The WHO's Ebola response in North Kivu province is operating under conditions that have no precedent in the agency's disease control history. Active armed conflict between government forces and multiple rebel groups makes routine contact tracing and vaccination activities dangerous for field workers and contributes to population displacement that spreads the virus faster than containment measures can be implemented.
The agency has developed conflict-sensitive protocols that involve community engagement with armed group leadership to secure passage for health workers in their controlled territories, an approach that has achieved some success in specific localities but remains deeply precarious and dependent on the continued goodwill of actors whose cooperation cannot be guaranteed. International humanitarian law protections for health workers are regularly violated in active conflict zones, creating safety risks that limit the number of international responders willing to deploy to the region.
