The death toll from Democratic Republic of Congo’s year-long Ebola outbreak has climbed above 2,000, government data showed on Friday, as responders battle to overcome community mistrust and widespread security problems.

The government team overseeing the response said the number of confirmed and probable cases had also hit a milestone of more than 3,000 in what has become the second-worst epidemic of the virus on record.

Despite the development of an effective vaccine and treatments, health workers have struggled to control the spread of the disease in remote and conflict-hit areas of eastern Congo, where many locals are wary of the response effort.

“For the treatments to work, people need to trust them and the medical staff who administer them. This will take time, resources and a lot of hard work,” the International Federation of the Red Cross said in a statement.

This is Congo’s 10th Ebola outbreak, but it is the first in the densely forested hillside provinces of North Kivu and Ituri, where militia-led violence and ethnic killing have undermined security in certain areas for decades.

The government data released on Friday showed Ebola deaths reaching 2,006 and cases at 3,004.

Only the 2013-2016 Ebola outbreak in West Africa has been deadlier. More than 11,300 people died then out of 28,000 who were infected.