In Congo's Ebola fight, a push to open treatment centers to communities

As the Ebola outbreak in eastern Democratic Republic of Congo continues to spread, health experts are calling for a fundamental shift in how the response engages with local populations. The appeal comes amid rising cases, high fatality rates, and persistent resistance to response teams in affected communities.

Papy Kasereka, a former team leader for risk communication and community engagement during the country's 10th Ebola outbreak, now works as an analyst. He argues that the current response has failed to make communities partners in the fight against the virus.

"I believe that to defeat an epidemic, we must place communities at the heart of epidemic management," Kasereka said. "Communities are not mere spectators watching the epidemic spread or claiming lives. We must make communities our allies."

Kasereka specifically criticized the secrecy surrounding Ebola treatment centers (ETCs), saying this breeds suspicion and distrust. He proposed opening the facilities to community leaders and members, and allowing survivors to share their experiences directly with the public.

"We must not continue to treat ETCs as something mysterious," he said. "We need to demystify the operations of the ETCs by giving community leaders the opportunity to visit and see what is happening."

His comments come as official figures show the outbreak has recorded 5,514 cases and 2,642 deaths as of Saturday. However, Congolese experts believe the true scale could be three times larger, as the outbreak began weeks before it was officially confirmed.

This is now the fastest-growing Ebola outbreak in history, with many patients dying outside treatment centers. At this stage, it has recorded seven times more deaths than the 2014-2016 West Africa outbreak, the deadliest on record with over 11,000 fatalities.

Nearly half of those infected have died, with the fatality rate reaching 68.6% in hard-to-reach areas like North Kivu province. Most new cases in Ituri province, the current epicenter, still come from outside monitored contacts, indicating gaps in surveillance.

The response has also been hampered by attacks on treatment centers and staff. Michel Tosalisana, chief medical officer of the Beni Health Zone, warned that such resistance is counterproductive.

"It is not by attacking the Ebola response teams that they are preparing for their future; on the contrary, they are destroying their future by doing so," Tosalisana said. "We must remind these young people, who are most often behind these protests, that the Ebola response teams are there to protect the health of the entire population."

Kasereka echoed the need for a different approach, emphasizing that trust is built through familiar faces and genuine inclusion.

"Communities trust the people they know—people who are deeply rooted in their communities," he said. "If you do something for the communities without involving them, the communities feel as though you're doing it for yourself. And that's what needs to change."