The Bundibugyo wake-up call: why the UK cannot afford to ignore the latest Ebola outbreak

On 17 May, the Ebola outbreak, caused by the Bundibugyo ebolavirus (BDBV) in the Democratic Republic of the Congo (DRC) and Uganda, was declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO).

By the beginning of July, there were 1,460 confirmed cases, including 452 deaths, in the DRC, as well as 20 confirmed cases, including 2 deaths, in Uganda. These grim statistics represent a direct test of the global health security architecture – and should serve as a stark wake-up call to the UK Government.

For those watching from Whitehall, the temptation might be to view the outbreak as being of low risk to the British public. Statistically, the immediate threat to the UK population is low. But looking at health security purely through the lens of domestic transmission would be a strategic error, which could potentially leave the UK more vulnerable to infectious disease threats.

In an interconnected world, health is a universal right. As we often heard during the COVID-19 pandemic, no-one is safe until everyone is safe. Supporting pandemic prevention, preparedness and response (PPPR) at home and beyond is about ensuring that no community is left to face a deadly pathogen alone, starting with the most vulnerable.

The outbreak is also the latest test of the 100 Days Mission: the shared global goal to have diagnostics, therapeutics and vaccines within 100 days of a pandemic threat being identified. At over halfway to day 100 of the outbreak, progress is underway, but important gaps remain.

The reality of the Bundibugyo ebolavirus: a test of the 100 Days Mission

What makes the current outbreak particularly alarming is the pathogen itself. There are currently no approved point-of-care diagnostic tests, therapeutics or vaccines for BDBV.

Unlike Zaire ebolavirus – the species responsible for previous Ebola-related PHEICs and the focus of decades of countermeasure development – BDBV has received far less attention from developers and funders. As a result, important preparedness gaps remain across all three tools.

However, progress is being made. Diagnostic candidates are being evaluated through coordinated international processes, with field evaluations expected to commence shortly – one therapeutic trial has begun, and another is expected to start imminently – and a phase 1 trial for vaccines is being initiated in the UK.

Effective and accessible diagnostics are vital for early disease detection and containment. While therapeutics – including post-exposure prophylaxis – are key to reducing the severity of disease and can be a lifesaving tool for people who are unable to use or access vaccines, or those who get ill despite vaccination. Given the early-stage status of BDBV vaccines, these interventions are particularly critical for healthcare workers, household contacts and other exposed individuals during the response phase.

Critically, progress across countermeasures is not evenly distributed. Vaccines benefit from relatively mature financing and access mechanisms, while therapeutics often lack clear pathways for development, manufacturing and post-trial access. Diagnostics have seen significant progress in coordinated evaluation, but as promising tools move towards scale-up and deployment, funding gaps often occur. As a result, scientific advances can stall long before they reach affected communities.

The success of the 100 Days Mission will ultimately be measured by whether all three tools can reach people through timely and equitable access. This requires investment in these tools before a disease outbreak happens.

When medical countermeasures are unavailable, strong surveillance, infection prevention and control, clinical care and community trust become even more important. This means local primary healthcare systems remain the foundation of effective outbreak response.

The toll on women and children

Health emergencies are never neutral and seldom affect everyone equally. Over 60% of the suspected BDBV cases in the DRC are women, while early evidence suggests children may have an elevated risk of dying from BDBV, consistent with patterns observed in previous ebolavirus outbreaks.

This reflects a predictable social reality: across the world, women are the main formal and informal healthcare providers, traditional healers, and caregivers inside the home. When a mother contracts Ebola, the ripple effects on her children and household are immediate and devastating.

Effective outbreak response requires health systems to surge resources where they are needed most, without abandoning routine services. Children often bear a disproportionate burden during Ebola outbreaks, but the impact extends far beyond infection itself. The 2014–2016 West Africa epidemic showed that disruptions to maternal care, routine immunisation and family planning services can create a secondary health crisis, which can ultimately claim more lives than the virus itself.

Current challenges around paediatric formulations and generating evidence for vulnerable populations also highlight the importance of ensuring that women, children, and pregnant people are not left behind in the development and evaluation of medical countermeasures. If the UK wants to protect its historical investments in reducing global maternal and child mortality, it must defend the health systems that keep these services running during a crisis.

Health security is completely inseparable from reproductive, maternal, newborn, child and adolescent health (RMNCAH).

The economics of crisis

For UK policymakers managing tight budgets, global health spending must be understood as an insurance policy. Containment at the source is exponentially cheaper than a reactive global emergency response.

In a highly globalised economy, an unstable health system in central and eastern Africa creates a vacuum. Epidemics compound existing humanitarian crises, fuel displacement, and strain regional economies, which directly impacts the UK’s broader geopolitical and strategic interests.

The UK has historically been a scientific superpower and a leader in global health. Its recent commitment of up to £26 million to support the Ebola response demonstrates the continued importance of rapid international action. But the BDBV outbreak also highlights a deeper challenge: preparedness is not simply a scientific challenge – it is a financing one.

Promising new tools cannot be developed, tested, manufactured and deployed without sustained investment. Yet, global funding for pandemic preparedness has declined sharply in recent years, particularly for therapeutics and diagnostics.

Countries must respond quickly when outbreaks occur, but they must also invest continuously between crises. As the UK prepares for its G20 Presidency in 2027, it has an opportunity to champion the long-term financing needed to build a truly global 100-day-ready ecosystem, consisting of well-resourced research and development, health systems, clinical trials, and manufacturing alongside regulatory readiness and equitable access.

The path forward

The UK cannot afford a policy of panic and neglect – waiting for an outbreak to explode before mobilising capital. The FCDO should leverage its diplomatic and financial weight to take three immediate actions:

1. Flexible funding for primary healthcare: Protect and expand flexible funding for primary healthcare and community health systems in outbreak-prone settings, ensuring that routine RMNCAH services can continue during emergencies, and that local systems are capable of delivering outbreak response measures and medical countermeasures.
2. Support rapid development and equitable access to diagnostics, therapeutics and vaccines: Recommit UK support to research, clinical trials, regulatory pathways, and manufacturing readiness in between outbreaks to ensure equitable access to diagnostics, therapeutics, and vaccines for pathogens that remain underserved by existing countermeasure pipelines, including BDBV and others with pandemic potential. Particular attention should be given to therapeutics and diagnostics, where funding and access pathways remain less developed than for vaccines, to address the barriers to scaling promising tools and ensuring equitable access.
3. Champion the 100 Days Mission as part of the UK G20 2027 Presidency: The UK should use its G20 Presidency to place pandemic preparedness and medical countermeasure financing high on the global agenda. This should include championing sustainable coordinated financing for diagnostics, therapeutics and vaccines, strengthening surge financing arrangements for future outbreaks and maintaining political momentum behind the 100 Days Mission.

If we wait until a novel pathogen threatens our own borders to value the lives of our communities, mothers, and children – and, in turn, the global health systems that protect us – we have already lost the battle.

For the UK Government, standing with our global partners in their time of need is the only path toward a safer, fairer and more resilient world for everyone.

Investing in global health security overseas is the only way to guarantee security at home.