Ebola Threatening Millions of Children Already Living on the Edge

As confirmed Ebola cases reach 1,000, UNICEF has warned that nearly 3 million children and adolescents are at risk in affected health zones of eastern Democratic Republic of the Congo. The outbreak is not only exposing children to infection, death and orphanhood, but also threatening essential services in a region already weakened by conflict, displacement, malnutrition and low immunisation coverage.

Ebola is spreading through eastern Democratic Republic of the Congo, but the virus is only one part of the emergency. With confirmed cases now at 1,000, UNICEF warns that nearly 3 million children and adolescents are at risk in affected health zones where conflict, hunger, low immunisation and weak access to care have already left young lives exposed. Children account for a smaller share of confirmed cases than adults, but a far larger share of deaths, a sign that the outbreak is hitting the youngest hardest where protection is already thin.

According to UNICEF, an estimated 2.95 million people aged 18 and under are at risk from Ebola and from the breakdown of essential services across 31 affected health zones. Children and adolescents make up 54 per cent of the population in those areas, turning the outbreak into a public health crisis with a major child protection dimension.

As of 19 June, children and adolescents accounted for approximately 15 per cent of confirmed Ebola cases and more than 25 per cent of confirmed deaths in eastern DRC. Children with confirmed Ebola are almost twice as likely to die as adults, underscoring how quickly the disease can become more dangerous when it strikes younger populations already weakened by poor nutrition, low immunisation and limited access to care.

The Virus Is Spreading Through a Region Already Under Strain

The outbreak's epicentre is Ituri Province, particularly the Mongbwalu, Rwampara and Bunia health zones. Cases have also been reported in North Kivu and South Kivu, raising concern in a region long affected by conflict, displacement and insecurity. Ebola containment depends on rapid detection, contact tracing, safe care, community trust and reliable access to affected areas. In eastern DRC, those conditions are difficult to maintain. Testing capacity has recently improved, but surveillance and contact tracing remain constrained by insecurity and restricted access.

The danger for children is escalated by conditions that existed before the outbreak. In Ituri, more than half of children under five are chronically malnourished. Immunisation coverage is also weak, with more than one in five children never having received a first dose of the diphtheria, tetanus and pertussis vaccine. These vulnerabilities can make Ebola harder to detect and more dangerous to survive. Early Ebola symptoms can resemble other illnesses such as malaria, delaying diagnosis. Malnutrition can also increase children's vulnerability, making a fast medical response even more critical.

For Children, Ebola Is Not Only an Infection Risk

The outbreak is separating children from the adults who care for them. In Ituri, 135 children orphaned by Ebola are receiving support, including psychosocial care, referral to essential social services and alternative care arrangements.

Ebola outbreaks are medical emergencies, but they also generate fear, stigma and trauma. Children may lose parents, be separated from caregivers during treatment, or be shunned by communities that associate them with infection. Even children who never contract the virus can suffer lasting emotional and social harm.

The opening of a UNICEF-supported nursery for infants and young children separated from parents or caregivers receiving treatment is therefore more than a welfare measure. It is part of outbreak control. Children need safe care while adults receive treatment, and families need systems that reduce fear around seeking help. Two additional nurseries are expected to open soon.

Essential Services Are at Risk of Collapsing Around the Outbreak

Ebola is also threatening the systems children depend on to survive. Healthcare, nutrition, immunisation, education, water and sanitation, child protection and social services are all under pressure. When health workers and humanitarian teams shift resources toward Ebola containment, routine services can weaken. When families fear visiting clinics, children may miss vaccinations, nutrition support or treatment for other illnesses. When schools and community services are disrupted, children can become more exposed to exploitation, violence and neglect.

The risks are especially severe in eastern DRC because conflict and mass displacement have already exposed children to protection threats. Infectious disease outbreaks can also increase the risk of violence, including sexual violence, against women and girls. In fragile settings, the secondary effects of an outbreak can outlast the immediate wave of infection.

UNICEF's response is focused on both containment and continuity of services. The agency is supporting infection prevention and control, contact tracing, safe and dignified burials, and community engagement with young people and community leaders. Meanwhile, the UN agency is working to keep essential services running, from nutrition and immunisation to education, water and sanitation, and child protection.

The Cross-Border Risk Makes Delay More Costly

The outbreak has already crossed into Uganda, where 20 Ebola cases and two deaths have been confirmed among people who travelled from DRC to seek testing and treatment. Children have also been affected there: one child has tested positive, and 19 are under quarantine monitoring. The cross-border dimension raises the stakes. Ebola response depends on coordination between governments, health agencies and communities. Delays in testing, tracing or isolation can allow transmission to move across health zones and borders. In parallel, overly restrictive or poorly communicated measures can undermine trust and discourage people from seeking care early.

UNICEF is working with governments and partners, including WHO and Africa CDC, to contain the outbreak in DRC and Uganda. But funding remains a serious constraint. The agency is seeking US$70.7 million for its initial six-month response, with US$20 million still unfunded. It is also calling for immediate, safe and sustained humanitarian access to affected communities.

The next phase of the response will be critical. Key developments to watch next include whether confirmed cases continue to rise, whether child deaths decline, whether contact tracing improves despite insecurity, and whether cases in Uganda remain contained. The opening of additional nurseries, support for orphaned children and continued access to health and protection services will also show whether the response is protecting children beyond the immediate medical emergency.