Ebola emergency in Congo could deepen gender-based violence crisis

A new public health emergency declared by the World Health Organization (WHO) over an Ebola outbreak in eastern Democratic Republic of Congo is likely to have severe secondary impacts on women and girls, according to an opinion article published in Stat News by public health professor Lindsay Stark of Washington University in St. Louis.

The WHO has reported that the Bundibugyo strain of Ebola—described as having no available vaccine or treatment—is spreading in eastern DRC, with more than 900 suspected cases and about 220 suspected deaths. The outbreak, centred in a conflict-affected region with fragile health systems, has already crossed into neighbouring Uganda.

In the opinion piece, Stark warns that while public health responses will focus on transmission rates, mortality, and containment measures, the social consequences for women and girls are likely to receive less attention.

Drawing on a systematic review of 112 studies on violence against women and girls during infectious disease outbreaks, the article argues that such crises consistently increase the risk of gender-based violence through interconnected factors, including income loss, movement restrictions, school closures, reduced access to healthcare, fear of infection, and weakened trust in health systems.

The author states that these mechanisms were repeatedly observed across multiple countries and outbreaks, including previous Ebola outbreaks in the Democratic Republic of Congo and the Covid-19 pandemic.

The opinion piece warns that, in the current outbreak, households in affected areas may face reduced incomes as markets shut and movement is restricted, while women could be confined with abusive partners and have fewer opportunities to seek help. It also highlights concerns that school closures may increase risks of early marriage and sexual exploitation for girls, and that overstretched health facilities may deprioritise care for survivors of sexual violence.

The article further notes that disruptions to services during earlier outbreaks led to reduced reporting of domestic violence cases, as survivors feared poor treatment or lack of support.

Stark also argues that three factors make the current outbreak particularly concerning: the absence of a vaccine, reductions in international public health funding and infrastructure, and a shift toward remote or digital support services that may not be accessible to the most vulnerable populations.

According to the opinion piece, digital reporting tools such as hotlines can be effective only for individuals with access to phones, internet connectivity and privacy—conditions that many at-risk women do not have.

However, the author also cites evidence that mitigation is possible, pointing to strategies such as integrating gender-based violence monitoring into outbreak surveillance, maintaining or restoring funding for survivor services, ensuring that clinical and shelter services remain operational with appropriate protection measures, training frontline responders, and keeping schools open or providing structured alternatives.

The article concludes that while the risks are well documented in previous outbreaks and WHO guidance, the outcomes are not inevitable if gender-based protections are incorporated into emergency responses from the outset.

By Sabina Mammadli