Failure to manage Ebola outbreak will be catastrophic

Failure to manage Ebola outbreak will be catastrophic

8 June 2026 - Nthabiseng Makgana, Patrick Kadima and Katleho Mokoena

Call for African-led solutions grows as global aid shifts away from health emergencies.

The Democratic Republic of Congo and Uganda confirmed that an Ebola outbreak had occurred during the month of May 2026. The World Health organisation subsequently confirmed that the outbreak involved the Bundibugyo strain of Ebola, one for which there is currently no vaccine or specific treatment, but that there are ongoing efforts to develop one.

Without any approved vaccine, containing the virus from spreading will depend largely on the launch of excellent contact tracing and asking individuals who may be infected or have been in contact with infected people to isolate themselves. But here is the catch. The current Ebola outbreak in the North Eastern and Eastern provinces of the vast DR Congo presents significant challenges for health workers to respond adequately given that the areas are conflict ridden and experience a worsening humanitarian crisis.

But as the virus now outpaces the response, one question remains, will the region be able to contain it? In this piece, we demonstrate three things.

Firstly, that the African Continent should take full ownership of this public health emergency and find solutions to it. Failure to do so will have direct consequences.

Secondly, we also urge the international community not to turn away as the virus engulfs East Africa because, in an interconnected world, infectious diseases do not respect borders, and no country is immune to transmission.

Lastly, Africa needs resilient health systems, skills exchange and proper governance in order to be better prepared for future public health emergencies in the face of global aid cuts.

Context of the Ebola outbreak

Given the vast geographical size of the DR Congo, the Ebola outbreak is currently concentrated in three provinces Ituri, North Kivu, and South Kivu. All these provinces situated in the volatile East of the Country. It is a well-known fact that all three provinces or rather the Eastern part of the country is engulfed in a bitter conflict and this makes it difficult for healthcare workers to carry out their work efficiently. What complicates the matter further is the fact that the ravaging conflict forces residents of these areas to flee their homes and increasing the risk of the virus spreading throughout the rest of the country.

The health systems in the east of the country are either non-existent or do not function at a level they should be due to the conflict. Already, Uganda has been affected by the spread of the virus and as per the director of the African centre for Disease Control (Africa CDC) Dr Jean Kaseya, 10 other East and central African countries are at risk. 8 of those 10 countries at risk share a border with the vast central African country. Misinformation on the virus that continues to spread also makes it difficult for healthcare workers to operate efficiently.

Just a few days back, residents of affected communities set fire to a section of the hospital used to treat Ebola patients due to anger from the family and friends of a young man who died from the virus, after they were prevented from taking the body for burial. It has long been established that the body of a dead Ebola victim is highly infectious and healthcare workers need to ensure that the body is buried in a proper manner to avoid the spread of the virus. It is important that the affected communities are educated about the virus in order to contain the spread of misinformation.

Africa needs to take ownership of its health security

The formation of Africa CDC in 2016, was a major step in the health transformation of the African continent. In 2022, when the African Union granted the Africa CDC powers to be a fully autonomous agency, it heralded an era in which Africa sought to be in charge for its own health sovereignty. While we should all commend the agency for being autonomous, we should in the same vein rally African states and the private sector to invest heavily in the agency. An autonomy of an agency means nothing if it cannot undertake operations due to strain in its fiscal purse. The fiscal strain on the agency risks reversing the strides made in public health.

We are in an era of pandemics and therefore it is important that agencies such as the Africa CDC are equipped with financial power to address the health issues that confront the continent. On a more country to country scale, the Covid-19 pandemic and the 2013-2016 Ebola crisis in West Africa gave us an important lesson that health systems in African countries were fragile and unable to contain public health emergencies without external support. There has never been a more appropriate time to uplift our health systems but lack of proper governance remains an Achilles' heel in the quest to strengthen these systems.

On the other hand, health partnerships between African countries whether on a bilateral or multilateral level need to be upscaled. Public health diplomacy in the region remains significantly low and this affects how countries respond to public health emergencies. When the Ebola outbreak was announced, South Africa, which by all means is the most successful African country in public health diplomacy pledged a $5-million contribution to the Africa CDC and Prevention to support the continent's Ebola response.

The kind gesture from the South African government and its people comes at a time when President Ramaphosa is the official African Union (AU) Champion on Pandemic Prevention, Preparedness, and Response. This is not the first time that South Africa has undertaken such a pledge, it did so on numerous occasions including the 2013-2016 Ebola crisis. However, we are of the view that other African countries need to step up as well in their public health diplomacy. The funding cuts in global aid from western nations means that

Africa's public health system remains vulnerable and unable to respond to public health emergencies. We further call on universities in the region to step up efforts in terms of collaboration.

For example, South Africa is home to 26 public universities, several of which possess globally recognised health and medical research capabilities. In recent years, these universities have been at the forefront of pioneering ground-breaking medical research in HIV/AIDS, Malaria and Tuberculosis treatment, through specialised research centres and strong international partnerships. Importantly, the universities have been extending their influence beyond lecture halls, to global health policy and increasingly becoming strategic instruments of South Africa's public health diplomacy.

Universities in the region can play an even greater role in confronting public health emergencies, not only through cutting edge research, but cross-border scientific collaboration, medical training and knowledge exchange programmes. Despite this critical role, universities are also confronted by challenges relating to funding constraints as well as the need to navigate ever changing geopolitical factors that undermine the funding of critical research initiatives and health partnerships. Nevertheless, universities remain indispensable to Africa's public health diplomacy agenda.

The failure of Africa to take ownership of its health security architecture will be fatal. In an era where Western nations have pulled out their aid to re-route them to other pressing issues, African leaders have the moral and legal obligation to uplift pour public health systems.

• Makgana is CEO of Chris Hani Baragwanath hospital and holds an MBChB degree and MBA in healthcare management.
• Patrick Kadima is based at Wits University and holds a BA, LLB and interdisciplinary MA degree having specialized in Law, Economics and Social Sciences.
• Katleho Mokoena, is based at Wits and holds a BA (law), LLB and LLM.

They all write in their personal capacity.

This article was first published in Business Day.