A British nurse who treated patients during the West African Ebola epidemic has warned that the latest outbreak in the Democratic Republic of Congo presents ‘massive challenges’ to global health security, as the World Health Organisation grapples with funding shortages and political instability in the region.
Rachel Miller, a veteran intensive care nurse from Manchester who spent six weeks in Sierra Leone in 2015, spoke to the Manchester Evening News after the WHO declared the outbreak a ‘public health emergency of international concern’. She described the situation as ‘incredibly precarious’, noting that the DRC’s fragile health system, combined with conflict and community mistrust, could allow the virus to spread unchecked.
‘In Sierra Leone, we had the military and international aid pouring in, but here you have armed groups, displaced populations, and a healthcare system that was already on its knees before this started,’ Miller said. ‘The challenges are enormous. If we don't get a grip on this quickly, it won't just stay in the DRC. This is a global threat.’
Her comments come as the death toll from the outbreak, which began in August 2018, approaches 1,500, with more than 2,000 confirmed cases. It is the second largest Ebola outbreak in history, behind only the 2014-2016 epidemic that killed more than 11,000 people across West Africa.
The WHO’s emergency declaration, made on Wednesday, was intended to galvanise international support, but Miller warned that without sustained funding and a coordinated response, the crisis could spiral. ‘We saw what happened with the 2014 outbreak. It was catastrophic because the world didn't act fast enough. We cannot afford to make that mistake again.’
Miller’s concerns are echoed by public health experts who point to the DRC’s unique challenges. The outbreak is concentrated in North Kivu and Ituri provinces, areas plagued by armed conflict and large-scale displacement. Health workers have been attacked, and distrust of authorities has led to community resistance. In April, two Ebola treatment centres were burned down in coordinated attacks.
‘It's not just about the virus. It's about the context,’ said Dr. Alastair Grant, an epidemiologist at the London School of Hygiene and Tropical Medicine. ‘You have to build trust, you have to ensure security, and you have to have a well-funded health system. All of these are lacking.’
For Miller, the human cost is central. She recalls the fear she saw in patients’ eyes during her time in Sierra Leone. ‘When a child dies from Ebola, it's not just a number. It's a family destroyed. The people in those communities are terrified, and they need our help. We have a moral responsibility to act.’
But funding remains a critical issue. The WHO has appealed for $148 million to fight the outbreak, but as of this week, only $74 million had been received. The UK has pledged £5 million, but critics say that is insufficient given the scale of the threat.
‘This is a classic case of short-term thinking,’ said Miller. ‘If we don't invest now, we'll end up spending billions later on containment, treatment, and economic damage. It's cost-effective to act early, but more importantly, it's the right thing to do.’
The British government defended its contribution, stating it was ‘working closely with international partners’ to support the response. A Foreign Office spokesperson said the UK was providing ‘expertise and equipment’ to help contain the virus.
As the outbreak enters its eleventh month, the clock is ticking. Miller’s message is stark: ‘We cannot look away. This is not a problem for the DRC alone. It's a problem for all of us.’
