The Democratic Republic of the Congo (DRC) is five months into the largest Ebola outbreak in its history, caused by the Bundibugyo strain, for which no vaccine or treatment is approved. It is burning through the same eastern provinces where M23, the Islamic State-affiliated ADF and local militias are fighting. Ethiopia's renewed war in Tigray has broken relations with Eritrea, and Sudan's war is now compounded by drought. Over all of it sits a record El Niño forecast to peak in December. Each crisis makes the others harder to manage, and the money to manage them is shrinking.
Why now: in the first half of October Ebola reached Kenya (three cases by 2026-10-16), former president Joseph Kabila launched an armed front that includes M23 (2026-10-12), and the World Meteorological Organization (WMO) called El Niño "firmly established and strengthening rapidly" (Anadolu Agency).
The outbreak was announced in mid-May, though some experts suspect it began as early as February (Al Jazeera). DRC Health Minister Samuel Roger Kamba says it began in the Mongbwalu mining zone of Ituri, where workers from North Kivu went home when they fell ill, carrying the virus along trade routes (RFI). It is the DRC's 17th Ebola epidemic (RFI).
The baseline matters. The DRC's 2018 to 2020 outbreak, caused by a different virus species, killed nearly 2,300 people; for Bundibugyo, the WHO says there are no approved vaccines or specific treatments (Al Jazeera). The West African epidemic of 2014 to 2016, the only larger outbreak on record, saw 28,600 confirmed cases and more than 11,000 deaths (Al Jazeera).
Uganda recorded 20 cases and two deaths and was declared Ebola-free in August (UN News). In the DRC the virus kept moving. By 2026-10-06 the WHO counted 8,728 confirmed cases and 4,205 confirmed deaths in 64 health zones across seven provinces, a case fatality ratio of 48.2% (Al Jazeera). On 2026-10-13 the health ministry reported 9,066 confirmed cases and 4,381 deaths (Al Jazeera).
Eastern DRC was already one of the world's largest humanitarian crises. M23, which Congo, the United States and UN experts accuse Rwanda of backing, took Goma and other key cities in a lightning assault last year, and US-brokered talks in Doha have produced only limited results (The Seattle Times/AP). The outbreak now straddles that front line: six cases were reported in AFC/M23-held Alimbongo and Kayna, linked to a chain from government-held Butembo (IJR). The health minister says Kinshasa has no channels to the rebels and will not open any, which means contacts who cross into rebel territory are lost to tracing (RFI).
Violence has hit the response directly. In Ituri, a transit centre for Ebola patients burned after soldiers entered a displacement site; in North Kivu, a contractor detecting cases was killed (Yahoo News/AFP). A local politician was beaten to death in September after defending the Ebola response on the radio (Al Jazeera). From 2026-10-14 to 10-16, civil society reported ADF attacks on mining sites and a health centre in Mambasa, where the virus is circulating, with at least ten reported dead (RFI).
To the north-east, a rebel alliance led by the Tigray People's Liberation Front has fought federal troops in Tigray, Amhara and Afar since 2026-09-23, the biggest escalation since the 2020 to 2022 Tigray war, which killed hundreds of thousands (Hiiraan Online/Reuters). Ethiopia told the UN Security Council that Eritrean forces had advanced up to 60 km into the country in an "all-out invasion"; Eritrea denies backing the rebels and accuses Addis Ababa of eyeing the port of Assab (same source). Federal forces and a pro-government militia have since taken Mekelle, and Prime Minister Abiy Ahmed named a caretaker government for Tigray with elections promised within six months (The Irish Times/Reuters).
Sudan's war between the army and the Rapid Support Forces (RSF) has run since April 2023. The army holds the centre and east; the RSF holds Darfur and parts of the south (Al Jazeera). The war is spilling over borders: a Sudanese rights group says an air strike on gold miners near the disputed Egypt border on 2026-10-10 killed at least 72 and blames Egyptian jets; the attack could not be independently verified and Egypt has not commented (Al Jazeera).
Sudan's death toll is contested: ACLED counts at least 150,000, and aid groups say the real toll is likely higher (Al Jazeera); a day earlier the same outlet gave "more than 200,000" without a source (Al Jazeera, above). Treat 150,000 as a documented floor.
In Somalia, federal and regional forces have fought fighters loyal to a former South West State president in Baidoa repeatedly since August (Hiiraan Online).
The US Climate Prediction Center's 2026-10-08 discussion keeps an El Niño Advisory in place: "a strong-to-very strong El Niño likely through January-March 2027", with high chances of "a historic event" (NOAA CPC). The WMO gives a near-100% likelihood that it persists through February 2027 and peaks around December, with Niño 3.4 sea-surface temperatures forecast at about 3.7°C above normal for October to December, against a previous record of 2.6°C in November 2015 to January 2016 (Anadolu Agency). "We are currently witnessing an El Niño event that is unprecedented in the historical record," Zeke Hausfather of Berkeley Earth told the BBC (BBC Weather).
In 1997-98 parts of East Africa had devastating floods; in 2015-16 southern Africa had one of its worst droughts in decades (same source). This year the WMO again forecasts a wetter than normal Greater Horn of Africa (Anadolu Agency, above).
Ebola is moving east and north. MSF says North Kivu now accounts for nearly 40% of new confirmed cases, up from 24% at the end of August, and that 34% of confirmed patients were being treated in non-specialised facilities as of 2026-09-28 (Al Jazeera). Contact follow-up stood at 80.4% on 2026-10-04, below the 85% target (same source). Two health officials told Reuters of two cases in North Ubangi, bordering the Central African Republic, which would be the eighth affected province; Congolese authorities had not announced it (Al Jazeera).
Kenya is the first test beyond the DRC and Uganda. Its first patient, a Kenyan living in the DRC, travelled by road to Uganda, flew to Nairobi on 2026-10-03 and died on 2026-10-05. The third case, confirmed 2026-10-16, is a close relative of the first two and was already in quarantine; 127 of 130 listed contacts are in quarantine, and the ministry says there is no community spread (Al Jazeera). The WHO has made Djibouti, Somalia and Sudan priority countries for readiness (UN News).
Other epidemics compete for the same health system. The DRC has recorded more than 51,412 suspected cholera cases and 1,487 deaths in 2026, and rainfall helps spread it (UN News).
Hunger is the common denominator. The IPC says "an El Nino-induced drought, affecting roughly half of the country" is compounding conflict in Sudan, and two South Darfur camps show acute malnutrition above famine thresholds (Al Jazeera). Tigray faces drought linked to El Niño, with 750,000 people still displaced as of February (The Irish Times/Reuters). Across East Africa, OCHA counts 40.9 million people in crisis-level hunger or worse, up from 40.5 million the previous quarter, with only 39% of 2026 humanitarian funding received (teleSUR).
Somalia faces the opposite problem: water. The FAO puts the chance of wetter-than-normal Deyr rains as high as 90% in parts of central and southern Somalia, and the IPC projects about 26,000 displaced people in Baidoa could face catastrophic hunger from October to December (Hiiraan Online). The comparable 2023 floods affected close to two million people and displaced more than 500,000 (Hiiraan Online/ICRC).
Here the experts split. The DRC health minister says "the peak of the epidemic is behind us": new cases peaked at about 120 a day and now run at 50 to 70 a day, smoothed over three weeks, though he concedes the epicentre has shifted to North Kivu (RFI). MSF's Stephanie Hoffmann in Butembo describes something else: "It is like fighting a megafire," with multiple outbreaks developing at once (Al Jazeera). The WHO sits between them: signs of slowing in some areas, intensification in others, and a fatality rate that still points to late detection (teleSUR).
The evidence favours caution: a falling national curve can hide a rising one in North Kivu, tracing is below target, and the minister cannot see inside rebel-held zones. Wolfgang Preiser, head of medical virology at Stellenbosch University, expects spread to other provinces and countries to "continue to happen until such time that the trajectory has been reversed" (Al Jazeera).
A vaccine is the swing factor. Two Bundibugyo candidates, one of them from Oxford, are in trials, and Gavi's Emanuele Capobianco stresses that community trust will be decisive (RFI). The WHO says an efficacy trial is being prepared for the coming weeks (Al Jazeera); the minister hopes for a launch within two months (RFI).
The money fight could slow everything. Africa CDC's Jean Kaseya says donors disbursed about $962m to organisations running the response, which report receiving $228m, leaving more than $700m unaccounted for, though he says it is too early to speak of embezzlement; Kinshasa threatens to bar aid groups that do not report (Al Jazeera). Carried out mid-outbreak, that threat would cut capacity just as North Kivu needs more.
Geopolitics follows the aid: RFI commentary calls China's Ebola assistance soft power, notes Beijing replaced Washington as the WHO's top public contributor after the US left, and links it to China's bid to lead the WHO (RFI).
Yvon Muya, a researcher at the University of Ottawa, reads Kabila's new front as a direct confrontation with President Félix Tshisekedi: "We will likely witness an escalation on the military front," and with M23's leaders folded into the new front, "it is hard to see... how the Doha process will work" (The Seattle Times/AP). No named analyst in the available reporting argues the opposite.
North Kivu is where Ebola is growing fastest; any escalation there will hit tracing first (an assessment: no single source connects the two trends).
Ethiopia also accuses Egypt and Sudan of backing the rebels, which both deny (The Irish Times/Reuters). In Sudan, the IPC warns that "food insecurity, acute malnutrition and excess mortality will likely intensify" (Al Jazeera). In Somalia, ICRC delegation head Antoine Grand sums up the bind: better preparation and data than in 2023, but "humanitarian funding and capacity in general have seriously decreased" (Hiiraan Online/ICRC).
| Indicator | Why it matters |
|---|---|
| WHO's weekly new-case count by province, especially North Kivu | Tests the minister's "peak is behind us" claim |
| Contact follow-up reaching the 85% target | Below it, chains of transmission go unseen |
| Official confirmation of North Ubangi, or any case in the Central African Republic | Opens a new border |
| Start of a Bundibugyo vaccine efficacy trial in the DRC | The main way to bend the curve |
| Fighting around Beni, Butembo and Mambasa, and any resumption of Doha talks | Hotspots, and whether the political track survives |
| Shabelle and Juba river levels during the Deyr rains | Flood displacement in Somalia |
| Next IPC update for Darfur and Kordofan | Whether famine thresholds spread |
| El Niño peak in December | WMO and NOAA expect it; the impacts on Africa lag the peak |
How this was made: methodology and limits.