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When ISIS gunmen drove 180 patients from a North Kivu hospital in the DRC, a terrorism insurgency and a health emergency became one crisis that threatens regional stability.
By André Pienaar
On the night of 05 November, gunmen attacked the village of Cantine-Aloya, about 50 kilometres west of Beni in the Democratic Republic of the Congo. They killed at least 33 people, most by gunfire and the rest with machetes or fire. They burned more than 50 houses, churches and a health post. With shots and flames within 50 metres of the Kelekele Hospital Centre, 180 patients fled. The patients included one confirmed Ebola patient and five suspected cases. “High-risk contacts and other individuals under monitoring have all fled,” said the hospital’s medical director, Christian Kakule.
DRC officials blame the Allied Democratic Forces (ADF), a Ugandan-rooted insurgency that has been Islamic State’s (ISIS) Central Africa branch since 2019.
As of 03 November, the World Health Organisation (WHO) had counted 10,668 confirmed cases and 5,198 deaths, the largest Ebola outbreak ever recorded in the DRC. The Bundibugyo strain has no approved vaccine or treatment. North Kivu reported more new cases than any other province in the latest week. North Kivu has the highest provincial fatality rate, at 54.8 per cent. Its teams are seeing 82 per cent of known contacts each day, against a required 95 per cent. Ebola is contained by finding the sick, isolating them and tracing everyone they touched. Terrorist attacks, massacres, arson and mass flight break each of those links. The DRC Government does not seem to have the capacity to contain either.
Almost exactly a year ago, in Byambwe, the ADF, also known as ISIS Central Africa, killed at least 17 people inside a Catholic-run health centre and set four wards alight. In the Beni-Lubero belt today, every such raid also scatters potential carriers of a lethal virus into the forest, into neighbouring towns and the region.
ISIS Central Africa is badly underestimated. It is the branch of ISIS in Africa with the most lethal attacks in 2026. In August, the UN’s sanctions monitors reported that it was operating at a “heightened level of lethality” while pushing as far north as Haut-Uélé. ISIS Central Africa carried out more than 80 attacks and killed more than 400 people in the first five months of this year. ACLED data made it the world’s second deadliest non-state armed group in 2025. Amnesty International has documented war crimes and crimes against humanity, including the abduction of children and forced marriage.
The UN estimates that all this is the work of an insurgent force of 2,000 with 600 battle hardened adult male fighters. Their advantage is mobility. The Soufan Center has documented small mobile units using Starlink, surveillance drones and handheld GPS. The group’s leader, Musa Baluku, has relocated his headquarters north into Haut-Uélé. ISIS Central Africa strikes where the DRC state is absent across this vast terrain and quickly moves when any semblance of the state arrives.
A weak DRC government is running the counter-terrorism campaign and the Ebola campaign on separate tracks without any capacity to contain either. Both threats are rapidly escalating. Since the ISIS Central Africa attack of 05 November on the health center these two threats are also intersecting. An undefeated ISIS insurgency in the DRC and an uncontrolled ebola epidemic each poses a serious threat to regional stability. But the combination of a jihadist insurgency that weaponises the ebola epidemic in the DRC is a grave threat to the entire world.
I helped to build the Scorpions for Mandela in South Africa as an elite law enforcement and counter terrorist unit. I still assess armed groups as an investigator would by following the money. The Sentry’s investigation, published in October, found that trafficked gold now provides most of ISIS Central Africa’s new financing. Mines around Manguredjipa alone yield an estimated $1 million to $1.6 million a year. The UN reports that the group’s financier, Meddie Nkalubo, remains a key link to the ISIS core and moves funds through cryptocurrency, mobile payments, banks and informal transfers. One member state told the UN that he has rebuilt his network since the 2024 arrest of Abubakar Swalleh, whom the US Treasury identified as physically moving funds from South Africa to DRC through corruption.
The stakes are extremely high. ISIS Central Africa’s operations has already reached Kampala, the capital of Uganda, where its suicide bombers struck in 2021.In the same year, the Rwandan police arrested an ISIS Central Africa cell of 13 operatives who were planning similar suicide bombing attacks in Kigali. Since 2021 meetings to share tactics and strategy have been documented by the UN Panel of Experts between ISIS Central Africa and ISIS Mozambique to coordinate a jihadist insurgency across central and southern Africa. In March 2026 ISIS Central Africa attacked the Chinese-owned Muchacha mine, a fortified industrial site guarded by DRC soldiers, which should concern anyone counting on the region for secure mineral supply.
The WHO on 14 August assessed the ebola risk as very high in the DRC, high for the countries bordering the DRC, and still low globally. But the WHO is quickly revising that assessment. Ebola cases have already reached France, Kenya, Nigeria and Uganda, while the first ebola case involving a British aid worker in the DRC last week reached the United Kingdom.
At last report, nobody could say whether the ebola patients of Kelekele had returned to the medical center. Ebola can incubate for up to 21 days. The impact of this ISIS Central Africa’s attack may not surface until much later, but by then it may be too late.
