In the Democratic Republic of the Congo and Uganda, more than half of the people who are getting sick with Ebola are women and girls.
This has happened in past Ebola outbreaks too.
This Rapid Gender Analysis (RGA) reviews what the evidence shows, and what it does not yet show, about gender in this outbreak.
The 2026 outbreak is caused by Bundibugyo virus, which is one type of Ebola.
It is now the largest recorded outbreak of this type, and the World Health Organization has called it a global health emergency.
By 17 June 2026, the Democratic Republic of the Congo had reported 837 confirmed cases and 196 deaths, most of them in Ituri Province.
Uganda had reported 19 confirmed cases and two deaths.
There is no licensed vaccine and no specific treatment for Bundibugyo virus.
That makes stopping exposure the main way to save lives, and stopping exposure is where gender matters most.
The sections below stay close to what the data can support, and they say clearly where the picture is still uncertain.
More than half of the cases are women, but we should read that number carefully
By early June 2026, women were 53.4% of the confirmed Ebola cases that had sex recorded.
At the very start, women were more than 60% of suspected cases, according to the World Health Organization.
This deserves a careful reading, not a quick conclusion.
A case count tells us two things at the same time.
It tells us who got infected.
It also tells us who got tested and counted.
Both can be shaped by behaviour, by fear, and by how a health system records people.
So the number is a starting point for a question, not the end of one.
The same pattern has shown up before.
- In the 2018 to 2020 outbreak in eastern Congo, women were 57% of cases.
- In the Kasai outbreak in 2025, women were 57.8% of confirmed cases.
- Across West Africa from 2014 to 2016, women were about 51% of cases overall.
The pattern is steady across many outbreaks, which is why it is worth taking seriously.
The leading explanation is exposure, not biology
The most widely supported explanation is that women are more exposed to the virus through the work they do.
Reviews of past outbreaks find no evidence that female bodies catch Ebola more easily than male bodies.
The difference comes from contact, not from biology.
In many communities, women do most of the caring for sick relatives, much of the household cleaning, and a large part of preparing bodies for burial.
Each of these brings close contact with the fluids that spread Ebola.
Burial matters a great deal for Bundibugyo virus.
In the 2007 outbreak in Uganda, handling dead bodies without protection was the single largest way the virus spread.
It is important to be precise about why this work falls to women.
- It is not because of something fixed in their culture.
- It happens because of how roles, money, and power are arranged, and those arrangements are shaped by poverty, by conflict, and by history.
Naming culture alone as the cause hides the larger forces at work.
What we do not yet know, and why honesty matters here
We should be honest about the limits of the data.
A case count can be pushed up or down by how people seek care and how cases are found.
Some evidence here points in a direction that may surprise some readers.
- In several settings, families have been more likely to seek medical care for men than for women.
- During outbreaks, many women and girls have avoided health centres because they were afraid of catching the virus there, or of being forced into isolation.
- In Sierra Leone, women reported avoiding care for fear that bleeding would be mistaken for Ebola and lead to quarantine, so injuries and violence went untreated.
If anything, these patterns suggest that women may be undercounted.
That would mean the true exposure gap could be even larger than the case numbers show.
So a careful conclusion is this:
- Women are a consistent majority of Ebola cases.
- The best explanation is that they are more exposed through their work.
- Health-seeking and testing also shape the numbers, and they appear to work against women rather than in their favour.
- The exposure explanation is strong, but it should be held as the leading explanation supported by evidence, not as the only possible cause.
A second crisis: pregnancy and maternal health
Pregnancy makes Ebola far more dangerous.
The outbreak also puts pregnant women in a terrible position.
UNFPA estimates that the outbreak threatens the health of about 37,820 pregnant women in the Ituri response area alone, and about 642,000 women of childbearing age across the wider response area.
UNFPA describes a second, less visible crisis.
Some pregnant women, afraid that the hospital is where Ebola spreads, are staying home to give birth.
A problem that could have been treated becomes a death.
During the West Africa epidemic from 2014 to 2016, the number of mothers who died is estimated to have risen by about 75%.
This happened because health workers died and because women stopped coming to clinics.
In Guinea, the use of pregnancy care was still 37% below normal even after the outbreak ended.
Maternity care must be protected from the first day, not rebuilt after the outbreak.
Health workers carry a double load, and most of them are women
Health workers face a much higher risk of catching Ebola than the general public.
The lower-paid health roles, such as nursing, midwifery, community health work, and cleaning, are mostly done by women.
So women carry much of this risk.
In the current outbreak, the first Ebola infections reported at the Nyakunde medical centre in Bunia were all among frontline health workers, and four of them died.
Health facilities in Bunia are reporting a serious shortage of protective equipment for the people doing this work.
Protecting health workers is both a safety measure and a matter of equity.
Outbreaks and violence against women feed each other
Outbreaks and violence against women are linked.
They often rise together because they share the same roots, such as poverty, fear, and the breakdown of normal life.
In the 2018 outbreak, the International Rescue Committee asked community members in Beni whether violence against women had changed.
21 of 24 said it had increased since the outbreak began.
This outbreak sits on top of a long war.
Ituri has lived through more than 20 years of armed conflict, and sexual violence linked to the conflict had already risen by more than a third in the year before the outbreak.
Movement restrictions and insecurity now make it harder for survivors of rape to reach care.
There is also a medical reason to act.
Men who survive Ebola can carry the virus in semen for months, and in many communities women have little power to insist on condom use.
Abuse by aid workers was a separate crime, not a side effect of the virus
We must be careful and exact about one of the worst events of the last outbreak.
During the 2018 to 2020 response, an independent commission found that 83 responders, including 21 WHO staff and consultants, had likely abused Congolese women by trading work for sex.
The commission confirmed cases of rape and many resulting pregnancies.
Later reporting found that more than 100 women came forward, and that survivors received one-off payments of 250 dollars.
It would be wrong to say that the virus, or the outbreak, caused this abuse.
The abuse was caused by the people who committed it, and it was allowed to continue by agencies that failed to prevent it and failed to punish it.
What the outbreak did do was create the conditions that those men exploited.
Many local women depended on response jobs for income, and there was a wide power gap between international staff and local women.
That gap is the same kind of power gap that shapes who is most exposed to the virus.
The two problems share a root in unequal power.
They do not share a cause.
Keeping this distinction clear protects two things at once.
It holds the right people responsible, and it respects the women involved as people who were wronged, not as an unlucky outcome of a disease.
New teams are now arriving in the same region.
Preventing abuse by responders is not an extra task to add later.
It must be in place before staff are deployed.
What works: women, organised and funded
The evidence on what helps is as clear as the evidence on what harms.
In one 2025 study, communities that had active women’s groups were far more likely to report Ebola-like symptoms early.
Early reporting shortens outbreaks and saves lives.
Information itself is unequal.
A survey of 1,395 adults in eastern Congo found that men reported knowing more about Ebola, and that this was linked to higher vaccine acceptance and safer behaviour.
Women were more likely to believe rumours.
When outbreak information travels mainly through channels that men control, women are left out.
Women-led organisations are the most trusted way to close that gap, yet they receive far less money than other groups.
This is a choice about funding, and it can be changed.
Some of the right actions are already under way.
UNFPA has activated its highest level of emergency response, deploying midwives across 29 health zones, supplying protective equipment made for delivery rooms, and integrating services for survivors of violence.
The limit is money.
UNFPA had raised about 2.8 million dollars against a need of 15 to 20 million dollars, so the gap itself is a gendered harm.
Whose knowledge counts
There is a deeper issue under the data gap.
A 2024 review found that, even now, outbreak responses rarely collect and use data broken down by sex, despite years of calls to do so.
This pattern seems to be repeating in 2026.
Early reports gave case counts without showing sex, and the gender picture became visible mostly because UNFPA and UN Women spoke up.
The harder question is whose knowledge is treated as expert.
The usual model sends an outside specialist to find out what local women already know.
A fairer and faster approach is to fund local women-led organisations directly, treat them as the authors of the analysis, and let the outside agency carry the paperwork instead of taking credit for the findings.
The women living through the crisis are already analysing it every day.
The fastest way to understand the crisis is to listen to them and fund their organisations so they can cover costs.
Two gender analyses already exist, and they are worth reading closely
Two Rapid Gender Analyses for this outbreak have already been published, one by CARE International and one by a group of consultants.
Both were produced in days, which is a real achievement.
Both also describe women mostly as a vulnerable group, and explain their risk mostly through roles and customs.
That framing shapes what a responder sees, and what they fund.
Learn more: Reimagining Rapid Gender Analysis as decolonial practice
A Rapid Gender Analysis exists to make sense of a confusing situation fast enough to act.
If it tells you women are a vulnerable group shaped by their customs, you will protect them with messages and add a gender note to your plan.
If it tells you women are the workforce and the intelligence network of the response, operating inside a war and a broken health system, you will resource them and recognize their leadership of the parts they already run.
The same outbreak, read two ways, produces two different actions.
One of them works better for women and girls.
The framing also decides whether the response is trusted.
In the 2018-2020 Ebola outbreak, a heavily biomedical approach that sidelined community concerns about insecurity and poverty helped drive resistance to the response.
A community that distrusts responders is one where women delay care, hide symptoms, and refuse isolation.
Treating women as the network that already holds local trust becomes a condition for containing the outbreak at all.
Practical recommendations for Bundibugyo outbreak responders
Gender shapes who gets sick, who gets care, who does the dangerous work, who is harmed during the response, and who carries the cost long after.
The Bundibugyo outbreak is showing this again, in real time.
Here is a short list of actions that do not need to wait for the outbreak to end.
- Share case data broken down by sex from the very first report.
- Protect maternity care so that staff and rooms are not pulled away from it.
- Give protective equipment first to the caregivers and health workers most exposed, most of whom are women.
- Plan safe and dignified burials together with women, since they often do this work.
- Send health information through women’s groups and networks that women already trust.
- Keep services for survivors of violence open, and fund the local women-led groups that run them.
- Put strong measures against abuse by responders in place before any staff arrive.
None of this is new knowledge.
That is the point.
We already know what an Ebola outbreak does to women and girls, because it has happened before.
The real test of this response is whether we act on what we already know.
Bundibugyo virus outbreak response: learn, take action, and get certified
Share your experience and learn from colleagues about Bundibugyo virus outbreak response. Learn more and enrol in this certification from The Geneva Learning Foundation: HH-EN-01 Share experience: Bundibugyo virus outbreak response in Uganda and the Democratic Republic of Congo
Learn with peers who are living this work
The Geneva Learning Foundation (TGLF) offers the Certificate peer learning programme for gender in emergencies.
It is built on the experience of community-based practitioners and grounded in intersectional, decolonial, and feminist scholarship.
In response to the outbreak, we are opening two courses.
- One is a short introduction, Gender in emergencies: a rapid introduction.
- One is a practical guide, Mitigating gender-based violence in practice.
We believe no one should have to pay in order to learn how to protect women and girls in an emergency.
Gender-based violence in health settings: learn, take action, and get certified
Share your experience and learn from colleagues about Gender-based violence in health settings. Learn more and enrol in this certification from The Geneva Learning Foundation: EQUITY-EN-004 Mitigating gender-based violence (GBV) in practice: a primer for health and humanitarian responders
Gender in emergencies: learn, take action, and get certified
Share your experience and learn from colleagues about Gender in emergencies. Learn more and enrol in this certification from The Geneva Learning Foundation: EQUITY-002 Gender in emergencies: a rapid introduction
That is why these course are open access, with costs supported by TGLF and its partners.
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