Congo's Ebola outbreak outpaces health worker supply, WHO warns

Congo is facing a critical shortage of health workers to staff Ebola treatment centres as the outbreak continues to spread across the country, the World Health Organization said on Wednesday.

The gap is most acute in the eastern province of North Kivu, where confirmed cases have jumped 73% over three weeks. Although treatment beds are being added daily, facilities lack the staff and partners needed to run them.

"The human resources gap is one of the biggest gaps," said Catherine Smallwood, the WHO's Ebola incident manager.

According to WHO representative in Congo Anne Ancia, a single Ebola treatment centre requires roughly 300 health professionals, including anaesthetists, hygienists, nurses and general practitioners.

"We are building Ebola treatment centres but do not always have the human resources needed to operate them," Ancia said. "Those health workers must be paid."

The warning comes even as some provinces show improvement. Between Aug. 31 and Sept. 20, cases fell 26% in Ituri — the outbreak's epicentre — and 15% in Haut-Uele, said Marie Roseline Belizaire, the WHO's regional emergency director for Africa.

But she cautioned that transmission patterns vary widely. "While cases and deaths are declining in some provinces, they continue to rise in others," Belizaire said. "The outbreak is still not under control and remains spread across a wide geographic area."

Smallwood noted that cases and deaths had begun declining in North Kivu after several weeks of increases.

The outbreak has now reached seven provinces, with 7,773 confirmed cases and 3,759 deaths, according to the latest government figures. It is spreading under extremely difficult conditions, driven by insecurity, displacement, a health workers' strike and intense population movements.

The WHO has said the outbreak is on track to surpass the 2014-2016 West Africa Ebola epidemic, the deadliest on record, which killed more than 11,000 people, mainly in Guinea, Liberia and Sierra Leone.

Frontline workers in Ituri previously went on strike over unpaid wages, worsening access to care. Health Minister Roger Kamba said in July that the government was verifying payroll lists after the names of people not involved in the response were added. Workers said officials promised to pay arrears, but some received nothing and others only part of what they were owed.

Children under five remain the most vulnerable, with a case fatality rate above 60%, compared with approximately 40% among adults, Belizaire said. Smallwood added that detecting cases in young children is particularly difficult because they cannot always explain their symptoms and their presentation can be confusing.