Commentary: This Ebola outbreak should never have caught the world off guard
The uncomfortable truth of the ongoing Bundibugyo virus epidemic is that it is not an exception, says Medecins Sans Frontieres Secretary-General Laura Leyser.
Read a summary of this article on FAST.
Get bite-sized news via a new
cards interface. Give it a try.
Click here to return to FAST
Tap here to return to FAST
FAST
GENEVA: In the Democratic Republic of Congo (DRC), people infected with Ebola have been fighting for their lives with little more than fluids and supportive care. Healthcare workers cannot do much more because there are no approved treatments for the Bundibugyo virus, nor vaccines to stop its spread.
About two months after the outbreak was first declared in the conflict-ridden Ituri province, there have been 2,124 confirmed cases, including 828 deaths, from Ebola disease caused by the Bundibugyo virus (as of Jul 15). The outbreak has spread across four DRC provinces, into neighboring Uganda, with European and American aid workers infected too.
But that alone does not explain how this has become the world’s fastest-growing Ebola outbreak. This outbreak surpassed 1,000 confirmed cases within 40 days of response activation compared to the 2018 Ebola outbreak in North Kivu, which reached the same mark in 235 days. Today’s lack of options is the symptom of a much older failure.
For Medecins Sans Frontieres (also known as Doctors Without Borders or MSF) teams among the responders on the ground, what is unfolding is painfully familiar. The uncomfortable truth is that this outbreak is not an exception.
Guess Word
Crack the word, one row at a time
Buzzword
Create words using the given letters
Mini Sudoku
Tiny puzzle, mighty brain teaser
Mini Crossword
Small grid, big challenge
Word Search
Spot as many words as you can
THE WORLD STOPPED PREPARING
This outbreak is the result of a familiar pattern. Disease preparedness does not fail because it does not work. It fails because the world invests in it only during crises – and abandons it once the headlines fade.
Previous Bundibugyo virus outbreaks in 2007 and 2012 clearly exposed the gaps seen today: There is no approved treatment nor crucially, at this stage, a reliable rapid diagnostic test. There is no approved vaccine to protect health workers curb the spread in the community.
But once those relatively small outbreaks subsided, so did the urgency. Calls by MSF and other organisations for sustained investment to close the gaps did not bring funding, either commercially or as a matter of global biosecurity, because there was no active crisis to justify the expense.
Today, we have approved vaccines and treatments for disease caused by the Ebola virus (formerly Zaire virus) but these only emerged after the devastating West Africa epidemic from 2014 to 2016, when it became a global security concern. By then, 11,325 people had died.
This month, the WHO-sponsored PARTNERS clinical trial was launched to identify the first effective treatments for Bundibugyo virus disease, coordinated by the INRB in the DRC, the Institute of Tropical Medicine in Belgium, the University of Oxford and Africa CDC. It is a welcome step, and MSF is one of the partners in this trial, but it has taken two decades and yet another deadly outbreak to get here.
This reactive approach to disease preparedness today is this: invest narrowly, declare success, move on. The result is a cycle of predictable, preventable health emergencies that claim far too many lives.
NOT JUST AN EBOLA PROBLEM
The problem of this approach is not limited only to Ebola.
Drug-resistant infections have long been recognised as a major public health threat, but the process of developing new antibiotics is scientifically challenging and commercially unattractive when antimicrobial resistance has not yet become a full-blown crisis in the minds of most policy makers.
The same goes for vaccine-preventable diseases, such as measles, where the challenge is in sustaining the immunisation systems to deliver vaccines before outbreaks occur.
Cholera offers another warning. Outbreaks have surged since 2017 and vaccine supply has not been able to meet global demand since. Faced with a global vaccine shortage in 2022, the international body that manages emergency cholera vaccine supplies had to switch from the standard two-dose regimen to a single dose to stretch limited supplies across more countries. Such use of vaccines, as emergency instead of prevention, risks larger outbreaks that will consume more doses and deepen the shortage.
None of these failures exist as isolated emergencies. But they are increasingly colliding where health systems are weakened by conflict, displacement and recent international aid funding cuts. Deep cuts to aid and health financing over the last 18 months did not cause this Ebola disease outbreak, but they punctured an already fragile health system.
CRISIS COSTS MUCH MORE THAN PREPAREDNESS
Still, there is some good news: One of the tools needed for a better system is already on the table. World Health Organization member states adopted the Pandemic Agreement in 2025 and are still negotiating an important component called the Pathogen Access and Benefit Sharing.
It offers an opportunity to strengthen global preparedness by laying out clear rules for how test samples, scientific data, and the benefits of research are shared. If they get it right, vaccines, tests and treatments can reach the people who need them – not just those who can pay.
But this is also the most contentious component of the agreement. Member states could not agree on finalising those rules at this year’s World Health Assembly in May.
Still, governments can act now by attaching equitable access conditions to the research they fund; by guaranteeing that clinical trial participants and at-risk communities are not left at the back of the queue; by sharing supplies according to need.
Preparedness works when we treat it as something the whole world depends on, not a line item to cut when political priorities shift. The 2014-2016 West Africa Ebola epidemic and the COVID-19 pandemic taught us that containment strategies are no effective substitute for sustained investment in research, surveillance and resilient health systems.
The real choice before us is not whether to invest in healthcare readiness, but whether we do so before the next crisis happens. Prevention looks expensive today until we see that failing to prepare costs a vastly higher price tomorrow – both in money and human lives.
Right now, the courageous doctors, nurses, community health workers and local responders in DRC know this lesson all too well.
Laura Leyser is Secretary General of Medecins Sans Frontieres International, also known as Doctors Without Borders.
Source: CNA/zw(ch)
Sign up for our newsletters
Get the CNA app
Stay updated with notifications for breaking news and our best stories
Get WhatsApp alerts
Join our channel for the top reads for the day on your preferred chat app
Get bite-sized news via a new
cards interface. Give it a try.
Click here to return to FAST
Tap here to return to FAST
FAST
About The Author
