There is no approved drug to save lives in the ongoing Ebola outbreak in the Democratic Republic of the Congo, but hope emerges as the first patients are enrolled in a treatment trial.
Scientists call this the fastest initiation of such research, with enrollment starting just six weeks after the outbreak was declared a public health emergency of international concern by the World Health Organization (WHO) on May 17.
In Bunia, the capital of Ituri province where the virus is spreading, residents express urgency. “I hope these drug trials proceed quickly,” said Neema Haba, a mother of three and banana seller. “Financially, we are being driven to the brink by this outbreak and nothing is going right.”
By July 9, 1,792 confirmed cases and 625 deaths from the Bundibugyo strain were reported—a strain with no vaccine or approved treatment. The WHO states the outbreak remains in its expansion phase.
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The response relies on identifying cases, isolating them for care, and tracking contacts. About 75% of known contacts are being traced, but community mistrust and population mobility hinder efforts. Some frontline workers protested unpaid wages this week.
Ebola victims’ bodies are highly contagious, requiring trained teams for safe burials. Ovide Maliabo, a driver in Rwampara, warned, “At one point, we narrowly escaped being lynched. It’s a shame that we aren’t being financially supported.” Head of the team, Bahati John, added, “Since May 15, with the insults we’ve endured, we haven’t received a single penny.”
DRC officials acknowledged payments, though activity resumption remains unclear. A local airport closure in Bunia hindered supply logistics.
Hopes rest on scientists pursuing effective medicines. The Partners trial tests two drugs: remdesivir and MBP134, with patients randomly assigned to receive either, a combination, or standard care.
Remdesivir, developed by Gilead Sciences, is a 10-day antiviral therapy. MBP134, a monoclonal antibody by Mapp Biopharmaceutical, uses engineered immune proteins to neutralize the virus in a single infusion.
“These drugs have proven efficacy against Bundibugyo in animal models,” said Prof Laurens Liesenborghs of the Institute of Tropical Medicine, Antwerp. “We must now test their impact on human mortality rates.”
Bundibugyo typically has a lower death rate (one in three) compared to the Zaire strain, which previously caused over 28,000 cases and 11,000 deaths in West Africa. Researchers will monitor whether experimental treatments significantly reduce mortality compared to standard care.
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Trials must enroll 700–1,000 patients. Prof Liesenborghs noted that prior Zaire strain trials reduced death rates from 50% to 35% with monoclonal antibodies, a target the team aims to replicate.
To date, WHO has secured remdesivir and MBP134 supplies for 1,200 patients, with discussions ongoing for post-trial distribution if proven safe and effective. Pregnant and breastfeeding women, typically excluded from trials, are eligible here due to high risk-benefit considerations.
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A separate trial this week examines whether obeldesivir can prevent Ebola in contacts. Africa CDC estimates it requires $18 million, with $6 million pledged.
Prof Amanda Rojek of the University of Oxford highlighted the team’s rapid progress since the 2014-16 West Africa outbreak, where trials took over a year to launch. Strong leadership from DRC’s National Biomedical Research Institute (INRB) enabled a six-week start.
Focus remains on simplicity, as seen in the Recovery trial during the COVID-19 pandemic. The WHO sponsors Partners with funding from Wellcome Trust, FCDO, and UKRI. Prof Yap Boum of Africa CDC emphasizes that effective care, surveillance, and isolation capacity are critical to containing outbreaks.