Congo Faces Critical Health Worker Shortage Amid Uncontrolled Ebola Spread, WHO Warns

Congo is experiencing a shortage of health workers needed to staff Ebola treatment centers, particularly in the eastern province of North Kivu, where cases have risen 73% over the past three weeks, the World Health Organization (WHO) reported on Wednesday.

The warning comes despite improvements in other provinces, including Ituri, the outbreak’s original epicenter. The virus has now spread to seven provinces, with 7,773 confirmed cases and 3,759 deaths according to the latest government figures.

Between August 31 and September 20, cases declined 26% in Ituri and 15% in Haut-Uele, said Marie Roseline Belizaire, MD, PhD, MPH, WHO’s regional emergency director for Africa. However, transmission patterns remain uneven and the outbreak is still not under control, she added.

“While cases and deaths are falling in some areas, they continue to rise in others,” Belizaire said. “The outbreak remains widespread and uncontrolled.”

The response is hampered by insecurity, population displacement, a health‑workers’ strike, and intense movement of people. WHO officials warn that the current outbreak could surpass the 2014‑2016 West Africa Ebola epidemic, which claimed more than 11,000 lives in Guinea, Liberia, and Sierra Leone.

Catherine Smallwood, PhD, WHO’s Ebola incident manager, noted that cases and deaths in North Kivu have begun to decline after several weeks of increase. Nevertheless, although treatment beds are being added daily, facilities still lack sufficient staff and partners to operate them.

“The human‑resources gap is one of the biggest obstacles,” Smallwood said.

WHO representative in Congo Anne Ancia, MD, MPH, explained that a single Ebola treatment center requires roughly 300 health professionals—including anesthetists, hygienists, nurses, and general practitioners.

“We are constructing treatment centers but often lack the personnel needed to run them,” Ancia said. “Those workers must be paid.”

Frontline staff in Ituri previously went on strike over unpaid wages, further limiting access to care. Health Minister Roger Kamba, MD, said in July that the government was reviewing payroll lists after discovering that names of individuals not involved in the response had been added. Workers reported that promises to pay arrears were not fulfilled, with some receiving nothing and others only partial payment.

Another significant challenge is the high fatality rate among children. According to WHO, children under five have a case‑fatality rate exceeding 60%, compared with about 40% for adults, Belizaire said.

Smallwood added that detecting cases in young children is especially difficult because they cannot always describe their symptoms, and clinical presentations can be confusing.

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