The Ebola outbreak in the Democratic Republic of Congo and Uganda has killed 1,001 people, according to a World Health Organization situation report dated 20 July, crossing a threshold reached in just over two months. The pace of mortality is the fastest recorded for any Ebola epidemic: the 2013–2016 West African outbreak, which killed more than 11,000 people, took roughly eight months to reach 1,000 deaths. Congolese health authorities have confirmed 2,473 cases and 999 deaths, while Uganda has recorded 20 cases and two fatalities, though it has now gone three weeks without a new infection.

The outbreak is driven by the Bundibugyo ebolavirus, a rarer strain with a case fatality rate of around 40 percent. No vaccine or therapeutic has received regulatory approval for this strain. The absence of proven medical countermeasures has forced responders to rely on containment alone, yet containment is being undermined by the fact that 80 percent of new cases are emerging through unknown chains of transmission. Health workers and burial teams in Ituri province, the epicentre, face repeated attacks from community members who mistrust the response or wish to perform traditional rites. Some health staff have walked off the job over unpaid wages, and at least 36 infected health workers have died, further thinning the frontline.

In Geneva, WHO officials describe an epidemic that “remains ahead of us,” with the true scale likely two to four times larger than confirmed figures. The response is concentrated in five Congolese provinces, though Ituri accounts for 89 percent of cases. Uganda discharged its last confirmed patient in mid-July and must complete a 42-day countdown without new cases to be declared free of the virus. A report released this week by PATH and Impact Global Health found that 88 percent of approved Ebola diagnostics require laboratory infrastructure absent from most African primary-care facilities, a gap that delayed confirmation of the Bundibugyo strain by 10 days.

Clinical work is accelerating on several fronts. Oxford University has launched a Phase I safety trial of the ChAdOx1 vaccine candidate in 50 healthy adults aged 18 to 55. A separate rVSV-based candidate, considered the most advanced by WHO, is seven to nine months from entering clinical trials. Two experimental treatments are being tested in Ituri, and WHO has granted emergency-use authorisation for the first molecular diagnostic test specific to the strain. The next factual milestone will be the initial safety and immunogenicity data from the Oxford trial, expected in the coming months, which will determine whether the candidate proceeds to larger efficacy studies.