Congo's Ebola Outbreak Is the Second-Largest Ever Recorded. The City It Has to Move Through Is Run by a Rwanda-Backed Militia.

STAT's 16 September report carries the current toll directly from Tedros: 7,258 cases and 3,510 deaths as of Sunday 14 September, with transmission 'declining in most of the affected provinces' even as he stresses the response has months of work left. MSF's own count, current to 1 September, puts confirmed cases at 6,250 with 3,039 deaths and over 1,400 survivors, and details the scale of its own operation: more than 1,700 staff across five eastern provinces, nine treatment centres with over 480 beds, and more than 2,770 patients admitted since May — 82% of them in Ituri province alone, where mortality has ranged from 43.7% to 67.6% depending on province. The UN's own relief chief, in a 1 September dispatch, frames the core problem bluntly: the response has to outpace the spread, and as of that report's baseline (day 100 of the outbreak) there were already 5,515 cases and 2,642 deaths — meaning the toll roughly doubled again over the following two weeks even as WHO's cautious optimism took hold.

Refugees International's June briefing lays out the access problem in granular terms: M23 'effectively governs Goma and has closed its airport,' described as 'a critical humanitarian lifeline,' while responders must 'negotiate militia checkpoints, navigate looted warehouses and border closures' across North Kivu and South Kivu — and separately notes M23 seized Uvira and displaced 200,000 civilians within days after the Washington Peace Accord collapsed. Public reporting on that accord's collapse confirms the timeline: President Trump presided over the 4 December 2025 signing of the Joint Declaration of the Washington Accords for Peace and Prosperity with DRC President Tshisekedi and Rwandan President Kagame, and Rwanda-backed M23 fighters captured Uvira — leaving at least 400 dead — within days, in a clear violation of the accords, with the Rwandan army reportedly providing support. On the funding side, Think Global Health's analysis attributes delayed detection partly to 'the dissolution of the U.S. Agency for International Development (USAID)' and 'staffing cuts at the U.S. Centers for Disease Control and Prevention (CDC),' which it says limited 'country-level surveillance capacity' — a claim the article does not back with a quantified before/after comparison specific to this outbreak, which is why this question is rated likely rather than confirmed.

Refugees International's report frames the access negotiations as inseparable from M23's territorial control — the group's closure of Goma's airport and checkpoints are described as leverage points responders must work around, not incidental obstacles, which by definition gives the group bargaining power over aid flows it would not otherwise hold. The UN relief chief's 1 September assessment stresses the response must 'outpace' the spread, implicitly crediting WHO and Africa CDC's joint appeal and vaccine trial rollout as the mechanism that could still turn the outbreak, assuming the $1.1bn funding gap narrows. Rated uncertain because no source here states plainly that M23 or Rwanda are deliberately leveraging the outbreak rather than simply continuing a pre-existing pattern of territorial control that happens to now intersect with it — the evidence supports opportunity, not intent.

MSF's own figures put the direct toll at 3,039 dead as of 1 September (since risen past 3,500), with mortality rates as high as 67.6% in the worst-hit province, and its statement that 'maintaining access to routine health care is as important as controlling the outbreak itself' is a direct acknowledgment that the crisis is compounding rather than isolated — cholera, malaria and measles are named as concurrent emergencies competing for the same strained response capacity. Refugees International's figure of 200,000 civilians displaced by the Uvira offensive alone, on top of the outbreak's own toll, describes a population absorbing both the war and the disease simultaneously. Think Global Health's linkage of the US funding collapse to delayed surveillance means the loss is not confined to the outbreak's direct victims — it extends to whatever earlier, cheaper intervention a fully funded surveillance system might have made possible. Confirmed, because unlike the causal and beneficiary questions above, the scale of loss itself is not in dispute across any source cited here.