We Are Losing the Fight Against the Bundibugyo Ebola Outbreak. The World Must Take Urgent and Bold Action to Turn the Tide and End the Suffering

24 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.

“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,” said 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. 

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 August 22, more than 5,500 people have been confirmed to be infected, and more than 2,640 people have 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,” said 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, vaccine and therapeutic trials being commenced 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.

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. 

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.

“We have learned to develop vaccines and treatments at extraordinary speed. We have not learned to guarantee they reach the people who need them. A roadmap will tell us how to make the link between a product that exists and a product that arrives,” said Professor Michel Kazatchkine, Member of The Independent Panel.

1. Ceasefires in conflict-affected areas, and a cease of attacks on health and other Ebola care workers, so that people can be reached, diagnosed and treated.
2. Testing, treatment and safe and dignified burials at the scale this outbreak demands, alongside delivery of essential health services.
3. Communities resourced and engaged as partners in the response, with the thousands of additional support workers required trained and paid.

4. Immediate financing commitments, with rapid follow-through, to fund the updated WHO–Africa CDC plan as soon as it is published.
5. Funding provided with minimal conditions attached, so that those responding can meet the evolving needs of the population.
6. 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.

7. 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.
8. Financing identified now for the purchase and delivery of successful products, including diagnostics and therapeutics, where least has been committed.
9. Commitments from companies and intellectual property owners to state publicly the volumes, prices, and timing they will deliver on.

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At 100 Days – where do financing and outbreak countermeasures stand?

Financing

As of 23 August, the WHO-Africa CDC finance tracker shows pledges of US$1.3 billion and disbursements of US$333.3 million against a continental plan costed at US$518 million to the end of November. The tracker shows disbursement flows from financing partners to receiving governments or institutions and the geographical target for the funding. On 20 August, Africa CDC reported some US$758 million released, and it is unclear why this differs from the joint tracker.

The “research, knowledge management and access to MCMs” estimated budget of US$67.7 million attracted US$213.6 million in pledges, and as per the data on the tracker as of 23 August, US$80.2 million of that has been disbursed. Risk communication and community engagement require US$46.6 million and has received US$24.2 million. The IPC, WASH and Safe and Dignified Burials pillar has seen US$23.3 million disbursed against a budget of US$49.1 million. Case Management and Clinical Care is the lowest funded pillar, with only US$753,200 disbursed against an estimated requirement of US$66.5 million.

The United States has announced more than US$512 million and says publicly that it is the largest donor to this response, but that funding is not tracked on the WHO–Africa CDC platform and cannot be reconciled with published figures. As with much other donor funding, it is unclear how much is new and how much is reprogrammed, and how much is directly available for the response in the DRC.

Vaccines

CEPI is supporting four vaccine candidates. Two have entered first-in-human trials: the University of Oxford’s ChAdOx1 BDBV which began in Oxford on 13 July, and Moderna’s mRNA-1469, which dosed its first participant on 3 August in Canada. Two further candidates, from IAVI and Public Health Vaccines, both using the rVSV platform, remain in preclinical development.

On 31 July WHO’s technical advisory group recommended that Ervebo – the licensed Zaire ebolavirus vaccine – be included in a Phase 3 study in this outbreak on evidence of possible cross-protection. On 20 August, WHO announced the DRC would receive 70,000 Ervebo doses including 50,000 for compassionate use for front line health workers, and 20,000 for a Phase 3 clinical trial to understand the impact of the vaccine on the Bundibugyo virus.

Therapeutics

Two therapeutic trials are also enrolling. The PARTNERS trial, sponsored by WHO with the DRC Ministry of Public Health, ALIMA and MSF, is testing the monoclonal antibody MBP134 (Mapp Biopharmaceutical) and the antiviral remdesivir (Gilead) in confirmed patients, and had enrolled 100 people by 12 August. EBO-PEP, led by INRB Kinshasa with ANRS/Inserm and ALIMA, is testing the oral antiviral obeldesivir as post-exposure prophylaxis in contacts of confirmed cases.

Diagnostics

On 2 July, the first Bundibugyo-specific diagnostic received WHO Emergency Use Listing. A platform to validate the performance of laboratory-based, near-point-of-care and antigen rapid diagnostic tests now exists, led by WHO and Africa CDC, with PATH, FIND and CHAI and support from Unitaid.

Published access commitments

Moderna has committed to 500,000 vaccine doses for low- and middle-income countries at access pricing, and Oxford has committed to “affordable supply”. Gavi has committed up to US$50 million, with US$10 million for outbreak response and protection of routine immunisation and US$40 million for accelerating access to investigational doses and any future approved vaccines. An additional US$7 million has been committed for the Ervebo vaccines. Unitaid has also announced US$3.4 million to support rapid access to diagnostics and therapeutics.

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