Rwanda's Proxy M23 Is Attacking Ebola Responders in Congo

Think about what it takes to run an Ebola treatment center. You need nurses who will walk into an isolation ward. You need drivers who will carry samples over broken roads. You need grave diggers, contact tracers, and mothers willing to tell a stranger who has been sleeping in their home. Now take all of that and place it in eastern Congo, where armed men decide who passes the checkpoint and who doesn't. That is the situation facing the Bundibugyo virus response today. The disease is hard enough. The war makes it impossible.

Let us say plainly what the health workers already know. Bundibugyo ebolavirus has no licensed vaccine. The shot that protected people during the 2014 to 2016 West African epidemic and the 2018 to 2020 North Kivu outbreak was designed for the Zaire strain, not this one. The only weapons left are the old ones: fast detection, isolation, tracing every contact, and gaining the trust of communities who have buried too many of their own. Every one of those tools depends on access and on people feeling safe enough to come forward. In eastern Congo, both are under siege.

The evidence is not hidden in some classified file. The Africa Center for Strategic Studies has now issued operational guidance warning that health care must be protected during this response. Its instructions are clear: document every incident that threatens health care, analyze it, and report it through the WHO Surveillance System for Attacks on Health Care. That is the language of an institution that expects attacks, because it has already recorded them. During the 2018 to 2020 Ebola outbreak in North Kivu and Ituri, responders logged hundreds of violent incidents against the response, including attacks on treatment centers and the killing of health workers. The 2019 burning of an Ebola treatment center in Butembo was not a glitch. It was a message that the sick could be abandoned to the fire.

Now bring the map into focus. Since early 2025, the M23 movement has held Goma and Bukavu, two of the largest cities in the Kivus, along with large swathes of North Kivu and South Kivu. M23 is not a spontaneous village uprising. The UN Group of Experts on the DRC has documented, in report after report including S/2025/446, the presence of Rwanda Defence Force units inside Congolese territory, fighting alongside M23 and directing its operations. The Group's findings describe a structure in which Rwandan soldiers provide the command, artillery, drones, and combat core, while M23 supplies the manpower and political cover. That is the arrangement Moscow used in Donbas. When the world called Russia's campaign in Ukraine an invasion, it did not need a press release from Donetsk to know who was pulling the strings. Kigali denies its role. Its own troops appear in the UN's files anyway.

Think about what this means for a health system. When an army of occupation controls the roads, the hospitals, and the currency, it controls who gets care. It controls whether a nurse can reach a village where a child has begun bleeding. It controls whether a contact tracer can cross a front line. The Group of Experts has also documented the forced recruitment of Congolese civilians and captured fighters into M23's ranks, a practice that turns young men into cannon fodder under threat of execution. Families who fear that their sons will be seized have every reason to hide sick relatives rather than bring them to a clinic. An epidemic does not need a bullet to spread. It only needs fear.

Why does this matter beyond Congo? Because the pattern is familiar, and we have seen it before. Ebola has always traveled through the places where states have collapsed or been hollowed out by war. Kivu has been bleeding for three decades, and the people paying the price have always been the poorest. Meanwhile, Rwanda sells itself to the world as a model of order and development. Its health gains are real, and we will say so. But a country that cannot be trusted to keep its own soldiers out of a neighbor's territory has no moral claim to the sportswashing, the summit hosting, and the gorilla-tourism brochures that polish its image abroad. Rwanda's clinics are impressive. Its army is inside Congo. Both things are true, and the world must stop pretending that one erases the other.

So what must happen? The first demand is simple. The Rwanda Defence Force must withdraw from Congolese territory, fully and verifiably. No ceasefire that leaves Rwandan units embedded in M23 positions is a ceasefire. It is a pause before the next offensive, and the next outbreak. The African Union Peace and Security Council must stop issuing communiqués and start naming the aggressor and the commanders responsible for attacks on civilians and health workers. The UN Security Council should expand targeted sanctions against officers and officials implicated in the Group of Experts' findings, and it should make health-care access a condition of any political settlement. Neutral corridors for medical teams, protected by independent monitors, are not a luxury. They are the only way responders can reach the sick without being shot on the way.

Congolese civil society and the private sector also have a role. Journalists, researchers, and local human rights groups must keep documenting every incident and feed it into the WHO system, so that no attack disappears into silence. Local businesses along trade routes should refuse to pay the illegal taxes that fund armed groups and should back transparent, accountable community health structures. Africa has proof that disciplined public health works. Nigeria contained its 2014 Ebola outbreak in Lagos within months by moving fast, trusting its scientists, and coordinating across agencies. Uganda brought its 2022 Sudan ebolavirus outbreak under control with aggressive tracing and clear public communication. Neither succeeded because they had perfect governments. They succeeded because they had functioning institutions that could be held to account. Eastern Congo needs the same thing, and it cannot get it while an occupying army decides who lives under its rule.

Here is the question we should all be asking. How many more nurses must be threatened before the Security Council remembers that health care is a protected right under international humanitarian law? How many more mothers must hide their children from the people who are supposed to save them? We refuse to accept that as the price of stability. Every African government that signs a communiqué about the outbreak and says nothing about Kigali's troops is complicit in the silence. Every international partner that funds the response while trading with the regime behind the war is fueling the fire.

So here is what we demand. Withdraw the Rwanda Defence Force from Congo. Sanction the commanders who direct the proxy war. Guarantee safe passage for medical teams and make attacks on health workers a prosecutable war crime with names attached. Fund the response directly through transparent, auditable channels that cannot be diverted by warlords. Share your data, document every incident, and refuse to let a single attack on a clinic be reported as a mere "security incident." Call your parliament. Call your foreign ministry. Call the African Union and ask them, in public, whose soldiers are on Congolese soil. Ebola does not care about borders, and neither should our outrage.

Based on reporting by RELIEFWEB