Ebola 101: What Africa's deadliest virus reveals about the next pandemic

From COVID-19 to Ebola and Marburg virus disease, Africa has in recent years found itself on the frontline of some of the world's most dangerous infectious disease outbreaks.

These viruses have claimed lives, overwhelmed health systems, disrupted economies and exposed weaknesses in preparedness that often take years to rebuild.

Today, the spotlight has once again turned to Ebola as the Democratic Republic of Congo (DRC) and neighbouring Uganda battle a fresh outbreak caused by the rare Bundibugyo strain of the virus.

The World Health Organisation (WHO) reported on Friday that there were 906 suspected Ebola cases in the DRC, including 223 suspected deaths under investigation. Of these, 125 cases have been laboratory confirmed, resulting in 17 confirmed deaths across Ituri, North Kivu and South Kivu provinces.

Uganda has also reported seven confirmed Ebola cases, three of them imported from the DRC, with one confirmed death. However, health authorities say there is currently no evidence of community transmission in Uganda.

The resurgence of Ebola has revived old questions. Could Ebola become the next global pandemic? Are African countries prepared to respond to another major health emergency? And after the lessons of COVID-19, do governments have the resources and political will to act quickly enough?

In eastern DRC, Ebola response efforts continue under extraordinarily difficult conditions.

Temporary isolation units, often constructed from tents and lightweight structures, remain at the centre of outbreak management. Yet these facilities have frequently become targets during periods of community unrest.

Health agencies and humanitarian organisations have documented incidents where Ebola treatment tents and isolation structures were attacked or set ablaze amid fears of infection, disputes over burial practices and widespread mistrust of health authorities.

In several instances, patients and health workers were forced to evacuate facilities, disrupting treatment, contact tracing and surveillance efforts.

The pattern is not new as previous Ebola outbreaks in the region have repeatedly shown that disease control depends as much on community trust as it does on medicine.

As the latest outbreak expanded, WHO Director-General Dr Tedros Adhanom Ghebreyesus travelled to the DRC to support response efforts and engage national authorities and international partners.

During his visit, Tedros stressed that outbreak control cannot succeed in conflict-affected areas without guaranteeing safe access for healthcare workers and humanitarian teams.

He called for stronger protection of health infrastructure and warned that insecurity and violence should never be allowed to interrupt life-saving interventions.

His message underscored a growing reality in global public health: controlling Ebola is no longer solely a medical challenge. It is equally a question of governance, security and public trust.

To understand why Ebola continues to generate global concern, one must first understand what the virus does once it enters the human body.

"Ebola virus disease is a severe and often life-threatening illness caused by a group of viruses known as filoviruses," explains Dr Ahmed Kalebi, a Nairobi-based consultant pathologist, founder of Dr Kalebi Labs and a PhD researcher in Public Health at the University of Cape Town.

"Once inside the body, Ebola attacks the immune system, damages blood vessels and affects multiple organs including the liver, spleen and kidneys. The illness can rapidly progress to shock, organ failure and death if not properly managed."

Unlike respiratory infections that primarily affect the lungs, Ebola triggers widespread systemic disease.

"It attacks the immune system, damages blood vessels, disrupts clotting mechanisms and can lead to shock and multi-organ failure," Dr Kalebi says.

The virus spreads through direct contact with blood and bodily fluids from infected individuals, making transmission very different from airborne diseases such as COVID-19.

Ebola was first identified in 1976 during simultaneous outbreaks in what is now South Sudan and the Democratic Republic of Congo near the Ebola River, from which it derives its name.

Since then, outbreaks have emerged intermittently across Central and East Africa.

Major outbreaks include the 1995 Kikwit outbreak in DRC, the 2000-2001 Uganda outbreak, the identification of the Bundibugyo strain in 2007, the devastating 2014-2016 West Africa epidemic, the 2018-2020 eastern DRC outbreak and now the 2026 Bundibugyo outbreak affecting both DRC and Uganda.

Each epidemic has expanded scientific understanding of the disease while exposing recurring weaknesses in surveillance, preparedness and public engagement.

The current outbreak is particularly challenging because it is being driven by the Bundibugyo strain, first identified in Uganda nearly two decades ago.

Unlike the Zaire strain, for which licensed vaccines exist, Bundibugyo currently has no approved vaccine and no widely available strain-specific treatment.

Researchers and the WHO are accelerating studies of experimental vaccine candidates and monoclonal antibody therapies, but experts caution that scientific advances alone cannot stop an outbreak.

According to Dr Ameyo Daglus, a microbiologist, virologist, vaccinologist and immunologist at Jomo Kenyatta University of Agriculture and Technology (JKUAT), the answer lies partly in the region's ecology and human interaction with wildlife.

"Talking about Congo, we understand the transmission mechanism and how people coexist with the environment," he explains.

"The Congo forest and the way people cohabit with this environment means many communities depend on wildlife and natural water sources. These environments act as reservoirs that can facilitate the spread of diseases."

Scientists believe fruit bats serve as natural reservoirs for Ebola viruses, with transmission occurring when humans come into contact with infected animals or contaminated environments.

Dr Daglus says poverty and weak infrastructure also contribute significantly.

"For them to afford basic needs is not really possible. They don't have very good water systems or food ecosystems, so they resort to wild animals for survival. These animals may carry enormous numbers of microorganisms that we don't fully understand."

He believes long-term prevention requires a One Health approach that recognises the connection between human health, animal health and environmental conditions.

"They need clean water, a reliable food supply and stronger public health systems. Together with vaccination, this offers the best chance of controlling outbreaks permanently."

Public comparisons between Ebola and COVID-19 are inevitable, but the two diseases differ significantly.

"It does not," Dr Kalebi says when asked whether Ebola spreads like COVID-19.

"Ebola spreads primarily through direct contact with the body fluids of an infected person who is already symptomatic. That makes it far less contagious than respiratory viruses such as COVID-19 or influenza."

COVID-19 spreads through airborne droplets and aerosols and can be transmitted before symptoms appear, making it much harder to contain.

Ebola, by contrast, generally becomes infectious after symptoms begin.

This distinction largely explains why COVID-19 evolved into a global pandemic while Ebola outbreaks have remained geographically limited.

Yet Ebola remains far deadlier. Case fatality rates can range between 25 and 90 per cent depending on the strain, outbreak conditions and availability of treatment.

"What makes Ebola different is the pathogenesis," explains Dr Daglus.

"It spreads very fast through systemic parts of the body, making it more fatal. Without vaccines and specific treatment strategies, it becomes a much bigger challenge."

One of the greatest challenges facing scientists and public health experts is that Ebola does not exist in isolation.

The virus persists within complex ecological systems involving wildlife reservoirs, environmental conditions and human behaviour.

"The best way to solve this once and for all is through the One Health approach," says Dr Daglus.

"Looking at the animal perspective while ensuring communities have access to clean water and food means people will not need to depend on risky interactions with wildlife."

Another challenge is the virus's ability to evade detection during the early stages of infection.

"For Ebola, there is a window period where spread can occur before people are identified," he says.

"It becomes difficult to track contacts and map transmission chains."

The danger posed to healthcare workers also complicates response efforts.

"Ebola is quite deadly and fatal. Convincing health workers to commit to outbreak response can be difficult because the risks are significant."

The recent outbreak has inevitably raised concerns about Kenya's preparedness.

Lessons from COVID-19 strengthened surveillance systems, laboratory networks and disease awareness among frontline healthcare workers. 

However, experts say important gaps remain. "The reality is that Kenya's capacity to manage a large Ebola outbreak is still limited," says Dr Kalebi.

"We have only a small number of specialised facilities capable of safely managing viral haemorrhagic fever patients and only a few highly specialised laboratories capable of confirming Ebola infection."

He emphasises that rapid detection remains the country's strongest defence.

"Every border screening team, every healthcare facility and every frontline health worker must be able to rapidly recognise a suspected case, isolate the patient safely and activate the appropriate public-health response without delay."

Dr Daglus is even more candid. "From where I sit, we are actually not very ready."

He notes that surveillance efforts continue to rely heavily on external support.

"People supporting the National Public Health Institute and KEMRI are mainly partners such as the US Centers for Disease Control and Prevention."

He further argues that Kenya still lacks dedicated quarantine infrastructure and sufficient trained personnel.

"We have challenges in human resources, contact tracing and specialised facilities. Setting up quarantine centres requires enormous amounts of money."

Nonetheless, he says current efforts by government agencies and international partners could significantly improve readiness in the coming months.

If COVID-19 taught the world anything, it is that misinformation can spread faster than disease itself.

"Perhaps the most important lesson from COVID-19 is that misinformation can spread faster than any virus," says Dr Kalebi.

"Timely, accurate and credible communication is essential."

False information can delay treatment, discourage reporting of symptoms, fuel vaccine hesitancy and trigger hostility toward healthcare workers.

The attacks on treatment centres in eastern DRC demonstrate how fear and misinformation can directly undermine outbreak control.

The larger threat: Disease X

Scientists increasingly warn that the next pandemic may not come from a known pathogen.

Disease X is the term used by global health experts to describe an unknown future pathogen capable of causing a major epidemic or pandemic.

Most emerging infectious diseases originate in animals before spilling over into humans.

Deforestation, climate change, wildlife trade, urbanisation and increased global travel have accelerated the conditions that make such spillovers more likely.

 

.While Ebola itself is unlikely to become a worldwide pandemic under current conditions, experts acknowledge that a  future Ebola-like virus with different transmission characteristics could potentially fit the Disease X scenario.

The concern, therefore, is not only Ebola, but what it represents: a warning about humanity's increasingly fragile relationship with nature.

As outbreaks continue to emerge, African health leaders are increasingly calling for greater domestic investment in preparedness.

The recently adopted Nairobi Declaration on African Health Security and Collaborative Disease Surveillance warns that outbreaks are still detected too late, surveillance systems remain fragmented and financing continues to depend heavily on external partners.

The declaration urges governments to treat health security as a national development, economic and security priority and to establish dedicated funding for surveillance, laboratories, preparedness and rapid response.

Dr Damaris Matoke-Muhia, Deputy Director at KEMRI, agrees.

"It is extremely important that we have domestic funding, as it helps us to own the solutions that we have developed locally," she says.

"Countries are able to set their own priorities based on the data that has been generated. It also ensures that there's sustainability going forward."