Since mid-June 2020, MSF has been responding to the 11th outbreak of Ebola Virus Disease (EVD) in Equateur province in the Democratic Republic of Congo (DRC). This epidemic, in its evolution and development, was different from the one that occurred between 2018 and 2020 in the provinces of North Kivu and Ituri: although the first cases appeared in the town of Mbandaka, the provincial capital, the majority of positive patients were declared in small clusters in peripheral health zones, which were isolated and therefore very difficult for medical and logistical teams to access. Throughout the epidemic, from 1 June to 18 November 2020, no outbreak of cases was ever reported.

Because of the logistical challenges and the difficulty for patients to access care, but also because of the lessons learned from the last epidemic on families' medical decisions and choices, MSF opted for a strategy based on decentralisation of care, i.e. management of suspected and confirmed cases in small isolation units set up in health centres in the areas affected by the disease, while limiting the use of parallel structures, such as the Ebola treatment centres set up in the east of the country between 2018 and 2020, to the essentials.

MSF teams were flexible at the medical intervention sites, monitoring the evolution of the epidemic and taking care of patients where they were, including those who were not suffering from VME but from malaria or acute malnutrition. Accompanied by the communities, the medical organisation was able to work calmly, contributing to the strengthening of the health surveillance system and the capacity of the local healthcare staff.