Drivers of Ebola Virus Disease Resurgence in DRC: A Root Cause Analysis of the 16th Outbreak in Mweka, Kasai Province (2025)

In 2025, the Democratic Republic of the Congo (DRC) experienced its 16th Ebola Virus Disease (EVD) outbreak, centered in the Bulape Health Zone of Kasai Province, amid multiple concurrent epidemics and limited health infrastructure. Genomic sequencing revealed a novel zoonotic spillover genetically related to the 1976 Yambuku strain. A Root Cause Analysis (RCA) using the “5 Whys” framework, integrating epidemiological data, genomic analysis, and surveillance reports, identified key contributors to delayed detection and response, with comparative insights drawn from the 2018–2020 North Kivu outbreak. The Mweka outbreak resulted in 28 confirmed, probable, or suspected cases and 15 deaths, including four healthcare workers. Root causes included inadequate ecological surveillance, weak community alert systems, diagnostic delays due to reliance on centralized laboratories, health system overload from concurrent outbreaks, and structural underfunding of preparedness and coordination. Unlike North Kivu, where security issues drove response delays, systemic and ecological vulnerabilities predominated in Mweka. These findings highlight how ecological and structural weaknesses facilitate novel Ebola spillovers and their escalation, emphasizing the need for sustained investment in One Health surveillance, decentralized diagnostics, and resilient public health governance to strengthen outbreak response capacity.