On May 30, as football fans around the world counted down to the start of the FIFA World Cup in North America and airlines prepared for the annual surge in summer travel, the World Health Organization Director-General Tedros Adhanom Ghebreyesus was sitting in Bunia, a city in eastern Democratic Republic of Congo, listening to community leaders describe a very different reality.
Religious leaders, youth representatives, women's groups and local officials had gathered to discuss a disease that has haunted Central Africa for decades but continues to unsettle the rest of the world whenever it reappears: Ebola. The timing could hardly have been worse.
A few days earlier, Uganda had tightened extraordinary measures along its 800km-long western border with DRC, announcing restrictions on cross-border movement following what officials described as the continued escalation of the Ebola outbreak in Ituri Province.
Similarly, the United States, Canada and Mexico, the joint hosts of this year's global football jamboree, had unveiled coordinated public health travel measures ahead of the FIFA World Cup, citing the need to protect millions of expected visitors as well as their own populations.
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Thousands of kilometres away, diplomats, epidemiologists, aviation authorities and public health officials were asking variations of the same question: Could the current Ebola outbreak become something much bigger? The concern is not merely about the number of cases.
Dr Jean Kaseya, the Director-General of the Africa Centres for Disease Control and Prevention told a continental ministerial meeting on May 25 that more than 3,500 contacts were already being monitored across affected areas in Uganda and the DRC. In DRC, contact tracing operations had expanded across seven of the eight affected health zones in Ituri Province, while governments and international partners pledged close to US$500 million toward response efforts.
To Dr Kaseya, the figures illustrated both the scale of the challenge and the urgency of the response. "Our responsibility is clear," he said. "Stand with the countries leading the response and protect those who risk their lives to protect us."
Growing global anxiety
But beneath the declarations of solidarity lies a deeper anxiety that extends far beyond Central Africa. Unlike previous outbreaks involving the Zaire strain of Ebola virus, scientists have confirmed that the current epidemic is being driven by Bundibugyo Ebola virus, one of the rarest forms of the disease ever documented.
First identified in Uganda in 2007, the strain has caused only a handful of known outbreaks. More significantly, there is currently no licensed vaccine and no approved treatment specifically designed for it. That is the reason health authorities have had to rely on the traditional tools of outbreak control: surveillance, isolation, contact tracing and community mobilisation, even as transmission spreads across one of Africa's most complex and mobile regions.
In a paper published in The Lancet on May 29, Congolese researchers cautioned that the outbreak exhibits several features that make it especially challenging to contain. They pointed out that infections have been recorded in both rural and urban areas, with transmission extending across national borders.
The situation, the researchers noted, is further complicated by ongoing conflict and population displacement in the affected region. This is further exacerbated by the fact that health authorities initially overlooked the outbreak because testing capabilities were meant for the more prevalent Zaire strain, resulting in a critical delay in detection and response.
Remembering West African Ebola nightmare
For public health specialists, those lost days matter. "Diseases are easiest to stop at the beginning," said Dr Tolbert Nyenswah, the former Liberian health official credited with helping lead his country's response during the 2014-2016 West African Ebola epidemic and now Director of Pandemic Prevention, Preparedness and Response at Africa CDC. "When you don't have vaccines and therapeutics, your strongest tools become public health measures. You have to find cases, trace contacts, isolate infections and engage communities."
Those lessons were learned painfully during the West African epidemic, the deadliest Ebola outbreak in history. That crisis infected more than 28,000 people and killed over 11,000 across Guinea, Liberia and Sierra Leone. Beyond the human toll, the epidemic devastated economies, crippled tourism, disrupted trade and generated losses estimated in billions of dollars.
The current outbreak remains far smaller. But officials are acutely aware that outbreaks are not judged solely by today's numbers but by tomorrow's possibilities. That concern is particularly evident in Uganda, where authorities have moved aggressively to prevent further spread.
On May 27, Health Ministry Permanent Secretary Dr Diana Atwine announced temporary restrictions on movement across the Uganda-DRC border. Only authorised Ebola response teams, humanitarian operations, cargo transport and designated security personnel are permitted to cross under enhanced health surveillance protocols.
Any person entering Uganda from Congo must face monitoring measures, while schools in border districts have been ordered to intensify health surveillance and track learners arriving from affected areas. The measures reflect a difficult balancing act. Uganda is not only one of Africa's most important tourism destinations but also a major transport and trade hub linking East and Central Africa. The country understands both the economic consequences of Ebola and the political consequences of failing to contain it. That tension is increasingly visible internationally.
Dr Kaseya has emerged as one of the most vocal critics of travel restrictions imposed on African countries. Speaking from Kinshasa on May 28, he expressed frustration that some countries had introduced measures affecting nations with few or no confirmed cases. "It is a shame to see a country like South Sudan, with zero cases, zero suspected cases and zero deaths subjected to travel restrictions," he said.
His criticism touches on a longstanding debate in global health. Do travel restrictions help stop outbreaks, or do they simply punish countries already struggling to contain them? The answer remains contested, but what is not disputed is the political pressure facing African governments.
Drawing lessons from COVID-19
COVID-19 fundamentally altered how leaders think about infectious disease threats. Before 2020, outbreaks in distant regions were often viewed primarily through a humanitarian lens. Today they are increasingly treated as national security concerns. That shift helps explain the speed with which North American governments have moved to coordinate travel measures ahead of the World Cup.
In a joint statement released on May 28, the United States, Canada and Mexico announced aligned public health travel measures for individuals arriving from regions considered at highest risk. "The health and safety of every person in the region remains our highest priority as we welcome the world to North America," the statement said.
The United States has gone even further. According to State Department briefings released on May 28 and 29, Washington has "mobilised more than US$162 million in bilateral assistance for the Ebola response and hundreds of millions more through humanitarian channels." The American-funded programmes are supporting border screening, laboratory diagnostics, treatment centres, contact tracing and surveillance activities across the region.
Secretary of State Marco Rubio also spoke with Kenyan President William Ruto about preparedness efforts, underscoring growing concern that the outbreak could place pressure on regional health systems if transmission continues. But, while governments focus on borders and preparedness, WHO officials insist the decisive battleground lies elsewhere. In Bunia, Dr Tedros repeatedly emphasised that community trust would determine whether the outbreak is contained.
"Ebola is a terrible disease that you get when you care for someone," Anaïs Legand, a WHO official involved in the response, said in a public message. "You get it when you care for your husband, your child, your mother. That is why communities must understand how to protect themselves and why seeking care early is so important." Legand's sentiments reflect one of Ebola's cruellest characteristics. The disease often spreads through acts of love and care; bathing a sick relative, comforting a dying family member or preparing a body for burial.
A region on the edge
By the end of May, the outbreak had begun reshaping policy far beyond the forested hills and mining corridors of eastern Congo. In Kampala, Uganda's Ministry of Health confirmed on May 27 that the National Task Force on Ebola Response, chaired by the country's Vice President, Jessica Alupo, had approved a series of extraordinary containment measures along the border with the DRC. The directive effectively restricted cross-border movement, allowing entry only to authorised response teams, humanitarian personnel, cargo transport and security services operating under strict screening protocols.
"All returning persons (from DRC) shall undergo mandatory self-isolation for 21 days under supervision," Dr Diana Atwine, Uganda's Permanent Secretary for Health, told a press briefing. Schools in border districts, she added, would remain open but operate under intensified surveillance, with daily temperature monitoring for learners who had recently travelled from the DRC.
Uganda's decision reflects a calculation that has become familiar in Ebola outbreaks; act early and decisively, even at significant economic and social cost, in order to avoid far greater disruption later. Health and other government officials in Kampala have been explicit, noting that the measures are driven by rising cross-border risk, particularly given the intensity of movement between Ituri Province and western Uganda through informal trade routes that are difficult to fully monitor.
On the same day Dr Diana Atwine addressed the press, spelling out several measures to contain the outbreak, Gen. Muhoozi Kainerugaba, the Chief of Defence Forces, said, "Uganda's security forces are sealing our entire border with the DRC until further notice.No movement of people between the two countries is permitted. This is in response to the Ebola outbreak in DRC. Trying to breach this order will endanger your life. We will update you on the situation as it develops," he said in a tweet, posted on his personal X handle on May 27.
The timing underscores a growing concern among epidemiologists: the outbreak is no longer containable within a single administrative geography but is instead moving along the very networks that sustain daily economic life in the region.
The Bundibugyo strain and the limits of medical tools
While governments have moved to tighten borders and surveillance systems, scientists have been grappling with a more fundamental constraint: the absence of specific medical countermeasures. A review referenced by epidemiologists at WHO and the scientific journal The Lancet, highlights a critical gap: there is currently no licensed vaccine or approved therapeutic specifically targeting Bundibugyo Ebola, leaving health authorities reliant on supportive care and classical containment strategies. That absence has shaped every aspect of the response.
"Without a vaccine, you are essentially working with time and behaviour," said Dr Nyenswah. "You must identify cases early, trace every contact, and ensure communities understand what is happening before transmission chains expand."
Nyenswah's warning echoes lessons from West Africa, where delays in detection and weak health systems allowed Ebola to spread rapidly across borders, eventually infecting and killing thousands of people. In the current outbreak, the same principles apply, but under more complicated conditions.
Early warning signals and a delayed identification
According to epidemiological analyses cited in The Lancet, the outbreak likely began in late April when a health worker in Bunia developed symptoms consistent with haemorrhagic fever. The patient died within days. What followed illustrates how quickly an outbreak can expand before it is correctly identified.
The deceased was transported to Mongbwalu for burial, where traditional funeral practices brought family members and community contacts into close physical proximity with the body. Several of those contacts later became ill.
Initial laboratory testing, however, failed to detect Ebola. Samples were screened for the more commonly circulating Zaire strain and returned negative results. It was only after further investigation at reference laboratories in Kinshasa that Bundibugyo Ebola virus was identified.
By May 5, the World Health Organization had been alerted to an unusual cluster of unexplained deaths in eastern Congo. Ten days later, on May 15, authorities formally declared an Ebola outbreak. By that point, transmission had already extended across multiple health zones in Ituri Province. For epidemiologists, the delay between first infection and confirmation is not just a technical detail; it is the defining variable that determines how large an outbreak may become. "Every missed chain of transmission becomes a new outbreak cluster," said a senior WHO field epidemiologist involved in the response who requested not to be named due to operational sensitivity.
Ituri: a region where movement defines risk
The geography of eastern Congo has long shaped the behaviour of disease outbreaks in the region. Ituri Province, where the outbreak is concentrated, is both resource-rich and structurally fragile. Gold mining drives large-scale informal migration, drawing workers from across the DRC and neighbouring countries. At the same time, persistent insecurity linked to armed groups has displaced populations repeatedly over the past decade.
These conditions create what public health specialists describe as a "high-connectivity environment", a setting in which diseases can travel quickly through dense and constantly shifting human networks. The region also sits along critical cross-border routes linking the DRC to Uganda and South Sudan, meaning that even localized outbreaks can rapidly become regional concerns. That dynamic is already visible.
Uganda has already confirmed nine cases linked to cross-border transmission. Health officials in South Sudan have increased surveillance in border counties. Screening measures have been reinforced at major transport points, including airports and official border crossings. For Africa CDC Director-General, Dr Jean Kaseya, the situation underscores why regional coordination is essential. He also announced that governments and partners had pledged approximately US$500 million in support for the response. "We are standing with countries leading the response," he said, "because protecting them is protecting the continent."
WHO's message: community trust is the decisive factor
While governments have focused heavily on surveillance, border control and funding, the World Health Organization has emphasised a different dimension of the response: trust. Dr Tedros Adhanom Ghebreyesus, who met with local leaders, including representatives of faith-based organisations, women's groups and youth associations in Bunia, said, 'Ending Ebola depends on communities.' He said the past 16 outbreaks in the DRC had been contained largely through local engagement rather than external intervention alone.
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Anaïs Legand reinforced the point in a public message, describing Ebola as a disease that often spreads through acts of care within families. "It is when people care for their loved ones that transmission happens," she said. "That is why trust, early care-seeking and safe burial practices are essential."
Public health experts note that such messaging is not incidental. It reflects decades of experience showing that resistance, misinformation and fear can significantly prolong Ebola outbreaks, particularly in regions where distrust of state institutions is high.
A World Cup shadow and global anxiety
Still, the timing of the outbreak has amplified its visibility. With the FIFA World Cup set to begin in mid-June across North America, governments are under intense pressure to demonstrate preparedness for any potential health threat. Although Ebola is not easily transmissible in mass gatherings, its presence in international travel networks is politically sensitive.
A joint statement by the three host countries emphasized that their coordinated approach was designed to ensure both safety and continuity of travel during the tournament period. For aviation authorities and tourism-dependent economies, including Uganda, the concern is not only health-related but also reputational. Even isolated suspected cases can trigger widespread attention and temporary travel disruptions. Public health experts say this is a defining feature of the post-COVID era: risk perception now travels faster than epidemiology.
Despite the anxiety, officials involved in the response stress that containment systems are actively functioning. Contact tracing teams are monitoring thousands of individuals across affected regions while treatment centres are being expanded. Surveillance systems have been reinforced in Uganda and eastern Congo. Several infected healthcare workers have recovered following supportive care.
The DRC itself has extensive experience managing Ebola outbreaks, having responded to more than a dozen previous epidemics. Still, uncertainty remains. As one WHO epidemiologist put it, "We are not dealing with an uncontrolled situation, but we are also not dealing with a stable one."
A test of global health governance
Ultimately, the agitation surrounding the outbreak reflects a convergence of factors rarely seen simultaneously. A rare virus with no vaccine; cross-border transmission in a conflict-affected region; large-scale population mobility linked to mining and trade; and a global travel peak season as well as a major international sporting event coming up.
Wrapped around all these intervening factors is a post-pandemic world increasingly sensitive to infectious disease threats. Whether the outbreak becomes a contained regional emergency or escalates into a broader international concern will depend on decisions being made simultaneously in treatment centres in Bunia, surveillance posts in Uganda, coordination offices in Kinshasa, technical headquarters in Geneva, and policy rooms in Addis Ababa, Brussels, Washington and other capitals.
For now, health officials remain focused on a narrower task: finding every case, tracing every contact, and breaking every chain of transmission before the virus finds new paths outward. The world is watching closely not because Ebola has changed, but because the world around it has.
