found nearly a third of schools had registered at least one suspected Ebola case or close contact.

On Saturday, the Red Cross said three of its volunteers who died this month were believed to have contracted the virus as long ago as 27 March while carrying out dead body management as part of an unrelated humanitarian mission.

People in Rwampara said the disease struck suddenly, and that early symptoms were mistaken for illnesses such as malaria. Botwine Swanze, whose son died, told a reporter for Associated Press: “He told me his heart was hurting. Then he started crying because of the pain. Then he started bleeding and vomiting a lot.”

Dr Núria Carrera Graño, a clinician with ICRC who has provided services in two previous Ebola outbreaks, described the situation in the DRC as a humanitarian, political and security crisis resulting from cumulative and unfortunate events.

She said responders should learn from past outbreaks about the importance of international cooperation and coordination. “We don’t have time to lose,” she said.

To control the outbreak, the DRC government is working with medics including those who have experience in handling the disease.

Dr Richard Kojan, an intensive care clinician with Alima who has provided services in several Ebola outbreaks, said there were many similarities between them, such as late discovery, insufficient resources to respond, and the lack of a vaccine at the outset.

“The outbreak is out of control,” he said from Kinshasa, the DRC’s capital, this week.

In the absence of a vaccine and approved treatment for the Bundibugyo strain of the virus, Kojan said, medics were working to optimise the standard of intensive care for patients and put in place surveillance and contact tracing for suspected cases.

“If they are admitted to the treatment centre early, the viral load will be low in their samples, and then, with optimised care, they will have a high probability of surviving,” he said.

The Alima team is also deploying a portable treatment unit called Cube, a transparent plastic structure that allows interaction between patients and their relatives and medics without the need to wear personal protective equipment. Kojan developed the concept after his experience with Ebola in the 2014-16 outbreak.

As the virus spreads, increasing numbers of people in Bunia are discovering friends and relatives have fallen victim, fuelling their anxiety.

“The mere thought of the name ‘Ebola’ scares me,” said Jeanne, who has a nephew in a health facility in Rwampara.

But she remains optimistic. “God is the one who knows what’s ahead,” she said. “I tell myself that the disease will spread but not to an alarming level. We can just hope for the best.”

These days, when she is not organising the annual International Day of Reggae celebrations in Côte d’Ivoire, Rose Ebirim picks up litter scattered on the beach in the historic port town of Grand Bassam, 25 miles east of Abidjan. Both activities have become a form of therapy since the time she saw someone die.

“13 March 2016 was a Black Sunday for me,” she said.

On that day, she saw three gunmen open fire at close range as they stalked three adjacent hotels on the beach in a 45-minute shooting spree. By the time security agencies shot the attackers dead, they had killed 19 people including nine foreigners, and traumatised the entire nation.

Al-Qaida in the Islamic Maghreb (AQIM) claimed responsibility for the attack, saying it was in retaliation for Côte d’Ivoire arresting its men and handing them over to Mali. It was not until December 2022 that an Abidjan court sentenced 11 men – including seven in absentia – to death for their roles in the attack.

“Our forces have strengthened their operational vigilance to ensure that such tragedies never happen again,” the defence minister, Téné Birahima Ouattara, said at a ceremony this March to commemorate the 10th anniversary of what was the first major terrorist incident on Ivorian soil.

Grand Bassam, a Unesco world heritage site and the country’s first capital, forms part of a relatively peaceful three-hour drive to the border with Ghana lined with resort towns that once again cater to residents and tourists.

But up in the north, on the borders with Mali and Burkina Faso, the threat of jihadism continues to lurk. Both states have expelled French and American troops in recent years after military takeovers, pivoting to stronger partnerships with Russia instead.

Côte d’Ivoire, now a key western ally for counterinsurgency in the region, stands as a buffer state between the Gulf of Guinea and the core of the Sahel. The violence in its neighbours has driven thousands of refugees into the country’s north.

At the time of the 2016 attack, the insurgency had just emerged in Burkina Faso as a spillover from Mali. Terrorism incidents linked to jihadists have almost tripled in coastal west Africa as armed non-state actors proliferate.

Military formations and security personnel in the region have been repeatedly targeted by Al-Qaida-affiliated Jama’at Nusrat ul-Islam wa al-Muslimin (JNIM), which swallowed AQIM. In June 2020, Katiba Macina, another group in the JNIM coalition, killed 14 Ivorian soldiers in the village of Kafolo near the Burkinabé border.

The groups are beginning to employ more sophisticated tactics and are adept at carrying out complex raids in a region that is now “the world’s most active zone of Islamist militancy”, said Héni Nsaibia, senior analyst for west Africa at the conflict monitor Acled. “JNIM’s use of armed drones has rapidly proliferated from fewer than 10 recorded strikes in 2024 to around 80 in 2025,” he added.

Since the Kafolo attack, the number of policemen and gendarmerie recruited in the Ivorian north has more than doubled. Five years ago, an EU-backed counter-terrorism academy opened in Jacqueville, another beach town west of Abidjan, where elite units are being trained to counter the evolving threat.

A spokesperson for the Ivorian government did not respond to questions about the status of talks about a speculated US drone base or American troops sharing an existing airbase with their Ivorian counterparts.

Backed by international development funding, the state has also been at work in remote border villages in the north – building primary schools, deploying mobile health clinics and funding vocational micro-loans for young cashew farmers who might otherwise be tempted by the financial promises of militant groups.

But its dense forests and porous borders are still cause for concern to citizens and residents. The Ivorian government spokesperson did not also respond to questions about regional and international counterinsurgency collaborations.

In Grand Bassam, the three hotels are shuttered. Near them, Ebirim still goes on with awareness about beach pollution and the reggae splash, which is now in its sixth year. “I occupy myself with those activities,” she said. “After 10 years, I’m starting to sort myself out.”

The Ebola outbreak in the Democratic Republic of the Congo poses a “very high” risk to the country, the World Health Organization said on Friday, revising its threat assessment upwards.

The outbreak is spreading rapidly, WHO leaders said, with almost 750 suspected cases and 177 suspected deaths, up from 246 cases and 65 deaths when it was first reported a week earlier.

The situation is “deeply worrisome”, said Dr Tedros Adhanom Ghebreyesus, the WHO director-general.

On Thursday, tents and medical supplies outside a hospital in Rwampara, Ituri province, were set on fire as medics tried to set up an Ebola treatment centre. A crowd was reportedly angry at not being allowed to retrieve the body of a local man who had died at the hospital. The bodies of Ebola patients must be buried according to strict infection control protocols to prevent further spread.

Tedros warned that “significant distrust of outside authorities among the local population” was causing issues for the response to the outbreak.

“Building trust in the affected communities is critical to a successful response, and is one of our highest priorities,” Tedros said.

The WHO’s representative in the DRC, Dr Anne Ancia, said the incident in Rwampara would “significantly jeopardise” the response operation there.

The treatment centre that was attacked was designed to separate Ebola patients from others being treated in the same hospital. Ancia said she was hopeful that it would be able to be up and running again within 24 hours.

The outbreak has been caused by the Bundibugyo strain of Ebola, for which no vaccines or treatments exist. Most cases are in the DRC’s Ituri province, with a handful reported elsewhere in the country, and two in neighbouring Uganda.

Rising case numbers may paradoxically be a “good sign”, indicating better detection, officials said. A slight fall in the number of samples testing positive suggests more people with potential symptoms are being picked up.

However, Ancia said: “We are running behind, we are not yet under control.”

She was confident, however, that the response would be successful.

“I can guarantee you that together, we will manage to get over this outbreak as soon as we can,” she said.

While the WHO raised its risk assessment for the DRC, it maintained its earlier assessment that there was a high risk at the regional level and low risk at the global level.

Representatives of humanitarian organisations working in Ituri said they did not yet have enough resources to mount an adequate response.

Dr Amadou Bocoum, country director for Care International in the DRC, said aid cuts last year meant “the system was not able to work properly because of lack of equipment”, while lower staff levels also made the labour-intensive work of informing cases and contact tracing harder.

Julie Drouet, country director for Action Against Hunger, said: “Everyone is working to try to implement as quickly as possible … the response in the field, however it is not quite yet ready. It is not really yet up to the emergency that we have in Congo at the moment.”

A WHO press briefing also heard that scientists had identified an antiviral drug, obeldesivir, which may be able to prevent contacts of Bundibugyo cases developing the disease, and were working to establish trials in the affected areas.

Emmanuel Macron is under pressure to open discussions on reparatory justice for France’s role in hundreds of years of enslavement of African people as he makes a key speech on the legacy of slavery.

On Thursday the French president will celebrate the 25th anniversary of France becoming the first country in the world to recognise the slave trade and slavery as crimes against humanity in a 2001 law brought by Christiane Taubira, a leading MP from French Guiana.

Macron’s office said “the memorial work around the question of slavery and the slave trade is a permanent project of recognition for the president”.

As he enters his final months as president, however, demands are growing on Macron to launch a formal discussion process on how to address the legacies of enslavement in French society. France is facing a political row over racism in politics, the media and society, and the far right is polling high in the run-up to the 2027 presidential election.

The sense of urgency comes amid anger in France that its representatives – alongside those of UK and other European nations – abstained in March’s UN vote to describe the transatlantic chattel slave trade as the “gravest crime against humanity” and call for reparations as “a concrete step towards remedying historical wrongs”.

Victorin Lurel, a Guadeloupe senator, wrote in an open letter to Macron that France had committed a “moral, historic, diplomatic and political mistake” in abstaining and had “tarnished” its image internationally.

From the 16th to the 19th centuries, France was the third largest trafficker of enslaved people across the Atlantic and Indian oceans among the European nations, after Portugal and Britain. France was responsible for kidnapping and enslaving about 13% of the estimated 13 to 17 million men, women and children forced from Africa across the Atlantic.

Among those calling for a process of dialogue in France is Dieudonné Boutrin, who heads the International Federation of Descendants of the History of Slavery and is a descendant of enslaved Africans who were trafficked from Benin to the French Caribbean island of Martinique. Boutrin works alongside Pierre Guillon de Princé, a descendant of 18th-century slave-ship owners in Nantes, who last month made a formal apology for his ancestors’ role in transporting about 4,500 enslaved Africans to the Caribbean, at least 200 of whom died at sea.

Boutrin and Guillon de Princé wrote to Macron this month asking him to initiate discussions on reparatory justice. They said this would “restore trust between our communities, acknowledge the reality of history, foster a spirit of brotherhood, and heal the psychological wounds suffered by communities of colour who have been made to feel inferior. Slavery is a wound whose scars are still visible through racism, the spread of which we have so far been unable to halt.”

Aïssata Seck, the director of France’s Foundation for the Remembrance of Slavery, an advisory body to the government partly funded by the state, and its president, the former prime minister Jean-Marc Ayrault, published an open letter to Macron last month asking for France to take the lead in opening up dialogue on how to address and repair the racism and inequality that are legacies of enslavement.

Paris is regarded as crucial to the global discussion on reparations, because several “overseas departments and regions” remain part of France, such as the Caribbean islands of Martinique and Guadeloupe, French Guiana, and the Indian Ocean islands of Réunion and Mayotte. In these places, structural inequalities and disparities on employment, health, the cost of living, pollution and environmental safety are seen by local parliamentarians as a direct legacy of the mechanisms of enslavement and colonialism.

France is also facing demands for potentially billions of dollars in reparations to Haiti, after it imposed a harsh financial penalty on the country in 1825 to compensate owners of enslaved people after the Haitian revolution. That debt, which many Haitians blame for two centuries of turmoil, was only fully repaid to France in 1947. In 2025, Macron announced a joint commission with Haiti to examine the issue, with conclusions due by the end of this year.

France was the only country to bring back slavery, when Napoleon reinstated it in 1802 after a first attempt to ban it in 1794. Slavery was finally abolished in 1848, with compensation awarded to the owners of enslaved people.

A US travel ban for people coming from the Democratic Republic of the Congo, Uganda or South Sudan in response to the Ebola outbreak could make the situation worse, critics have said.

The outbreak was declared a public health emergency of international concern on Sunday and continues to spread, with a new case reported in the DRC’s South Kivu province, an area under the control of armed rebel groups.

The American travel ban, which applies to non-US passport holders who have been in any of the three countries in the past 21 days, has caused disruption to the DRC men’s football team’s World Cup preparations. It also caused a flight to Detroit to be diverted to Canada on Wednesday because a traveller from the DRC was onboard.

Africa Centres for Disease Control and Prevention (Africa CDC) said that while it “fully recognises the sovereign responsibility of every government to protect the health and security of its people … generalised travel restrictions and border closures are not the solution to outbreaks”.

The body said: “Such measures can create fear, damage economies, discourage transparency, complicate humanitarian and health operations, and divert movement toward informal and unmonitored routes – potentially increasing public health risks rather than reducing them.”

There is no vaccine or treatment available to fight the Bundibugyo strain of Ebola responsible for the outbreak.

Africa CDC said this highlighted “a deeper structural injustice in global health innovation: the Bundibugyo Ebola virus was identified nearly two decades ago, yet no licensed vaccines or therapeutics specific to this strain exist today.”

It said: “Africa CDC believes that if this disease had predominantly threatened wealthier regions of the world, medical countermeasures would likely already be available.”

Dr Githinji Gitahi, the group CEO at Amref Health Africa, backed Africa CDC’s stance. He said: “Travel bans don’t stop viruses, they stop solidarity. The fastest way to protect everyone is to invest in outbreak control at the source, not isolate the affected. Africa needs partnership, not punishment.”

Uganda’s information minister, Chris Baryomunsi, told Reuters the US was “overreacting” by putting the travel ban in place. “We’ve handled cases of Ebola and other epidemics for a number of years,” he said. “There is capacity within the country to contain these epidemics.”

The outbreak had been linked to 139 deaths and about 600 suspected cases in the DRC as of Wednesday, the World Health Organization said, plus two confirmed cases in neighbouring Uganda.

Most cases have been in the DRC’s Ituri and neighbouring North Kivu provinces. On Thursday, the Alliance Fleuve Congo, which includes the Rwanda-backed M23 rebels, said there had been a case in South Kivu, which is under their control.

An Ebola case in the North Kivu capital city, Goma, which is also under M23 control, has prompted urgent calls for its airport to be reopened to facilitate the flow of aid and medical supplies.

Researchers at Imperial College London have revised their estimates of the size of the outbreak upwards based on the latest WHO figures.

Emmanuel Macron is under pressure to open discussions on reparatory justice for France’s role in hundreds of years of enslavement of African people as he makes a key speech on the legacy of slavery.

On Thursday the French president will celebrate the 25th anniversary of France becoming the first country in the world to recognise the slave trade and slavery as crimes against humanity in a 2001 law brought by Christiane Taubira, a leading MP from French Guiana.

Macron’s office said “the memorial work around the question of slavery and the slave trade is a permanent project of recognition for the president”.

As he enters his final months as president, however, demands are growing on Macron to launch a formal discussion process on how to address the legacies of enslavement in French society. France is facing a political row over racism in politics, the media and society, and the far right is polling high in the run-up to the 2027 presidential election.

The sense of urgency comes amid anger in France that its representatives – alongside those of UK and other European nations – abstained in March’s UN vote to describe the transatlantic chattel slave trade as the “gravest crime against humanity” and call for reparations as “a concrete step towards remedying historical wrongs”.

Victorin Lurel, a Guadeloupe senator, wrote in an open letter to Macron that France had committed a “moral, historic, diplomatic and political mistake” in abstaining and had “tarnished” its image internationally.

From the 16th to the 19th centuries, France was the third largest trafficker of enslaved people across the Atlantic and Indian oceans among the European nations, after Portugal and Britain. France was responsible for kidnapping and enslaving about 13% of the estimated 13 to 17 million men, women and children forced from Africa across the Atlantic.

Among those calling for a process of dialogue in France is Dieudonné Boutrin, who heads the International Federation of Descendants of the History of Slavery and is a descendant of enslaved Africans who were trafficked from Benin to the French Caribbean island of Martinique. Boutrin works alongside Pierre Guillon de Princé, a descendant of 18th-century slave-ship owners in Nantes, who last month made a formal apology for his ancestors’ role in transporting about 4,500 enslaved Africans to the Caribbean, at least 200 of whom died at sea.

Boutrin and Guillon de Princé wrote to Macron this month asking him to initiate discussions on reparatory justice. They said this would “restore trust between our communities, acknowledge the reality of history, foster a spirit of brotherhood, and heal the psychological wounds suffered by communities of colour who have been made to feel inferior. Slavery is a wound whose scars are still visible through racism, the spread of which we have so far been unable to halt.”

Aïssata Seck, the director of France’s Foundation for the Remembrance of Slavery, an advisory body to the government partly funded by the state, and its president, the former prime minister Jean-Marc Ayrault, published an open letter to Macron last month asking for France to take the lead in opening up dialogue on how to address and repair the racism and inequality that are legacies of enslavement.

Paris is regarded as crucial to the global discussion on reparations, because several “overseas departments and regions” remain part of France, such as the Caribbean islands of Martinique and Guadeloupe, French Guiana, and the Indian Ocean islands of Réunion and Mayotte. In these places, structural inequalities and disparities on employment, health, the cost of living, pollution and environmental safety are seen by local parliamentarians as a direct legacy of the mechanisms of enslavement and colonialism.

France is also facing demands for potentially billions of dollars in reparations to Haiti, after it imposed a harsh financial penalty on the country in 1825 to compensate owners of enslaved people after the Haitian revolution. That debt, which many Haitians blame for two centuries of turmoil, was only fully repaid to France in 1947. In 2025, Macron announced a joint commission with Haiti to examine the issue, with conclusions due by the end of this year.

France was the only country to bring back slavery, when Napoleon reinstated it in 1802 after a first attempt to ban it in 1794. Slavery was finally abolished in 1848, with compensation awarded to the owners of enslaved people.

A previously undetected outbreak of Ebola is coursing through parts of central Africa, and the US appears to be doing little to help stop it, after massive cuts to global and domestic public health efforts.

There is no cure and no vaccine for the rare Bundibugyo variant of Ebola, which has caused two outbreaks in recent decades. Health leaders and scientists are now racing to understand where the virus is spreading and attempting to stop it – but the US is notably absent in these efforts.

In the past year, the US Agency for International Development (USAID) has been dismantled, thousands of staff at US health agencies were laid off, communications stalled and key scientific research canceled.

There are 482 suspected cases and about 116 deaths reported since April in the Democratic Republic of the Congo (DRC), with two cases and one death in Uganda and potential spread to neighboring South Sudan. The outbreak “might have been going on for a few months”, said Kristian Andersen, a professor of immunology and microbiology at Scripps Research.

The outbreak was immediately declared a public health emergency of international concern (PHEIC) by Tedros Adhanom Ghebreyesus, the director general of the World Health Organization (WHO), before even convening the committee that usually makes that determination. Officials say it may last for months.

“The DRC is one of the most vulnerable health systems in the world, and was the second-biggest recipient of USAID funding,” said Matthew Kavanagh, director of the Center for Global Health Policy and Politics at Georgetown University. The US withdrawal of funding with “zero notice” has been “disruptive to the country’s basic activities”, he said.

US foreign assistance to the DRC dropped from $1.4bn in 2024 to $431m in 2025 and only $21m so far this year. Assistance to Uganda dropped from $674m to $377m in 2025 and a negative $1.2m so far in 2026.

“It was pennies compared to what you get in return,” Andersen said of global health investments. It is far cheaper and easier to prevent and contain outbreaks than it is to respond to them, he said. With the US cutting off the first option, the second scenario will become increasingly common.

The US also announced it would leave the WHO and end $130m in funding, which resulted in 2,371 lost jobs at the organization, Kavanagh said, calling the cuts a “self-inflicted wound that the administration has really brought on us”. This outbreak and response was “deeply foreseeable when you gut public health surveillance and you gut public health capacity”, Kavanagh added.

“It’s not just that we’re leaving the table, we are completely cutting ourselves out of the conversation,” Andersen said. “We are upending the table.”

The CDC has “always been the premier agency” when it comes to country-level leadership and played a key role as a partner “you could turn to”, Andersen said.

But under the second Trump administration, Ebola response teams were suspended, and health centers and medical supplies – particularly crucial with a virus spread through touch, with supportive care the only treatment – were dramatically cut back.

A world-class Ebola lab in Frederick, Maryland, with the National Institutes of Health (NIH) was designed for exactly this scenario. The lab would normally be swinging into action, following up on research indicating monoclonal antibodies and a vaccine might be effective against this strain, possibly testing those treatments and vaccines, performing in-depth sequencing work on the samples shared during the outbreak.

But that lab was shuttered last year, with staff laid off abruptly and their work – key for preventing and responding to outbreaks – ended with no notice. The website for the lab is still closed, indicating it has not been revived during this outbreak.

Satish Pillai, an incident manager for the CDC’s Ebola response, said he “can’t speak” to the NIH lab when the Guardian asked about it in a press conference on Monday. Instead, Pillai said that the US is able to test for Ebola through its laboratory network, a comment unrelated to the Guardian’s questions.

Because of layoffs, terminations and high-profile departures, key confirmed positions at US health agencies are vacant. Currently, the CDC has no director; there’s no US surgeon general; there’s no commissioner at the FDA.

Officials say there are now between 25 and 30 staff in the DRC country office. The CDC is sending one more person, Pillai said, and other experts are available remotely.

The DRC office suffered massive and sudden cuts when USAID was unexpectedly dissolved last year. Former employees sued the US government after they were abandoned and lost everything, with no jobs or options to evacuate from DRC, they said.

“When those USAID stop-work orders came out, there was a whole series of people who were actively looking for spillover in the DRC and in Uganda,” Kavanagh said. “There were hundreds of health workers doing surveillance activities, and then, of course, you had the bigger picture, which is the thousands of health workers who were doing HIV, TB, malaria, maternal and child health – all of these things funded through US funding from USAID and also some from CDC to be doing global health activities – who were the frontlines of detection.”

Patients don’t usually come to the clinic suspecting they have Ebola, he pointed out; they usually come in with a fever or other symptoms, and “those frontline community health workers … are always the ones that detect outbreaks early”.

That work ended abruptly and is now being replaced with country-by-country agreements, some of which appear to be predicated on resource-sharing agreements. The US government is “essentially holding hostage” the countries that have built health systems around US guidance, “and then from one day to the next you just cut it”, Andersen said.

In the past, the US had ensured that “many, many potential global outbreaks didn’t become global”, but now it’s stepping back, Kavanagh said, adding: “This outbreak should have been detected weeks ago, and exactly how and why will be figured out as we go, but it certainly says that the United States has stopped playing the role.”

Instead, the US is announcing travel bans for noncitizens who have recently traveled to the region, which is “public health theater” that essentially punishes the countries and doesn’t actually stop cases, Kavanagh said. The Africa CDC called for countries to refrain from “fear-driven” travel bans. “The fastest path to protecting all countries in the world is to aggressively support outbreak control at the source,” Dr Jean Kaseya, director general of the Africa CDC, said in a statement.

“At this point, this is an out-of-control epidemic that has now crossed borders, and this is really bad for the region, and will result in lots more deaths, and could be a real crisis,” Kavanagh said. Health leaders in the DRC are among the smartest, most experienced Ebola responders – but now they’re confronting an outbreak “with hundreds of millions of dollars cut from the global capacity to help them respond”.

Andersen noted “these countries are way more competent than we are in responding to something like Ebola” and that African scientists have done “remarkable” work already sequencing the virus, which demonstrates a new spillover event and could offer clues to where the outbreak originated.

“But that doesn’t mean that we should just completely cut ourselves out of the picture,” he said.

Outbreaks like these have economic, geopolitical and global stability implications, Kavanagh said. But they also matter because allowing anyone to die “needlessly of a disease that can be stopped is immoral, and we are living in a world where we don’t have to allow infectious diseases to spread unchecked”, he said. “Ebola can be stopped, and if we don’t mobilize the dollars and the public health efforts, then we are simply choosing not to stop the outbreak. Because it can be stopped. The question is, will it be? And when?”

An American doctor who contracted Ebola in the Democratic Republic of the Congo has been flown to Germany for treatment, along with his wife and four children, as the World Health Organization warned of the “scale and speed” of the outbreak.

Authorities have reported at least 134 suspected deaths and more than 500 cases of the hemorrhagic Bundibugyo virus, which has no approved treatments or vaccines. The outbreak, which has spread into urban areas, has been declared a public health emergency requiring international response.

Dr Peter Stafford, a surgeon and leader of the Christian missionary group Serge, has said he unknowingly operated on a patient with Ebola before the outbreak was detected. His wife, Rebekah Stafford, also a doctor, and their children, are being monitored for symptoms of the disease.

The infected surgeon was barely able to stand on his own when he departed for Germany, according to two leaders of the Christian missionary group where he worked.

Dr Scott Myhre, area director for Serge told NBC News that Stafford “looked really tired and really sick” as he left. “There were people in full – we call it PPE – the personal protective equipment, and they’re completely covered, and he’s hanging on them barely strong enough to walk.”

Stafford worked at Nyankunde hospital in the DRC’s Ituri province, where the Africa centers for disease control first confirmed the Ebola outbreak. He had operated on a 33-year-old patient with severe abdominal pain.

Doctors at first believed the patient had a gallbladder infection but, according to Myhre, Stafford “did an abdominal procedure and found that the gallbladder was normal and closed him up, but this patient subsequently died the next day”.

The patient was buried before he could be tested for Ebola, but Stafford developed symptoms and tested positive on Sunday, according to the US Centers for Disease Control and Prevention.

Myhre described Stafford as “a very meticulous professional, and for every surgical case he does, he would be completely gowned in sterile garb and gloves and hats and glasses. But that’s not quite enough to prevent an Ebola exposure.”

In an updated advisory Wednesday, the WHO said there are now more than 600 suspected cases and 139 suspected deaths from the virus, mostly in the DRC.

But with two cases and one suspected death in neighboring Uganda, the organization said the risk of a global pandemic was very low, but the threat for countries in the region was severe.

“We expect those numbers to keep increasing,” Tedros Adhanom Ghebreyesus, WHO’s director-general, said. “We know that the scale of the epidemic in DRC is much larger”.

An American doctor who contracted Ebola in the Democratic Republic of the Congo has been flown to Germany for treatment, along with his wife and four children, as the World Health Organization warned of the “scale and speed” of the outbreak.

Authorities have reported at least 134 suspected deaths and more than 500 cases of the hemorrhagic Bundibugyo virus, which has no approved treatments or vaccines. The outbreak, which has spread into urban areas, has been declared a public health emergency requiring international response.

Dr Peter Stafford, a surgeon and leader of the Christian missionary group Serge, has said he unknowingly operated on a patient with Ebola before the outbreak was detected. His wife, Rebekah Stafford, also a doctor, and their children, are being monitored for symptoms of the disease.

The infected surgeon was barely able to stand on his own when he departed for Germany, according to two leaders of the Christian missionary group where he worked.

Dr Scott Myhre, area director for Serge told NBC News that Stafford “looked really tired and really sick” as he left. “There were people in full – we call it PPE – the personal protective equipment, and they’re completely covered, and he’s hanging on them barely strong enough to walk.”

Stafford worked at Nyankunde hospital in the DRC’s Ituri province, where the Africa centers for disease control first confirmed the Ebola outbreak. He had operated on a 33-year-old patient with severe abdominal pain.

Doctors at first believed the patient had a gallbladder infection but, according to Myhre, Stafford “did an abdominal procedure and found that the gallbladder was normal and closed him up, but this patient subsequently died the next day”.

The patient was buried before he could be tested for Ebola, but Stafford developed symptoms and tested positive on Sunday, according to the US Centers for Disease Control and Prevention.

Myhre described Stafford as “a very meticulous professional, and for every surgical case he does, he would be completely gowned in sterile garb and gloves and hats and glasses. But that’s not quite enough to prevent an Ebola exposure.”

In an updated advisory Wednesday, the WHO said there are now more than 600 suspected cases and 139 suspected deaths from the virus, mostly in the DRC.

But with two cases and one suspected death in neighboring Uganda, the organization said the risk of a global pandemic was very low, but the threat for countries in the region was severe.

“We expect those numbers to keep increasing,” Tedros Adhanom Ghebreyesus, WHO’s director-general, said. “We know that the scale of the epidemic in DRC is much larger”.

US secretary of state Marco Rubio said on Tuesday that the World Health Organization (WHO) was “a little late” in identifying the deadly Ebola outbreak in the the Democratic Republic of the Congo and Uganda.

On Tuesday, Rubio told reporters: “The lead is obviously going to be CDC (the Centers for Disease Control) and the World Health Organization, which was a little late to identify this thing unfortunately.”

His comments follow Donald Trump’s decision to withdraw the US from the WHO, a move which experts described as “sowing the seeds of the next pandemic”. Trump made the move in one of his first acts on returning to office last year. The US’s departure also led to the loss of nearly a quarter of the WHO’s workforce – about 2,000 jobs – from a total staff of about 9,400.

Rubio said that the US, which has committed about $13m in assistance after sweeping aid cuts last year, was hoping to open about 50 clinics to treat Ebola in the DRC.

“It’s a little tough to get to because it’s in a rural area … and [a] hard-to-get-to place in a war-torn country, unfortunately,” Rubio said. “We’re going to lean into that pretty heavy.”

The WHO said earlier on Tuesday that it was concerned about the “scale and speed” of the Ebola outbreak that has killed an estimated 131 people in the DRC.

Gigi Gronvall, an immunologist and associate professor at the Johns Hopkins Bloomberg School of Public Health, rejected Rubio’s criticism of the WHO.

“Blaming the WHO is misplaced, because they are operating with limited resources in a difficult setting with many security challenges. But it’s also cold comfort for all the people who have gotten Ebola and died. And this should concern Americans as well. It’s highly worrisome given that public health resources in the US have been slashed and even a couple of cases in the US would be challenging with our current workforce,” Gronvall said.

She added: “It is a strategic mistake – and a national security vulnerability – that we are worse off now to handle infectious disease threats than at the start of Covid-19. Hantavirus [and] Ebola are terrible, serious diseases but they are not as transmissible as some other infectious disease threats we could face. Instead of dismantling everything, we need to invest in the vaccines, diagnostic testing, and public health and hospital responses we would need to protect Americans.”

On Sunday, the WHO announced that the Ebola outbreak in the DRC and Uganda was a “public health emergency of international concern”, saying: “Neighboring countries sharing land borders with the Democratic Republic of the Congo are considered at high risk for further spread due to population mobility, trade and travel linkages, and ongoing epidemiological uncertainty.

“The event requires international coordination and cooperation to understand the extent of the outbreak, to coordinate surveillance, prevention and response efforts, to scale up and strengthen operations and ensure ability to implement control measures,” the WHO added.

The organization also noted that countries not bordering the DRC and Uganda should avoid closing borders or restricting travel and trade during disease outbreaks, arguing that such measures are driven more by fear than science. Restrictions can force people and goods through unmonitored crossings, potentially increasing the spread of disease, they said.

WHO authorities also cautioned that travel bans can damage local economies and disrupt emergency response efforts.

The Guardian has reached out to the WHO for comment.

The WHO’s warnings come as US health agencies continue to face sweeping layoffs during Trump’s second term. Earlier this week, the Department of Health and Human Services announced plans to eliminate dozens of positions across agencies including the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, and the National Institutes of Health, among others.

The cuts follow health secretary Robert F Kennedy Jr’s announcement last year that he intended to reduce the department’s 82,000-person workforce by 10,000 jobs.

The latest layoffs also arrive amid mounting concerns over the US’s preparedness for the next pandemic.

While experts say the recent hantavirus outbreak is unlikely to spark a global health crisis, it has underscored the erosion of public health infrastructure in the US. Public health experts have also warned that deep political divisions and rampant misinformation could undermine Americans’ willingness to follow future health guidance.

Echoing Gronvall, Jennifer Nuzzo, an epidemiology professor and director of the Pandemic Center at Brown School of Public Health, said: “The CDC first learned of the outbreak when it was publicly confirmed, despite the fact that there’d been rumors of an outbreak for weeks. This represents a notable change for the US government, which has historically played a key role in responding to rumored outbreaks in places like DRC and, if the rumors are confirmed to be true, helping to stop the outbreak.

“It feels like the US government is on the sidelines this time,” she added.

Melody Schreiber contributed reporting

The director general of the World Health Organization has said he is deeply concerned about the scale and the speed of the Ebola outbreak in the Democratic Republic of the Congo.

Dr Tedros Adhanom Ghebreyesus said there had been at least 500 suspected cases of Ebola and 130 suspected deaths in DRC since the new outbreak began. Thirty cases had been confirmed in DRC’s north-eastern province of Ituri, and one death and one case had been confirmed in Kampala, Uganda, he added. A US citizen has also tested positive and been transferred to Germany.

“These numbers will change as field operations are scaling up, including strengthening surveillance, contact tracing and laboratory testing,” Tedros told members of the World Health assembly, who are meeting this week in Geneva.

Tedros declared the outbreak a public health emergency of international concern in the early hours of Sunday morning. On Tuesday he said: “This is the first time a director general has declared a PHEIC before convening an emergency committee. I did not do this lightly … I’m deeply concerned about the scale and speed of the epidemic.”

The WHO will convene its emergency committee on Tuesday to advise what recommendations it should make on how to control the outbreak. The US officially left the WHO in January in a move Donald Trump said was motivated by the organisation’s poor management of the Covid-19 pandemic.

Tedros said reports of cases in urban areas, where the virus typically finds it easier to spread, were also cause for concern.

Cases among health workers indicated potential spread in clinics and hospitals, he said, and there was “significant population movement in the area”, for work and also due to conflict.

The province of Ituri, where most cases have been reported, was “highly insecure”, Ghebreyesus said. “Conflict has intensified since late 2025, and the fighting has escalated significantly over the past two months resulting in civilian deaths. Over 100,000 people have been newly displaced. And in Ebola outbreaks, you know what displacement means.”

An outbreak of the Zaire strain from 2018-2020 in Ituri and North Kivu provinces was the second deadliest on record, killing nearly 2,300 people. The international response then was complicated by widespread armed violence in eastern DRC that continues today.

Ebola spreads through direct contact with bodily fluids from infected people or animals and causes symptoms that can include high fever, vomiting and internal and external bleeding. According to the WHO, the average fatality rate from Ebola is around 50%, varying from 25% to 90% in past outbreaks.

Bundibugyo virus, the type of Ebola that is causing the current outbreak, has no vaccines or treatments.

Although more than 20 Ebola outbreaks have been recorded in DRC and Uganda, this is only the third time that the Bundibugyo virus has been detected. Cases have now also been confirmed in Bunia and North Kivu’s rebel-held capital of Goma, as well as Mongbwalu, Butembo, and Nyakunde.

To be around the centre of an Ebola outbreak is to become used to the smell of chlorine. At hospitals and government buildings, surfaces are sprayed with it and hands washed in a 0.05% solution that can kill the virus in 60 seconds.

Infrared handheld thermometers take temperatures at airports and border crossings. Any indication of a fever prevents passage. Contact-tracing teams crisscross the countryside.

From 2018 to 2020, Butembo, in the Democratic Republic of the Congo’s northern Kivu province, was the setting for the largest Ebola outbreak the country had seen. The complexities of the crisis were not confined to the ravages of the virus itself – they were intensified by social, political and economic pressures of an area in the midst of a conflict.

As global health officials wrestle with a serious new Ebola outbreak in the DRC, which has shocked the World Health Organization with its speed and scale, the question is what lessons have been learned from previous outbreaks?

Ebola, unlike Covid, is not a particularly efficient virus. As it is not airborne it requires physical contact with bodily fluids, including blood and vomit, to spread. That makes it particularly risky for healthcare workers, who need full-body PPE and stringent disinfection processes.

Social practices including physical contact with the dead and dying in poor rural communities accelerated the spread in eastern Kivu and Ituri province.

A second critical factor that hampered the response six years ago was the history of political tension between the country’s government in Kinshasa and the Nande ethnic group in eastern Kivu amid an insurgency. The outbreak was exploited by cynical actors during elections, who either suggested Ebola did not exist or had been brought in by outsiders.

That, in turn, led to armed attacks, some lethal, on health workers and Ebola clinics, including one in Butembo while the Guardian was visiting.

While a new vaccination programme was available during that outbreak, there is no vaccine for the current strain of the Ituri outbreak, which is caused by Bundibugyo variant of Ebola. It is the least well known of the three forms of the disease and has caused only two outbreaks before – in 2007 and 2012 – which killed about 30% of those infected.

Another reason for concern in the current outbreak is the suggestion that the cases may have been missed early on, potentially enabling unrecognised transmission.

One key difference from previous major outbreaks in west and central Africa is the speed with which this time the WHO has declared it a public health emergency of international concern (PHEIC).

In 2018, the WHO was roundly criticised for delaying for four months before declaring a PHEIC, defined as “an extraordinary event that may constitute a public health risk to other countries through international spread of disease and may require an international coordinated response”.

In the current outbreak, a PHEIC was declared within 48 hours, and the WHO’s head, Tedros Adhanom Ghebreyesus, said his concern was so great he had decided to act without an emergency committee meeting.

Despite that, Daniela Manno, a clinical epidemiologist at the London School of Hygiene and Tropical Medicine, has warned the current Ituri outbreak shares some of the complicating elements of the 2018 to 2020 outbreak.

“First, the number of suspected cases reported before confirmation suggests transmission may have been ongoing for several weeks before the outbreak was formally recognised,” she said.

“Second, the outbreak is occurring in a region affected by insecurity, population displacement and high population mobility, all of which can complicate surveillance, contact tracing and delivery of healthcare.

“A previous Ebola outbreak affecting North Kivu and Ituri provinces between 2018 and 2020 lasted for nearly two years, with insecurity and community mistrust repeatedly disrupting contact tracing, vaccination and response activities.

“In addition, the outbreak is now thought to be caused by Bundibugyo virus, a rare Ebola-causing virus for which there are currently no licensed vaccines or therapeutics specifically approved. There are also no vaccines in late-stage clinical development that could be readily deployed during the outbreak.

“However, it is important to emphasise that the DRC has extensive experience responding to Ebola outbreaks, and outbreak response capacity is significantly stronger today than it was a decade ago.”

Anne Cori, an associate professor in infectious disease modelling at Imperial College London, said the spread of the disease across an international border had probably influenced the quick declaration of an international public health emergency.

“A PHEIC is an official declaration made by the WHO under the international health regulations, recognising the international nature of a public health threat. It aims to help mobilise attention and resources, and coordinate response efforts at international level.

“The last PHEIC for an Ebola outbreak was declared in July 2019 during the 2018 to 2020 Ebola epidemic in the North Kivu province of the DRC. At the time, the PHEIC was declared a year into the outbreak after it reached the urban area of Goma, threatening to spread internationally to nearby Rwanda.

“The current epidemic already comprises confirmed cases across both the DRC and Uganda, which likely influenced the declaration of a PHEIC as its focus is really the international nature of the threat.”

Peter Beaumont reported from Butembo for the Guardian in 2019, visiting Ebola treatment centres and vaccination efforts.

To be around the centre of an Ebola outbreak is to become used to the smell of chlorine. At hospitals and government buildings, surfaces are sprayed with it and hands washed in a 0.05% solution that can kill the virus in 60 seconds.

Infrared handheld thermometers take temperatures at airports and border crossings. Any indication of a fever prevents passage. Contact-tracing teams crisscross the countryside.

From 2018 to 2020, Butembo, in the Democratic Republic of the Congo’s northern Kivu province, was the setting for the largest Ebola outbreak the country had seen. The complexities of the crisis were not confined to the ravages of the virus itself – they were intensified by social, political and economic pressures of an area in the midst of a conflict.

As global health officials wrestle with a serious new Ebola outbreak in the DRC, which has shocked the World Health Organization with its speed and scale, the question is what lessons have been learned from previous outbreaks?

Ebola, unlike Covid, is not a particularly efficient virus. As it is not airborne it requires physical contact with bodily fluids, including blood and vomit, to spread. That makes it particularly risky for healthcare workers, who need full-body PPE and stringent disinfection processes.

Social practices including physical contact with the dead and dying in poor rural communities accelerated the spread in eastern Kivu and Ituri province.

A second critical factor that hampered the response six years ago was the history of political tension between the country’s government in Kinshasa and the Nande ethnic group in eastern Kivu amid an insurgency. The outbreak was exploited by cynical actors during elections, who either suggested Ebola did not exist or had been brought in by outsiders.

That, in turn, led to armed attacks, some lethal, on health workers and Ebola clinics, including one in Butembo while the Guardian was visiting.

While a new vaccination programme was available during that outbreak, there is no vaccine for the current strain of the Ituri outbreak, which is caused by Bundibugyo variant of Ebola. It is the least well known of the three forms of the disease and has caused only two outbreaks before – in 2007 and 2012 – which killed about 30% of those infected.

Another reason for concern in the current outbreak is the suggestion that the cases may have been missed early on, potentially enabling unrecognised transmission.

One key difference from previous major outbreaks in west and central Africa is the speed with which this time the WHO has declared it a public health emergency of international concern (PHEIC).

In 2018, the WHO was roundly criticised for delaying for four months before declaring a PHEIC, defined as “an extraordinary event that may constitute a public health risk to other countries through international spread of disease and may require an international coordinated response”.

In the current outbreak, a PHEIC was declared within 48 hours, and the WHO’s head, Tedros Adhanom Ghebreyesus, said his concern was so great he had decided to act without an emergency committee meeting.

Despite that, Daniela Manno, a clinical epidemiologist at the London School of Hygiene and Tropical Medicine, has warned the current Ituri outbreak shares some of the complicating elements of the 2018 to 2020 outbreak.

“First, the number of suspected cases reported before confirmation suggests transmission may have been ongoing for several weeks before the outbreak was formally recognised,” she said.

“Second, the outbreak is occurring in a region affected by insecurity, population displacement and high population mobility, all of which can complicate surveillance, contact tracing and delivery of healthcare.

“A previous Ebola outbreak affecting North Kivu and Ituri provinces between 2018 and 2020 lasted for nearly two years, with insecurity and community mistrust repeatedly disrupting contact tracing, vaccination and response activities.

“In addition, the outbreak is now thought to be caused by Bundibugyo virus, a rare Ebola-causing virus for which there are currently no licensed vaccines or therapeutics specifically approved. There are also no vaccines in late-stage clinical development that could be readily deployed during the outbreak.

“However, it is important to emphasise that the DRC has extensive experience responding to Ebola outbreaks, and outbreak response capacity is significantly stronger today than it was a decade ago.”

Anne Cori, an associate professor in infectious disease modelling at Imperial College London, said the spread of the disease across an international border had probably influenced the quick declaration of an international public health emergency.

“A PHEIC is an official declaration made by the WHO under the international health regulations, recognising the international nature of a public health threat. It aims to help mobilise attention and resources, and coordinate response efforts at international level.

“The last PHEIC for an Ebola outbreak was declared in July 2019 during the 2018 to 2020 Ebola epidemic in the North Kivu province of the DRC. At the time, the PHEIC was declared a year into the outbreak after it reached the urban area of Goma, threatening to spread internationally to nearby Rwanda.

“The current epidemic already comprises confirmed cases across both the DRC and Uganda, which likely influenced the declaration of a PHEIC as its focus is really the international nature of the threat.”

Peter Beaumont reported from Butembo for the Guardian in 2019, visiting Ebola treatment centres and vaccination efforts.

The director general of the World Health Organization has said he is deeply concerned about the scale and the speed of the Ebola outbreak in the Democratic Republic of the Congo.

Dr Tedros Adhanom Ghebreyesus said there had been at least 500 suspected cases of Ebola and 130 suspected deaths in DRC since the new outbreak began. Thirty cases had been confirmed in DRC’s north-eastern province of Ituri, and one death and one case had been confirmed in Kampala, Uganda, he added. A US citizen has also tested positive and been transferred to Germany.

“These numbers will change as field operations are scaling up, including strengthening surveillance, contact tracing and laboratory testing,” Tedros told members of the World Health assembly, who are meeting this week in Geneva.

Tedros declared the outbreak a public health emergency of international concern in the early hours of Sunday morning. On Tuesday he said: “This is the first time a director general has declared a PHEIC before convening an emergency committee. I did not do this lightly … I’m deeply concerned about the scale and speed of the epidemic.”

The WHO will convene its emergency committee on Tuesday to advise what recommendations it should make on how to control the outbreak. The US officially left the WHO in January in a move Donald Trump said was motivated by the organisation’s poor management of the Covid-19 pandemic.

Tedros said reports of cases in urban areas, where the virus typically finds it easier to spread, were also cause for concern.

Cases among health workers indicated potential spread in clinics and hospitals, he said, and there was “significant population movement in the area”, for work and also due to conflict.

The province of Ituri, where most cases have been reported, was “highly insecure”, Ghebreyesus said. “Conflict has intensified since late 2025, and the fighting has escalated significantly over the past two months resulting in civilian deaths. Over 100,000 people have been newly displaced. And in Ebola outbreaks, you know what displacement means.”

An outbreak of the Zaire strain from 2018-2020 in Ituri and North Kivu provinces was the second deadliest on record, killing nearly 2,300 people. The international response then was complicated by widespread armed violence in eastern DRC that continues today.

Ebola spreads through direct contact with bodily fluids from infected people or animals and causes symptoms that can include high fever, vomiting and internal and external bleeding. According to the WHO, the average fatality rate from Ebola is around 50%, varying from 25% to 90% in past outbreaks.

Bundibugyo virus, the type of Ebola that is causing the current outbreak, has no vaccines or treatments.

Although more than 20 Ebola outbreaks have been recorded in DRC and Uganda, this is only the third time that the Bundibugyo virus has been detected. Cases have now also been confirmed in Bunia and North Kivu’s rebel-held capital of Goma, as well as Mongbwalu, Butembo, and Nyakunde.

A former militia commander accused of overseeing murder, rape, enslavement and torture in Libyan detention centres will appear at the international criminal court on Tuesday for a hearing that campaigners say is a landmark step towards “justice, truth, reparation and deterrence” of abuses of refugees trying to reach Europe from Africa.

The prosecution of Khaled Mohamed Ali El Hishri on charges of war crimes and crimes against humanity is the first to reach a courtroom resulting from the ICC’s investigation into crimes in Libya after the fall of Muammar Gaddafi in 2011.

Legal experts said the hearing, when judges will decide if there is sufficient evidence against Hishri for a trial, would be a “huge milestone”.

“It is a really important development,” said Allison West, a senior legal adviser at the European Center for Constitutional and Human Rights. “The is the first case in the [ICC’s] Libya investigation that has been ongoing for more than 15 years. It’s the first time we have got someone into custody.”

For survivors of abuse in Libya, the court hearing will be a moment that survivors and victims “never thought would happen”, said David Yambio, who was held in Mitiga prison between 2019 and 2020 and accuses Hishri of beating him.

“Now [Hishri] is in front of the court, it sends a strong message to perpetrators wherever they are that they will be brought to account and justice will be delivered, even if it takes a long time,” Yambio said.

Hishri was arrested in Germany last year when, it is thought, he sought medical treatment for a family member. A senior officer in the Special Deterrence Force, a powerful armed group that ran detention sites in western Libya, the 47-year-old is accused of imposing a brutal regime at the Mitiga prison in Tripoli between February 2014 and at least mid-2020.

Such sites became infamous after Gaddafi’s fall as they filled with refugees detained in Libya or intercepted by the Libyan coastguard, which has been supported by the EU and member states since 2017, as they tried to reach Europe.

Amnesty International and other human rights groups have described “harrowing violations” that were “the horrifying consequences of Europe’s ongoing cooperation with Libya on migration and border control”. Human Rights Watch (HRW) said thousands of detainees were held in Mitiga in overcrowded, unhygienic cells and were systematically subjected to violent assaults.

At a hearing in December, prosecutors said there were reasonable grounds to believe Hishri personally killed one detainee, while a “significant number” of people died during his time at the prison, either from torture, being left outside in winter, untreated injuries or starvation.

Hishri is also accused of “personally torturing, mistreating, sexually abusing and killing detainees” and imposing “prison conditions aimed at increasing … suffering”. Detainees were variously shot, confined in small metal boxes and beaten with cables “sometimes for the entertainment and amusement of guards”, it is alleged.

Defence lawyers are expected to challenge the jurisdiction of the ICC and have called for Hithri’s release.

West said the case against Hithri would shine a new light on serious crimes against people in Libyan detention centres but that many alleged perpetrators remained at liberty. Eight ICC arrest warrants are still pending in connection with the violence in Libya that followed the fall of Gaddafi.

“One of the most significant things about this case, other than actually Hithri being in the dock, is that there are a lot of people who aren’t,” West said.

While some countries in Europe have investigated and prosecuted individuals for human smuggling and trafficking of people in Libya, these cases have not included charges of war crimes or crimes against humanity.

That Germany arrested Hishri was important, campaigners said. “One state finally … cooperated, in that they actually arrested and surrendered the suspect to the court, because there’s been many instances in the past where that hasn’t happened,” said Alice Autin, a HRW researcher.

One of Hishri’s alleged co-perpetrators at Mitiga prison was arrested in February last year in Italy but then released on a technicality and returned to Libya, prompting controversy in Italy and dismay at The Hague. “This case [with Hishri] is not against the most senior person of that prison but is … the first step in getting sort of to the perpetrators of that system,” Autin said.

Libya’s warring factions agreed a ceasefire in 2020 but the country remains divided between the administration of the military leader Khalifa Haftar in the east and the Tripoli-based government of national accord (GNA) led by the prime minister, Abdul Hamid Dbeibah, in the west.

The case of Hishri is politically sensitive. The Special Deterrence Force is allied to the internationally recognised GNA in Tripoli and nominally under the interior ministry.

The ICC, set up to be an independent international “court of last resort” for grave crimes that could not be dealt with locally, has been under immense pressure in recent years. The US has imposed sanctions on four judges for what it has called its “illegitimate actions” targeting the US and Israel, while the court’s chief prosecutor is being investigated over alleged sexual misconduct, which he denies.

Yambio called for an end to European programmes that support the Libyan militias. “The EU is complicit in these crimes,” he said.