The death toll from the Democratic Republic of Congo’s Ebola outbreak has passed 4,000 as researchers expand a clinical trial seeking a way to prevent exposed people from developing the disease.
Congolese government figures show that 4,018 people have died among 8,300 confirmed cases recorded across seven provinces. More than 2,000 patients have recovered.
The outbreak, declared in eastern Congo on May 15, is now the largest and deadliest in the country’s history. It is second globally only to the 2014–2016 West African epidemic, which killed more than 11,000 people.
The current outbreak is caused by the Bundibugyo species of Ebola virus. Unlike the more familiar Zaire species, it does not have an approved vaccine or specific treatment, making the search for effective protection especially urgent.
At Rwampara Hospital in Ituri province, more than 250 participants have enrolled in a trial testing obeldesivir, an experimental antiviral pill developed by Gilead Sciences. The study is seeking nearly 1,000 adults and children aged 12 or older who were exposed to a confirmed Ebola patient during the preceding five days but have not developed symptoms.
The drug is being tested as post-exposure prophylaxis. Instead of treating someone who is already visibly ill, researchers administer it shortly after suspected exposure in an effort to prevent the disease from developing.
Half of the participants will receive obeldesivir and half a placebo. Researchers monitor them daily for 21 days, followed by a final telephone assessment after 42 days.
The Associated Press spoke with patients and medical personnel at the trial centre this week. Participants include relatives of infected people and frontline health workers who face elevated exposure risks.
One participant enrolled after her husband tested positive for Ebola. She told AP that no one else in her household had developed symptoms, but an individual experience cannot establish whether the experimental medicine works. Researchers will need the complete trial data before determining its safety and effectiveness.
The study is coordinated by the medical organisation ALIMA in partnership with Congo’s National Institute of Biomedical Research and France’s ANRS Emerging Infectious Diseases agency.
If participants develop symptoms, they receive immediate supportive treatment. Researchers say that if obeldesivir proves effective, it could help interrupt transmission by protecting high-risk contacts during the virus’s incubation period.
The approach differs from both vaccination and treatment after illness begins. A vaccine prepares the immune system in advance and may require time to generate protection. Post-exposure prophylaxis is intended for recently exposed people who are not yet symptomatic.
Congo has started vaccinating some healthcare workers with Ervebo, which proved effective during outbreaks caused by the Zaire Ebola virus. Authorities believe it may offer some protection against Bundibugyo, but its effectiveness against the strain driving the current outbreak remains under study.
The epidemic continues to challenge health services. North Kivu has accounted for about 40% of newly confirmed cases since the end of August, according to Médecins Sans Frontières. At least 50 healthcare workers have died after contracting the virus.
An MSF employee infected while working in Congo was evacuated to the Netherlands for specialist treatment. Earlier in the outbreak, an ALIMA doctor was treated in France after testing positive.
Insecurity and community distrust are making containment more difficult. A transit and treatment centre at a displacement camp outside Bunia was burned during a military weapons search, according to a senior United Nations official. Approximately 19,000 camp residents fled during the incident.
Some surveillance and health workers have also protested or stopped work over unpaid wages. Their absence can weaken contact tracing, delay reporting and make apparent declines in new cases difficult to interpret.
Africa CDC has reported that infections are slowing in some areas while accelerating in others. Lower weekly figures could reflect genuine progress, but they may also indicate that insecurity and mistrust are preventing response teams from finding patients.
Mobile laboratories have reduced the time required for some test results from approximately 72 hours to six hours, allowing medical personnel to identify cases more quickly and move diagnostic equipment closer to difficult-to-reach communities.
The current figures are confirmed government totals, but the trial’s outcome remains unknown. Obeldesivir should therefore be described as experimental—not as an approved cure or proven preventive medicine.
The immediate priorities remain identifying infected people, tracing their contacts, protecting health personnel and maintaining public trust. The trial offers a significant possibility, but its value will depend on rigorous evidence and the ability of health teams to reach communities while the outbreak continues spreading.
