“As we scale up our detection and response, we expect to see more cases initially before the curve begins to go down” These were the words of Prof Mohamed Janabi, WHO Regional Director for Africa, speaking at the latest WHO press briefing on the Ebola outbreak in the Democratic Republic of Congo (DRC) and Uganda, which your Nigeria Health Watch team attended in person for the first time. It was important to be in the room with the Director-General, the Regional Director for Africa, and the Executive Director of the WHO’s Emergencies Programme as they briefed the media on the evolving response to the Ebola outbreak.
On 16 May, the World Health Organization (WHO) declared the Ebola outbreak caused by the Bundibugyo virus disease (BVD) strain, a public health emergency of international concern (PHEIC), its highest level of international alert.
At the briefing, Director-General of WHO, Dr Tedros Ghebreyesus confirmed 82 cases and seven confirmed deaths, with 750 suspected cases and 177 suspected deaths, at this stage, already the third largest Ebola outbreak ever. The confirmed cases reflect what laboratories have been able to detect, but the suspected cases give a clearer picture of the scale of the outbreak. The eastern DRC, where the outbreak is currently concentrated, is a remote, conflict-affected area with an already weak health infrastructure and hospitals that often lack basic supplies. These conditions delayed early detection and allowed the virus to spread silently before the alarm was raised. As Dr Anne Ancia, WHO Representative DRC, speaking from Bunia, put it, “the number will keep rising for some time” The response is, by its own admission, playing catch-up.
Across the border, it was encouraging to hear from the Director General that the “situation in Uganda is stable”. So far, the two confirmed cases and one death have both been linked to travel from the DRC. (Since then, a further three cases have been confirmed in Uganda, two from contacts of the first two cases and a third also from the DRC). A reminder that in cross-border outbreaks, stability in one country is very dependent on the response in the other.
“We know we are late. I can tell you we are running. We’ve got insecurity against us. We’ve got movement of population against us”, said Dr Ancia. Contact tracing in Bunia stood at just 11 percent, meaning about nine in ten known contacts of confirmed cases were not yet being followed. In response, WHO has deployed 22 international staff to the field and released US$3.9 million from its Contingency Fund for Emergencies, while the UN Humanitarian Chief, Tom Fletcher, has allocated a further US$60 million. The governments of DRC and Uganda are leading the response, with WHO, Africa CDC, and a growing coalition of partners working together to scale up contact tracing and establish treatment centres.
No tools yet for this virus
Unlike previous outbreaks driven by the Zaire strain for which vaccines were developed after the 2014–16 West Africa epidemic, this outbreak involves a strain with only two recorded outbreaks in history, in Uganda in 2007 and the DRC. The rarity of this Bundibugyo strain makes the development of specific medical countermeasures difficult. There are few incentives for research into rare viruses, as this is often the biggest driver of research and development, rather than epidemiological risk.
WHO’s R&D Blueprint has identified two monoclonal antibodies for clinical trial assessment, and the antiviral obeldesivir is being evaluated for treatment and post-exposure prophylaxis. When discussing vaccines for the Bundibugyo strain, WHO Chief Scientist Dr Sylvie Briand explained that the most promising candidate may take 6 to 9 months to reach trial readiness.
WHO convened partners under the Interim Medical Countermeasures Network, bringing together organisations including Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI), the Gates Foundation, Wellcome Trust and others to coordinate work on vaccines, therapeutics, and diagnostics. Prof. Janabi made the broader lesson clear, “This outbreak really highlights the need for broader vaccines and therapies, stronger R&D pipelines, and adequate access to medical countermeasures.”
Why community trust matters in an Ebola response
But one of the biggest challenges remains trust. On 21 May, tents and supplies at a hospital in Rwangara were set on fire after an Ebola patient died. Healthcare workers were placed under military protection, and operations in one of the outbreak’s hottest zones were suspended. Dr Ancia described the challenge: “This morning we had our security team with the governor and the provincial health authorities, talking to the population, discussing calming messages.”
During the 2014–15 Sierra Leone Ebola outbreak, scepticism and resistance were widespread in communities as there were misconceptions about the response rooted in a long history of inadequate healthcare and distrust of outside institutions. Survivors ultimately became the most credible advocates for treatment centres, but that trust took time to build, and the concern is that building community trust during the current response cannot afford the same delay. The reality of the beginning of a response is that both priorities have to be worked on in parallel, scaling up rapidly while sustaining trust in the community.
It is therefore critical that community engagement runs alongside the clinical response. Dr Teresa Zakaria, Unit Head for Humanitarian Operations at WHO, noted that the provinces of Ituri and North Kivu are home to more than 2 million displaced people, while 85 percent of health facilities face critical drug shortages. In settings like these, misinformation and fear can spread as quickly, especially when communities already do not trust outside authorities. This makes trusted communication through community leaders and frontline health workers an essential pillar of the outbreak response, building confidence in public health measures and responding quickly, while respecting local customs and traditions.
The importance of the Pandemic Agreement for global preparedness
The Ebola outbreak in DRC and Uganda is taking place at the same time that member states at the World Health Assembly are looking to continue negotiations on the Pathogen Access and Benefit Sharing (PABS) system in July 2026, after failing to reach consensus on the text. The Bundibugyo outbreak and previous hantavirus outbreak show clearly why the Pandemic Agreement and its PABS annex matter to the world.
There are no approved tools for these outbreaks. The DRC is sharing samples and data, not only to keep its own citizens safe, but to prevent spread to the rest of the world. The race to develop medical countermeasures has begun, but the world does not have a guiding framework. This outbreak is also a reminder of why the Pandemic Agreement matters. The agreement signed in 2025 is an important step in the right direction, but it requires countries to agree on the PABS annex before it can come into effect.
Fragmented approaches to preparedness, delays in information sharing, unequal access to medical tools, and weak financing arrangements all slow responses precisely when speed matters most.
Dr Maria Van Kerkhove, Acting Director of the Department of Epidemic and Pandemic Threat Management at the World Health Organization (WHO), put the structural failure plainly “This constant steady stream of funding to support national government in the capacities that they have, across surveillance, detection, research, infection prevention, control, workforce, building trust in communities etc, regularly as opposed to going into this cycle of panic and neglect, which we all contribute to.”
This outbreak is still unfolding, but it is already a major lesson on why the world needs to build stronger systems to quickly prevent outbreaks from escalating to this point again. There is no magic bullet here; we must build intentionally and sustainably.
Outbreaks can be prevented completely, but they can be stopped before they spiral, when there is political will, early detection, rapid access to resources, and communities are able to trust the existing health systems. This is why some of the most important lessons in epidemic preparedness come from outbreaks that were contained quickly before the world even took note of them.
