Bunia: The Democratic Republic of the Congo is struggling to find enough trained health workers to staff Ebola treatment centres as the country battles an outbreak that has recorded more than 7,700 confirmed cases and more than 3,700 deaths.
The latest figures from Congolese authorities put the number of confirmed cases at 7,773, including 3,759 deaths. The outbreak has spread across seven provinces and 63 health zones, while health authorities continue to report high levels of transmission in some areas.
The shortage of health workers is particularly serious in North Kivu, where the number of Ebola cases has risen by 73 percent over three weeks. At the same time, cases have started to decline in some other areas, showing that the outbreak is following different patterns across the country.
The World Health Organization said treatment capacity is being expanded, but there are not enough trained staff to operate all the facilities. WHO representative Anne Ancia said one Ebola treatment centre requires about 300 health professionals, including nurses, doctors, hygienists and anaesthetists.
The shortage is adding pressure to a response already facing insecurity, population displacement, poor road access and limited access to some affected communities. These conditions can make surveillance, contact tracing and treatment more difficult.
North Kivu has become one of the main areas of concern in the outbreak. The province recorded a sharp rise in cases in recent weeks, although WHO officials have reported signs of a decline more recently.
The situation is different in other provinces. Between August 31 and September 20, Ebola cases fell by 26 percent in Ituri and by 15 percent in Haut Uele, according to WHO. Ituri remains a major centre of the outbreak and continues to report substantial transmission.
Health officials have warned against assuming that the overall outbreak has peaked. While some areas are showing improvement, transmission remains active elsewhere and the virus has continued to reach new areas.
The latest WHO reporting said the expansion into Dungu Health Zone in Haut Uele brought the total number of affected health zones to 63 across seven provinces.
The outbreak is caused by Bundibugyo virus, a species of Ebola virus for which there is currently no licensed vaccine or approved specific treatment.
Congo began an Ebola vaccination programme for frontline health workers in Bunia, the capital of Ituri province, on September 19. The Ervebo vaccine is being used under research arrangements because it was developed for the Zaire species of Ebola. Its effectiveness against Bundibugyo virus has not yet been established.
Clinical trials are also under way to assess treatments and the effectiveness of the Ervebo vaccine against Bundibugyo virus.
The outbreak has been particularly difficult to contain in eastern Congo because of insecurity and population movement. WHO has said these conditions are making it harder for health teams to investigate cases, trace contacts and reach people who need treatment.
The virus has also spread beyond the eastern provinces where the outbreak was first concentrated. Sud Ubangi province is among the seven provinces affected by the outbreak, highlighting the continued risk of geographic spread.
The outbreak has also raised concerns about cross border transmission. Uganda, which reported cases linked to the same outbreak, declared its Ebola outbreak over on August 27 after reporting no new cases following the last patient being discharged from care on July 16.
Uganda's outbreak was linked to cases imported from the Democratic Republic of the Congo. Health authorities continue to monitor the border because transmission remains active in Congo.
International support for the response is also increasing. The United States announced an additional $267 million on September 23 for the Ebola response in central Africa. The funding is intended to support treatment facilities, testing and other measures to strengthen the response.
The additional funding comes as health authorities face continuing pressure to maintain treatment services and expand the response in affected communities.
WHO Director General Tedros Adhanom Ghebreyesus has said there are encouraging signs in some areas but warned that the outbreak is far from over.
For health authorities, the immediate challenge is to expand treatment capacity while finding enough trained workers to staff the facilities. The continued spread of the virus in some areas, despite improvements elsewhere, means the response remains under heavy pressure.