While global interest in mpox may be waning, outbreaks, illness, and death continue across Africa and the world. Ending transmission requires a sustained global response that moves beyond reactive measures.

The 2025 Ebola outbreak that ravaged the Bulape Health District (HD) in Kasai, Democratic Republic of Congo (DRC), was tackled using the incident management system (IMS) model. The Bulape HD is located in the Mweka territory, which has experienced two Ebola epidemics: one in 2007 and another in 2008. The IMS comprises seven strategies recommended for an effective response to an Ebola outbreak: (i) thorough investigation, (ii) strengthening infection prevention and control measures in the community, (iii) ensuring that medical care is provided by experienced professionals, (iv) strengthening risk communication and community engagement (RCCE), (v) ring vaccination, (vi) operational research, and (vii) anchoring interventions in the existing health system. We share our experience implementing these seven strategies and compare them with those utilized during three previous Ebola outbreaks. This paper describes our achievements, the resulting benefits, and the factors that facilitated the implementation of the aforementioned strategies. A literature review and interviews were conducted. The atlas.ti 22 software was used for data analysis. Implementing these seven strategies contributed to an effective response, largely due to the experience and expertise of those involved but also thanks to the support of technical and financial partners (TFPs) and the engagement of the local community. Challenges such as geographical accessibility, the fragile health system, the community’s strong attachment to traditional practices, and negative reactions to healthcare—which was widely discredited, with many of those involved expressing a lack of faith in its effectiveness—were major obstacles. To overcome these challenges, an integrated approach was utilized, combining a rapid comprehensive response with deep and respectful community engagement. The support and alignment of TFPs were invaluable during this process. The RCCE pillar proved key to successful IMS implementation. Our experiences will be useful during the next Ebola outbreak in the DRC; additionally, they may also help to inform the response to similar outbreaks in other countries.

Introduction: Ebolavirus disease (EVD) threatens global public health with fatality rates of 25% – 90%. From August 2018 to June 2020, the Democratic Republic of Congo (DRC) reported several EVD infections, including deaths among healthcare workers (HCWs). We analyzed the factors predicting death among infected HCWs during the 10th Ebola outbreak in the DRC. Methods: We conducted a retrospective cohort study using data from healthcare providers and frontline responders infected with Ebolavirus in North Kivu and Ituri provinces from August 2018 to June 2020. The outcome variable was the time in days from admission to death; the exposure variables were high viral load (Ct value ≤ 20), previous Ebolavirus vaccination, duration from onset to admission (DOA), socio-demographic and clinical factors. We calculated the hazard rate of dying among the subjects; we ensured that the global proportional assumption was met and ran all the exposure variables in a Cox proportional hazard regression at 5% significance level using STATA-17 to assess how they predicted the hazard of dying among the subjects, and we finally performed a backward elimination of factors to select the best-fitting model. Results: We analyzed data from 145 admitted HCWs out of 172 total infections recorded. Among them, the hazard rate of dying was 3 deaths per 100 infected-HCWs per day; 40 (27.59%) of them had Ct ≤ 20, and 52 (35.86%) died. Factors increasing hazard of dying were Ct ≤ 20 (aHR= 3.43, 95%CI: 1.78 – 6.59), DOA ≥ 5 days (aHR =2.23, 95%CI: 1.19 – 4.19), non-previous Ebola vaccination (aHR =2.56, 95%CI: 1.21 – 4.42), confusion (aHR 3.70, 95%CI: 1.05 – 13.05), vomiting (aHR= 2.76, 95%CI: 1.31 – 5.81) and sore throat (aHR =2.94, 95%CI: 1.05 – 8.23). Conclusion: High viral load, delayed admission, non-previous Ebola vaccination, confusion, vomiting, and sore throat were associated with increased hazard for death among infected HCWs. Strengthening early diagnosis, timely admission for appropriate treatment, and mandatory Ebola vaccination of HCWs should be advocated to reduce fatality among HCWs during future EVD outbreaks.