25 August 2026
One hundred days after the emergency
declarations, the Bundibugyo outbreak risks becoming the
deadliest Ebola outbreak in history. The Independent Panel
for Pandemic Preparedness and Response calls for a major
acceleration of effort on public health measures, including
community engagement and ownership, on financing, access to
outbreak tools, and coordination of effort. With the right
action now, the next hundred days could turn the tide on
this catastrophic outbreak.
This will take coordinated
efforts from the Democratic Republic of the Congo (DRC) and
neighbouring countries, community organisations and INGOs,
UN and regional organisations including WHO, Africa CDC, and
the African Union, international donors, and the medical
countermeasures industries.
Efforts to end this
emergency must lay lasting foundations to prevent future
outbreaks and allow for rapid action to contain them when
they do occur.
Immediate scale-up is needed to stop
this outbreak
“One hundred days ago the world was
warned of the Ebola Bundibugyo emergency. One hundred days
later it is the fastest-growing Ebola outbreak ever
recorded. Ending this emergency requires a dramatic increase
in the scale and speed of the response and follow-through to
put the necessary resources and tools in the hands of those
on the front lines.”
— The Right Honourable Helen
Clark, Co-Chair of The Independent Panel
WHO’s
Director-General has warned that at its current pace, this
outbreak will eclipse the 2014–2016 Ebola outbreak in West
Africa.
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Since WHO and Africa CDC each declared
Bundibugyo an emergency in mid-May, the outbreak has become
the fastest-growing and second largest in history. As of 22
August, more than 5,500 people had been confirmed to be
infected, and more than 2,640 people had died. According to
WHO AFRO, sequencing data indicates that the virus has been
circulating since mid-February, and Africa CDC estimates
that the true scale of the outbreak could be three times
higher than confirmed figures. Most reported deaths are
happening in the community, and not in Ebola treatment
centres.
Insecurity, significant unmet humanitarian
needs, the absence of basic health services, non-payment of
health workers, and low community trust are all challenging
the response. Reports from the field indicate continued
attacks on health workers and major gaps in community
reporting.
To turn the tide on this outbreak in the
next 100 days, a coordinated and massive acceleration of the
response is required.
“We must urgently secure
enough testing, build enough treatment centres to save as
many people as possible, and ensure safe and dignified
burials for every person who has died. We need enough
trained people to help engage with every community at risk
and continued essential health services for all. If we
don’t achieve this, this crisis will continue to
expand.”
— Dr Joanne Liu, Member of The
Independent Panel
Continued insecurity directly
affects the response. The Independent Panel calls for
ceasefires in the impacted region to ensure that people can
be diagnosed and treated, and the trajectory of the outbreak
can be reversed.
There has been some important
progress, including the recovery of more than 1,200 people
who had been infected, more funds being disbursed, the start
of vaccine and therapeutic trials as well as efforts to
identify new diagnostics. This progress must now be built
on. WHO, Africa CDC and the Government of DRC are now
shifting to a community-based approach that will require
thousands more support workers to be trained and mobilised.
Community trust, engagement, and ownership are all essential
to the response.
Funding and outbreak tools must reach
the front lines where they are most urgently
needed
“The science is doing what we asked of it. The
guarantee that effective products will reach the communities
bearing this outbreak must be secured now, while trials are
running — not after the results are announced. During the
COVID-19 pandemic, leaders from around the world said
‘never again’ to such gross inequity. That promise is
now being tested, and it is time to show it was more than
words.”
— Her Excellency Ellen Johnson Sirleaf,
Co-Chair of The Independent Panel
The scale-up
requires funding that reaches where it is needed at speed,
and guaranteed access to every tool that can end this
outbreak. In June, The Independent Panel called for greater
transparency on financing, and for clarity on how successful
vaccines, treatments and tests would reach those who need
them.
In the past two months, more emergency funding
has been disbursed, which is a positive development, yet
those working in the DRC say it is not arriving quickly
enough on the front lines where it is most needed. Reports
of unpaid health workers, and of insufficient funding for
community organisations, continue. A scale-up that depends
on thousands more support workers cannot be built without
financing that flows quickly and predictably.
Part of
the challenge is that the overall financing picture is
unclear. Money is arriving through many channels, much of it
earmarked, and the published figures on disbursements and
commitments do not always align. The joint WHO–Africa CDC
financing tracker – an important step towards providing
clarity and accountability – highlights some of the
challenge. Funding for leadership and coordination, and to
develop and secure countermeasures, has now received more
than its estimated budget in the joint WHO—Africa CDC
plan, while risk communication and community engagement has
received only half of the estimated needs.
Medical
countermeasures: guaranteed access required
The
science has moved quickly on medical countermeasures.
Vaccine and therapeutic trials were running within months,
and the first Ervebo vaccine doses are arriving in the DRC
for health workers and a Phase 3 trial. A
Bundibugyo-specific test has been approved for emergency use
and work to validate further tests is underway. Yet the
scramble for accurate testing amid a deadly crisis once
again highlights the vast underinvestment in the diagnostic
ecosystem. What remains elusive is a rapid, true
point-of-care diagnostic test that can be used directly in
communities.
What happens after any successful trial
is less clear. Some financing is secured, including US$40
million from Gavi for procurement of successful vaccine
candidates, and some public commitments on price and volume
have been made. But too many questions remain unanswered,
including whether successful vaccines, diagnostics and
therapeutics will be affordable for the countries that need
them most. Commitments from funders and medical
countermeasures industries are urgently needed to guarantee
the resulting tools and benefits are widely available to
those who need them in this outbreak and in future. These
commitments cannot wait until trial results are
announced.
What is needed now?
To stop the
outbreak
- Ceasefires in conflict-affected areas,
and an end of attacks on health and other Ebola care
workers, so that people can be reached, diagnosed and
treated. - Testing, treatment and safe and dignified
burials at the scale this outbreak demands, alongside
delivery of essential health services. - Communities
resourced and engaged as partners in the response, with the
thousands of additional support workers required trained and
paid.
For money to reach the front line,
quickly and consistently
- Immediate financing
commitments, with rapid follow-through, to fund the updated
WHO–Africa CDC plan as soon as it is
published. - Funding provided with minimal conditions
attached, so that those responding can meet the evolving
needs of the population. - Transparent reporting that
follows the funding to the point of use, showing what has
been disbursed and what has reached the front lines and
community organisations, and clarity on the gaps and
bottlenecks that remain.
For safe, effective
tools to reach people in need
- A clear roadmap of
who is responsible for taking each candidate vaccine,
treatment and test from trial to delivery, who is paying for
each phase, and where the gaps are. - Financing
identified now for the purchase and delivery of successful
products, including diagnostics and therapeutics, where
least has been committed. - Commitments from companies
and intellectual property owners to state publicly the
volumes, prices, and timing they will deliver
on.
At 100 Days –
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