The Ebola epidemic is spreading in the east of the Democratic Republic of Congo (DRC), a region where a myriad of armed groups are active, and where the Kigali-backed anti-government M23 group has seized vast swathes of territory, complicating the health response.

Between 2018 and 2020, an Ebola epidemic had already struck the eastern provinces of the DRC, which had been plagued by conflict for thirty years, and caused thousands of deaths.

- Community conflicts -

The epicenter of the epidemic is in Ituri, a gold-mining province in northeastern Congo bordering Uganda and South Sudan, which is experiencing intense population movements linked to mining activity but also to violence perpetrated by several armed groups.

The territories north of Bunia, the provincial capital, have been torn apart since 2017 by a violent conflict between the Hema and Lendu communities. Massacres, sometimes resulting in dozens of deaths, are regularly reported there.

The locality of Mongbwalu, the first hotspot of the epidemic, is located in an area of activity of the Codeco militia (Cooperative for the Development of Congo), which claims to defend the interests of the Lendu community.

"So far, we have not recorded any resistance from armed groups," a health official in Mongbwalu said on Monday, adding, "We are looking for strategies to reach the sick" in insecure areas.

The Convention for the People's Revolution (CRP), an armed group often associated with the Hema community, declared a unilateral ceasefire on Thursday, before the Ebola epidemic was reported.

The clashes between the CRP and the Congolese military and the Codeco militia are marked by numerous abuses and killings targeting civilian populations.

- Rebels linked to the Islamic State -

Southwest of Bunia, the capital of Ituri where the epidemic has spread, lies the vast Ituri forest, a refuge for the ADF (Allied Democratic Forces) rebels, who have pledged allegiance to the Islamic State and are carrying out numerous killings in the provinces of Ituri and North Kivu.

Formed by former Ugandan rebels, the ADF are notorious for their extreme violence against civilians, and killed at least 36 people in several attacks in early May.

The road leading from Bunia, the capital of Ituri, to Beni, a major city in the north of North Kivu province, crosses an area plagued by regular attacks from the ADF.

Health and humanitarian personnel are not spared by the fighters of this armed group, who kill indiscriminately on roads where the military is slow to intervene, despite the deployment of the Ugandan army in the province since 2021.

- Front lines -

The provinces of North Kivu and South Kivu are cut in two by the front lines between the forces of Kinshasa and those of the M23 supported by the Rwandan army.

Fighting has continued there since the start of the epidemic and despite the signing of a peace agreement between the DRC and Rwanda in early December, particularly in South Kivu, according to local sources.

Goma International Airport, which allowed emergency humanitarian aid to be delivered to the region, has been closed since the city was taken in January 2025.

The parties to the conflict signed a declaration in Switzerland in April committing them to facilitate the deployment of humanitarian aid.

François Moreillon, head of the International Red Cross (ICRC) delegation in the DRC, called on Monday for the "sense of responsibility" of the belligerents, urging them to open "the way to effective humanitarian access, cooperation and coordination".

- Parallel administration -

The first case of contamination has been confirmed in Goma, a major city in the east of the country and bordering Rwanda, which the anti-government armed group M23 seized in January 2025.

The M23 has installed a parallel administration in the areas under its control, but has never faced the challenge of managing a large-scale epidemic.

The governors appointed by the M23 of the provinces of North Kivu and South Kivu announced on Sunday the deployment of health, monitoring and awareness teams to the population, and a strengthening of health measures in health facilities and areas with high concentration.

Since Sunday, "no new cases have been recorded," the M23 spokesman said in a statement on Monday.