Red Cross Volunteers Die from Suspected Ebola in DR Congo

On March 27, 2026, three Red Cross volunteers from the Mongbwalu branch in Ituri province responded to a call for dead body management — a routine humanitarian task in a region scarred by decades of conflict. At the time, neither the volunteers nor their community knew that Ebola had already begun circulating in northeastern Democratic Republic of Congo. By mid-May, all three — Alikana Udumusi Augustin, Sezabo Katanabo, and Ajiko Chandiru Viviane — were dead [1].

Their deaths, confirmed by the International Federation of Red Cross and Red Crescent Societies (IFRC), mark one of the starkest illustrations of the risks facing local humanitarian workers in what has become the DRC's 17th Ebola outbreak since the virus was first identified along the Ebola River in 1976 [2]. The outbreak involves the Bundibugyo strain — a rarer species of ebolavirus for which there is no licensed vaccine or specific therapeutic — and it is spreading through a region fractured by armed conflict, foreign aid retrenchment, and a health system operating well below capacity [3].

The Toll So Far

As of May 22, the WHO had recorded approximately 836 suspected cases and at least 186 deaths across the DRC, with 82 confirmed cases and 7 confirmed deaths [4][5]. Five cases linked to the outbreak have also been confirmed in Uganda, including in the capital Kampala [6]. On May 17, the WHO declared the outbreak a public health emergency of international concern (PHEIC) — a designation reserved for events that pose a risk of international spread and require a coordinated global response [7].

The numbers remain imprecise because surveillance systems in the affected areas — Ituri, North Kivu, and South Kivu provinces — have been severely degraded. Suspected cases surged from 246 to 500 in just 96 hours in mid-May, a spike the International Rescue Committee attributed not to a sudden acceleration of transmission but to surveillance systems "catching up with transmission that has likely been occurring for some time" [8].

Source: WHO / CDC

Data as of May 23, 2026CSV

The case fatality rate among confirmed cases in the current outbreak stands at roughly 8.5% (7 of 82 confirmed), but the suspected death toll — 186 of 836 suspected cases, or about 22% — suggests that many fatal cases have gone unconfirmed due to limited testing capacity [4]. By comparison, the 2018–2020 Kivu outbreak (caused by the Zaire species) killed 2,287 of 3,481 cases, a case fatality rate of approximately 66% [9]. Historically, Bundibugyo virus has carried a lower fatality rate — 25% in the 2007 Uganda outbreak and roughly 40% among laboratory-confirmed cases — but with limited data from only two prior Bundibugyo outbreaks, projections remain uncertain [10].

How the Volunteers Were Exposed

The three deceased Red Cross volunteers contracted the virus while handling a dead body on March 27, weeks before the DRC Ministry of Health confirmed the outbreak on May 15 [1][3]. The IFRC stated that the volunteers "lost their lives while serving their communities with courage and humanity," noting that the intervention was part of a humanitarian mission unrelated to Ebola [1].

Dead body management is among the highest-risk activities in any Ebola response. The virus remains contagious for up to three days after death, and traditional burial practices — in which families wash, touch, and spend extended time with the deceased — are a primary vector for community transmission [11]. WHO protocols for safe and dignified burials require full personal protective equipment (PPE) including fluid-resistant coveralls, double gloving, face shields, and N95 respirators [12].

The critical detail in this case is that no Ebola-specific PPE protocols were in place when the exposure occurred. The outbreak had not yet been identified. The volunteers were performing standard body management, not Ebola-specific safe burial procedures. Heather Reoch Kerr, the IRC's country director for DRC, stated that "funding cuts have left the region dangerously exposed," with many health facilities in the affected areas "operating without basic protective supplies" [8].

A Strain Without Countermeasures

The current outbreak is caused by Bundibugyo ebolavirus, only the third recorded outbreak of this species. Genomic sequencing conducted by the Institut National de Recherche Biomédicale (INRB) in DRC and the Central Public Health Laboratory (CPHL) in Uganda confirmed a new zoonotic spillover event — distinct from both the 2007 Uganda and 2012 DRC Bundibugyo outbreaks [13]. DRC samples achieved greater than 99% genome coverage, and phylogenetic analysis places the estimated origin of the current cluster between late March and late April 2026 [13].

This determination has direct consequences for the medical response. The only licensed Ebola vaccine, Ervebo (rVSV-ZEBOV), was developed against the Zaire species and proved highly effective during the 2018–2020 Kivu outbreak, where approximately 250,000 people received doses under a ring vaccination protocol [14]. Against Bundibugyo virus, Ervebo's efficacy is unproven. The WHO's technical advisory group is evaluating whether Ervebo might offer some cross-protection, but Dr. Anne Ancia of the WHO stated that even if a decision were made to deploy it, "it would take two months for it to be available" in the affected area [7].

The same limitation applies to therapeutics. mAb114 (Ebonol) and REGN-EB3 (Inmazeb), the monoclonal antibody treatments approved for Zaire ebolavirus, target the receptor binding domain of the Zaire glycoprotein [15]. Their activity against Bundibugyo virus is not established. There are, as of May 2026, no approved therapeutics specifically targeting Bundibugyo virus disease [3][15].

Funding: Pledges Versus Reality

International funding commitments have begun to materialize, but gaps remain. Within two days of the outbreak announcement, the US State Department mobilized $23 million in emergency funding [16]. The World Bank reallocated $15 million originally earmarked for disease surveillance over three years, bringing its total commitment to $27 million [16]. The UN humanitarian chief allocated $60 million from the Central Emergency Response Fund (CERF) [16]. The WHO approved $3.9 million from its Contingency Fund for Emergencies (CFE) — but with only $5.4 million in total donor contributions to the CFE in 2026, that fund is close to exhaustion [16].

Source: WHO / UN OCHA / US State Dept

Data as of May 23, 2026CSV

The WHO has estimated that $26 million is needed to fund the immediate three-month response [16]. That figure is modest compared to the 2018–2020 Kivu response, which ultimately cost over $600 million — but the current outbreak is at a far earlier stage, and costs are likely to rise if containment fails [9].

The funding picture is further complicated by broader cuts to US foreign health assistance. The IRC documented that US government funding for its activities in DRC ended in March 2025, forcing the organization to reduce programming from five health areas in Ituri province to just two [8]. These cuts affected frontline health services, disease surveillance, outbreak preparedness, water and sanitation infrastructure, and infection prevention and control — precisely the capabilities most needed in the current response [8].

Conflict as a Force Multiplier

Eastern DRC's overlapping humanitarian crises — conflict, displacement, and epidemic disease — are not separate problems but interconnected ones. The country hosts approximately 5.2 million internally displaced persons, the fourth-highest figure in the world [17].

Source: UNHCR Population Data

Data as of Dec 31, 2025CSV

The first confirmed Ebola case in this outbreak was detected in South Kivu province, in territory controlled by M23, the Rwanda-backed armed group that has seized large swaths of eastern Congo [18]. M23 has never had to manage a response to a disease of this severity. Local health workers have reported that communications are monitored by armed groups, and sharing epidemiological information can carry risks of arrest, disappearance, or worse [18].

The conflict restricts physical access to health zones. Attacks on health facilities — documented repeatedly in eastern DRC over the past decade — undermine trust in the health system and disrupt surveillance and contact tracing [19]. More than 40 WHO health professionals have been deployed to the ground, but their operations are constrained by the security environment [7]. The Red Cross operates under negotiated access agreements with all parties to the conflict, but the fragmentation of territorial control between the DRC military (FARDC), M23, and other armed groups makes consistent access difficult to guarantee [18].

The Volunteer Gap: Local Workers, Global Risk

The deaths of the three Red Cross volunteers have renewed scrutiny of how international humanitarian organizations treat their local staff and volunteers. Critics have long argued that global NGOs channel the bulk of donor funding toward organizational overhead and internationally deployed personnel, while local volunteers — who face the highest exposure risks — receive minimal compensation and protection [20].

The IFRC's own volunteering policy acknowledges that volunteers are entitled to reimbursement of expenses and should not be financially disadvantaged by their service [20]. In practice, Red Cross volunteers in the DRC typically receive daily stipends that cover transportation and meals — amounts that vary by national society but generally range from $5 to $15 per day in comparable contexts across sub-Saharan Africa. Internationally deployed Red Cross delegates, by contrast, receive full salary packages that can exceed $5,000 per month, plus per diems, insurance, and hardship allowances [21].

The IFRC has not publicly disclosed what death benefit or life insurance payout the families of the three deceased volunteers will receive. The organization's statement focused on their "extraordinary dedication" [1]. The disparity between the risks borne by local volunteers and the protections afforded to them remains a structural issue across the humanitarian sector, one that successive Ebola outbreaks have repeatedly exposed without resolving.

Why the DRC Keeps Having Ebola Outbreaks

The DRC has experienced 17 Ebola outbreaks since 1976 — more than any other country [9]. Three of the last five outbreaks were declared over only to be followed by a new one within 18 months. The current outbreak began roughly five months after the 16th outbreak (in Kasai Province) was declared over in December 2025 [9].

Several structural factors explain this recurrence:

Health system underfunding. Over 80% of the DRC's approximately 100 million citizens live in extreme poverty [11]. Health expenditure per capita is among the lowest in the world. The surveillance systems that are supposed to detect outbreaks early depend on community health workers, laboratory capacity, and communication infrastructure that remain inadequate in much of the country — particularly in conflict-affected eastern provinces [8].

Burial practices. Traditional funeral rites in many Congolese communities involve extended physical contact with the deceased. Research on previous outbreaks has identified these practices as a primary driver of community transmission, but they are deeply embedded in cultural and spiritual life. Public health guidance on safe burials has often been perceived as a coercive replacement of mourning traditions rather than a protective adaptation of them [11][22]. In late May, protesters in the DRC set fire to an Ebola treatment center after demanding access to the bodies of dead relatives — an illustration of the tension between containment protocols and community grief [23].

Wildlife-human interface. The DRC's tropical forests host reservoir species for multiple filoviruses. Bushmeat hunting and consumption, driven by food insecurity and economic necessity, creates repeated opportunities for zoonotic spillover [11]. The genomic evidence from the current outbreak confirms a new animal-to-human transmission event, not a resurgence of a previous human-adapted lineage [13].

Armed conflict. The ongoing war in eastern DRC destroys health infrastructure, displaces populations into crowded conditions favorable to transmission, and creates zones where epidemiological surveillance is functionally impossible [18][19].

Addressing these root causes — rather than responding reactively to each new outbreak — would require sustained investment in primary health care, laboratory networks, community health worker programs, conflict resolution, and food security. Global health researchers have estimated that strengthening health systems across sub-Saharan Africa to a level capable of reliable outbreak detection and response would cost approximately $1–2 per capita per year in additional spending — a fraction of the cost of emergency responses after outbreaks are already underway [9]. For the DRC's population, that translates to roughly $100–200 million annually. The 2018–2020 Kivu response alone cost more than three times that figure [9].

What Happens Next

The WHO has more than 40 health professionals on the ground and is rushing diagnostic testing kits to eastern DRC [7]. The technical advisory group is expected to issue recommendations on whether to attempt cross-protective vaccination with Ervebo, despite its unproven efficacy against Bundibugyo virus. Contact tracing and community engagement efforts are underway, but they face the same obstacles that have hampered every previous response in this region: armed conflict, community mistrust, and a health system that was already stretched to its limits before the outbreak began.

The three Red Cross volunteers who died in Ituri province — Augustin, Katanabo, and Viviane — were exposed before anyone knew the virus was circulating. That gap between the start of transmission and the moment of detection is the interval in which outbreaks become epidemics. In the DRC, where surveillance systems have been weakened by years of underfunding and months of aid cuts, that interval may be growing longer [8].

The WHO has assessed the risk level in the DRC as "very high," while maintaining regional risk at "high" and global risk at "low" [4]. Five cases have already crossed into Uganda. Whether this outbreak follows the trajectory of the contained 2021 North Kivu cluster (12 cases) or the protracted 2018–2020 Kivu epidemic (3,481 cases) depends on decisions being made now — about funding, about access, about the willingness of the international community to invest in a response against a strain of Ebola for which the usual tools do not apply.