Recurrent zoonotic disease outbreaks in the African Great Lakes region reveal structural weaknesses in regional health security. Discuss with examples.

On 27 August 2026 the WHO declared Uganda Ebola-free after a 42-day countdown, closing a Bundibugyo virus outbreak shared with the Democratic Republic of Congo [2]. Three Ebola outbreaks in four years suggest that recurrence in the Great Lakes region is structural rather than accidental, though recent responses also show growing capacity.

A pattern of recurrence

• Uganda's Sudan ebolavirus outbreak (Sept 2022–Jan 2023): 164 cases, 55 deaths, 47% case-fatality across nine districts [3].
• Its sixth Sudan virus disease outbreak (Jan–Apr 2025), beginning with an infected health worker [4].
• The 2026 Bundibugyo outbreak, declared a Public Health Emergency of International Concern on 17 May 2026 — the DRC's 17th Ebola outbreak since 1976 [1].

Structural weaknesses exposed

• Weak surveillance and containment: only about a fifth of contacts were followed up in the DRC, alongside inadequate isolation facilities and unsafe burial practices [1].
• Conflict-affected health systems: insecurity in Ituri, North Kivu and South Kivu obstructed response, overwhelming facilities [1].
• Asymmetric state capacity and porous borders: 15 of Uganda's 20 confirmed cases were imported from the DRC — one state's weakness becomes its neighbour's emergency [2].
• Countermeasure void: no licensed vaccine or therapeutic exists for Sudan or Bundibugyo species; the TOKEMEZA trial had to be launched mid-outbreak in 2025 [1][4].

Countervailing capacity Uganda's rapid detection, contact tracing, border and facility surveillance and community engagement limited the 2026 outbreak to 20 cases with 18 recoveries, coordinated with WHO-AFRO and Africa CDC [2].

Recurrence therefore reflects zoonotic spillover ecology compounded by uneven state capacity and reactive, emergency-triggered financing. The way forward lies in One Health surveillance of wildlife reservoirs, harmonised cross-border protocols, regional diagnostic and vaccine stockpiles, and pre-approved trial frameworks, backed by sustained investment in IHR (2005) core capacities. Uganda's repeated closures show that, with early leadership and community trust, containment is achievable.