Ebola Control Lessons for DRC from Past Roundtables

June 18, 2026    The Democratic Republic of Congo (DRC) has long been a country of concern for conflict and hunger and remains a priority focus for U.S. and World Food Programme food assistance in 2026. Food insecurity in eastern DRC has been further aggravated by the latest Ebola outbreak, now the 17th recorded and the largest to date in terms of people infected.

The Adventist Development and Relief Agency (ADRA) is an example of an NGO that has been providing large scale food assistance in eastern DRC and has addressed the current and past outbreaks of Ebola with community education, hygiene promotion, and water, sanitation, and hygiene.

As described in the prior article of Hunger Notes, a lesson from the earlier West African Ebola outbreak was that self-isolation (self quarantine of people who may have been exposed to Ebola) was a critical measure to interrupt transmission, and, in turn, self-isolation depended on aid agencies providing ample food aid to compensate the family for lost income.   Today, the World Food Programme is doing the same thing, providing food aid to contacts and patients in DRC.

The map below shows the current spread, in 2026 of the virus, and possible future routes of spread.

In the West Africa outbreak there were 11,323 recorded deaths but probably over 30,000 actual deaths, where the majority of Ebola cases were never reported.  The United States Government alone spent some $2 billion on that earlier Ebola response.  The United Kingdom spent £667 million (roughly $850 million–$1 billion at 2014–2016 exchange rates), and the World Health Organization spent some $500 million.

The USAID evaluation of that outbreak response was commissioned by Jeremy Konyndyk, then Director of the Office of U.S. Foreign Disaster Assistance. Writing in the New York Times on June 13, he warned that the current DRC outbreak could become the worst ever.  He reports that the Centers for Disease Control and Prevention (CDC) projects that more than 20,000 cases may occur by late August. Konyndyk notes: “As bad as this situation is, we have a playbook for addressing such crises. But it requires a huge team effort.” He calls for specialized clinics, large‑scale contact tracing, safe burial management, and adequate personal protective equipment for health workers. However, he cautions that “security has deteriorated markedly as the government has lost control of large parts of the area.”

With clear relevance for the current global Ebola outbreak, a series of lesson‑learning roundtables were held in 2017 at George Washington University, Harvard University, and the Uniformed Services University of the Health Sciences. These discussions were part of a lessons‑learning evaluation requested by USAID and were intended to reflect on operational challenges during the West African Ebola crisis.  Each roundtable included seasoned emergency practitioners who had overseen or implemented programs in Liberia, Sierra Leone, and Guinea during the lethal 2013–2016 outbreaks.

The Harvard Roundtable concluded that the greatest challenges in the Ebola response involved trust, including community skepticism and occasional violence. One participant warned that “we are setting ourselves up for the same problems all over again.” Families were initially reluctant to cooperate with referral systems in which infected relatives were taken away with little explanation. As one participant noted, once treatment centers were introduced and communities saw that Ebola was not always a death sentence, and that patients could both enter and leave safely, community transmission began to decline. Another participant observed that promising “Community Care Centers” were denied or delayed funding unless the NGO also staffed a larger hospital. Others emphasized that faith‑based organizations were often more effective at face‑to‑face engagement with communities.

The 2016 lessons roundtable held with U.S. military representatives highlighted the indispensable role of the U.S. Navy’s Mobile Diagnostic Laboratories (MDLs) in West Africa. Operated by the Naval Medical Research Center (NMRC) in Guinea and Sierra Leone, these PCR‑based laboratories provided the only rapid diagnostic capacity early in the outbreak. The U.S. Air Force also played a critical role in airlifting doctors and epidemiologists across Liberia during the fall of 2014.

The roundtable at George Washington University’s Milken Institute School of Public Health, composed largely of NGO headquarters emergency coordinators—generated two major cautions about international response. First, although each NGO had developed new guidelines and standard operating procedures for Ebola‑type emergencies, there was no funding to package, archive, or preserve these materials for future use, and many were already being lost. There was no forward planning for how such lessons might be applied in future outbreaks, including today in the DRC.  Second, although not on the agenda, participants volunteered that their organizations now have serious reservations about having responded at all, given the massive legal and duty‑of‑care liabilities they incurred. Donors urged NGOs to respond, but were unable to shield them from punitive audits afterward.

See also:  https://www.worldhunger.org/ebola-lessons-from-2014-for-2026/