Lessons learned from Ebola outbreak 9 in Equateur Province, Democratic Republic of the Congo

Reviews of the humanitarian response to the 9th Ebola outbreak in the Democratic Republic of the Congo (DRC) in Equateur province show that shortcomings in previous responses, such as timeliness and coordination, were largely addressed in this response, although a number of outstanding issues, particularly relating to contextualisation of the response could have been improved. Key lessons learned from the 2018 Equateur response and related humanitarian interventions are: the immediacy of the response and coordination of agencies is critical to effectiveness, there is evidence indicating that the rVSV-ZEBOV vaccine was effective in reducing the risk of spread of the virus in Equateur, health seeking behaviour is highly context specific and certain social groups are at a greater risk of exposure and transmission of Ebola in Equateur due to gender norms and discrimination towards Twa indigenous groups. Also, a key finding to be emphasised is the need for a rapid situational analysis at the outset of and any future outbreaks and regular updating of that analysis as the situation unfolds.