drc-conflict

Somewhere in the Democratic Republic of Congo this week, a health worker is trying to explain to a frightened family why there is no vaccine for the virus that is killing their relatives. The answer is not that science has failed. Scientists have built candidate vaccines. The answer is that the doses are not reaching the people who need them, and the people who could release them have decided that their own stockpiles come first.
The Bundibugyo strain of Ebola is now spreading through Congo, with cases reported in Kenya and Nigeria as well. No vaccine is licensed specifically against it. What exists is Ervebo, licensed against the Zaire strain, which Congo's Ministry of Health is already using in the response even though nobody has proven it protects against Bundibugyo. That is a gamble being placed with African lives, and it is being placed while the supply of even that imperfect tool is being rationed.
Médecins Sans Frontières, through its Access campaign, has examined four vaccine candidates: Ervebo, rVSVΔG-BDBV-GP, ChAdOx1-BDBV-GP, and mRNA-1469. Two of these are being evaluated in trials, including the MSF-led BRAVO study and the Tumaini trial, to test whether Ervebo offers cross-protection. The findings are alarming not because they reveal a scientific mystery but because they expose a planning vacuum. Access was not built into these programs from the beginning. It is being improvised in the middle of an outbreak.
Consider what that means on the ground. A vaccine trial that enrolls people in Bunia or Butembo without a guaranteed supply pipeline is a study of who gets sick and who gets lucky. A vaccine that is proven effective in a laboratory in Geneva or Oxford but cannot reach a rural clinic in Ituri is a press release, not a public health intervention. Every week that passes without a clear allocation plan is a week in which nurses are unprotected, families are exposed, and the virus moves along the same trade routes and roads that people use to bury their dead and seek work.
MSF has urged Merck Sharp & Dohme, the company that manufactures Ervebo, to commit all Ervebo doses produced in the coming months to the global stockpile. It has also called on high-income countries to stop reserving doses beyond their immediate public health needs. Read that again. Wealthy nations are holding back vaccines against a deadly disease while outbreaks spread in countries that cannot afford to wait in line. This is not an accident of logistics. It is a choice about whose lives are treated as urgent.
We have seen this movie before. During the COVID-19 pandemic, rich countries secured billions of doses in advance while many African nations waited for months to receive their first shipments. Africa's vaccination rates lagged far behind those of Europe and North America, and the excuse was always supply constraints. The truth was simpler. Access was treated as charity, not as a shared obligation, and the countries with the most money made the most calls.
Now add the war. Eastern Congo is not a stable place to fight an epidemic. Since early 2025, the M23 armed group has controlled major urban centres including Goma and Bukavu, dismantling the state structures that a health response depends on. UN experts have repeatedly documented that Rwandan Defence Force units have operated inside Congolese territory alongside M23, a finding Kigali denies. Whatever one concludes about the chain of command, the result on the ground is the same. Clinics are cut off, supply chains are broken, and health workers are afraid to walk into the communities that most need them. An Ebola vaccine cannot be delivered by a cold chain that no longer exists, into a region where armed men decide who crosses the checkpoint.
Let us be precise about the moral arithmetic. The Congolese state is weakened by decades of conflict, by a war that is being fought partly on its territory with external backing, and by a global system that has repeatedly prioritised pharmaceutical margins over preparedness. Each of these pressures compounds the others. A mother in North Kivu does not care whether the vaccine gap was caused by a factory bottleneck, a contract clause, or a boardroom decision. She cares that her child is dying and no one is coming.
The solutions are not mysterious. They are overdue. Africa has already shown that a better model is possible. Rwanda, for all its failings in the Congo, has invested in building a domestic vaccine manufacturing hub in Kigali with BioNTech, a deal that signals what is achievable when governments commit to local production and transparent partnerships. South Africa's Biovac Institute and Senegal's Institut Pasteur de Dakar have demonstrated that African manufacturing capacity can be real. Botswana and Mauritius, with their track records of stable institutions and disciplined public finance, show that when rule of law and predictable governance are in place, investors and health systems alike can plan for the long term. These are not miracles. They are the building blocks of resilience: independent regulators, enforceable contracts, transparent procurement, and a private sector that competes on quality rather than on exclusive access.
What should happen next is concrete. First, every Ervebo and candidate vaccine contract should include binding access clauses that guarantee allocation to outbreak-affected countries before any stockpiling by high-income governments. Second, the African Medicines Agency and the African Vaccine Manufacturing Accelerator should be funded and empowered to fast-track regulatory approval and technology transfer, so that the next outbreak is met by African hands and African factories, not just African patients. Third, trial protocols must publish their allocation plans, their timelines, and their supply commitments before enrolment begins. Scientific ethics without supply ethics is a half-finished promise.
And we, the citizens, have a role that goes beyond sympathy. Congolese civil society, doctors' associations, and journalists in Goma, Kinshasa, Nairobi, and Abuja must demand public answers. Ministers of health must be asked, in parliaments and press conferences, how many doses they have secured, from whom, and when they will arrive. Regional bodies like the African Union and the East African Community must stop issuing statements and start tabling binding protocols for cross-border outbreak response. The UN Security Council, which has the power to protect health workers and humanitarian corridors in conflict zones, must treat an Ebola outbreak in a war zone as the emergency it is.
So here is the question that every African leader must answer. When the next vaccine arrives, will it go to the people who are dying, or to the countries that can pay the most? We already know what the wealthy will say. They will talk about manufacturing limits, regulatory caution, and the complexity of supply chains. Those are real problems, and they are solvable. What is not solvable is the decision to put our lives in second place.
Congolese mothers should not have to bury their children while vaccine doses sit in warehouses in Europe and North America. Nigerian and Kenyan health workers should not be the ones explaining to their communities why a vaccine trial is happening in one district and not another. Demand transparent allocation data. Demand binding access commitments in every contract. Demand that Merck release its doses to the global stockpile and that rich governments stop hoarding. The virus does not respect borders, and neither should our solidarity.
Based on reporting by RELIEFWEB