Over the last decade, every time Uganda has had an Ebola outbreak, it has always found Dr Diana Atwine, Uganda's Permanent Secretary at the Ministry of Health, waiting for it. From the terrifying uncertainty of the 2019 outbreak to the deadly 2022 epidemic in Mubende and later the ferocious COVID-19 pandemic that turned public health officials into some of the most scrutinised figures in Uganda, Dr Atwine has become one of the country's most enduring crisis managers.
Long before most Ugandans begin hearing rumours of unexplained fevers or seeing ministry press briefings on television, Dr Atwine is usually already deep inside the machinery of response; studying surveillance reports, coordinating district teams, activating emergency operation systems and speaking to health officials across Uganda's porous western border with the Democratic Republic of Congo.
For nearly ten years, Ebola outbreaks have repeatedly arrived to find her at the same desk. But this year's outbreak, which was officially declared on May 15 via an imported case from eastern DR Congo, has found her unusually exposed.
Face of frustration
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Ugandans, who appear to be suffering from pandemic fatigue, are angry again. The anger is familiar now, almost cyclical. It rises each time an outbreak appears, each time movement is restricted, each time travel plans collapse or economic expectations shift under the weight of a public health emergency. And once again, the anger has found a face.
As such, Dr Atwine is being blamed. Not in official statements, not in institutional resolutions, but in the way public frustration attaches itself to the most visible node in a system too complex to explain in everyday conversation. On radio talk shows, in taxi parks, and on social media threads where outrage often travels faster than epidemiological tone, her name has become shorthand for economic disruption.
Tourism operators have watched cancellations spread through what should be Uganda's busiest travel season. Hotels have been recalculating occupancy forecasts. Ugandans travelling abroad are suddenly facing suspicion, restrictions and additional scrutiny. Pilgrimage organisers who were preparing for Uganda Martyrs Day celebrations on June 3 at Namugongo Martyrs Shrines suddenly had all their plans halted when President Yoweri Museveni cancelled the commemoration on May 17 to avert a regional, if not continental, public health catastrophe.
Standing in the middle of all this is the woman who, for almost a decade, has become inseparable from Uganda's epidemic response system. Yet even as frustration rises around her, the crisis Dr Atwine is responding to did not begin in Kampala. It began hundreds of kilometres away in eastern DRC, inside the unstable outbreak geography of Ituri Province.
Lonely this time?
For years, Dr Atwine rarely carried this burden alone. Inside Uganda's Ministry of Health, her partnership with former Health Minister, Dr Jane Ruth Aceng, gradually evolved into one of the most recognizable public health leadership pairings in the country.
Dr Aceng, the medical doctor and politician, often occupied the political frontline during moments of national anxiety while Dr Atwine anchored the technical machinery underneath: surveillance systems, district coordination, emergency response structures, laboratories and workforce deployment.
Together, the two women became the face of Uganda's epidemic management architecture. When Ebola appeared in the previous years, they stood together before cameras explaining containment measures and reassuring a nervous country. During COVID-19, they defended lockdowns, school closures, curfews and vaccination campaigns before an exhausted public that increasingly viewed the Ministry of Health not simply as a technical institution but as an enforcer of painful restrictions touching nearly every aspect of daily life.
In many ways, Dr Aceng's political role often absorbed part of the public anger that naturally accompanies epidemic outbreak management. Ministers are expected to take political heat; technocrats usually operate with less direct public exposure. But over time, Uganda's repeated epidemics have gradually blurred that distinction. Dr Atwine is no longer merely an internal administrator. She has become publicly identifiable with the outbreak response system itself.
The current outbreak arrived at a moment of political transition following Uganda's recent general elections, in which President Yoweri Museveni won on Jan. 17, according to the Electoral Commission.
When the outbreak was announced, the government was operating through a period of institutional reorganization and uncertainty, and when President Museveni eventually announced the new cabinet on May 26, Dr Aceng did not return to the Ministry of Health. Her absence seems to have changed the optics of the entire Ebola response almost immediately.
For the first time, Dr Atwine is no longer operating inside a visible political-technocratic partnership. The familiar two-woman front that had defined Uganda's public health communication through Ebola and COVID has suddenly disappeared, leaving the Permanent Secretary as the single most visible anchor of the outbreak response. And as the restrictions have intensified, so has the public pressure around her.
The timing has been brutal. Uganda was entering one of the busiest travel periods on its social and economic calendar. The money-minting Uganda Martyrs Day celebrations were approaching, drawing pilgrims from across East Africa into one of the region's largest annual religious gatherings. Hotels, transport companies and tour operators were also preparing for what is normally one of the strongest tourism high-season windows of the year, which normally runs between June and August, drawing in thousands of tourists from Europe and North America.
A crisis imported from across the border
Then Ebola arrived again from eastern DRC. Inside Ituri Province, the outbreak was already moving through one of the most unstable epidemiological environments in the region. Continental preparedness documents circulated among African Union and World Health Organisation (WHO) partners describe "clustered transmission within families," "health care-associated transmission," and "undetected transmission chains" spreading across multiple health zones including Mongbwalu, Rwampara and Bunia along Uganda's western border with DR Congo.
"Over 100 deaths have been reported over six weeks," one continental assessment warned, adding that there had been "a notable instance where 15 deaths occurred within a single household over two weeks."
For officials inside Uganda's Ministry of Health, this is the outbreak they have been monitoring every morning. Not simply Uganda's confirmed numbers, but the wider transmission picture unfolding across the border as well.
The WHO Regional Director for Africa, Dr Mohamed Yakub Janabi recently captured the regional vulnerability bluntly. "Rwampara in Ituri is just 318 km from Kampala, but nearly 3,000 km from Kinshasa," he said during a WHO press briefing on June 4. "This is how people move."
And Dr Janabi is right. Movement across the Uganda-DRC border is a normal routine. Traders, miners, transporters, refugees and families move constantly through formal and informal crossing points linking eastern Congo to western Uganda, all along the 800km common border. Dr. Janabi revealed that Uganda's first identified case itself emerged from this movement system.
"The first case identified in Uganda came from DRC," he explained. "A person sought care across the border because it was closer." That reality has shaped every major decision that is emerging from Kampala.
On May 21, during a press briefing at the Uganda Media Centre in Kampala, Dr Atwine began outlining increasingly aggressive containment measures. "We are going to intensify mass risk awareness and sensitisation on infection prevention and control," she said. Then she escalated further. "We are going to double the screening, testing and also we are going to enhance treatment capacities along the DRC borderline."
Soon, the interventions moved beyond public health messaging into direct mobility restrictions. "We are temporarily suspending all cultural celebrations, and commemorations that attract big numbers of participants along DRC-Uganda border," she said.
"We are (also) temporarily suspending public passenger services on ferries, on Semliki River, the cross-border bus transport and all public transport between DRC and Uganda for four weeks."
And then perhaps the most controversial decision of all: "We are suspending all flights to and from DRC to Uganda and this takes effect within 48 hours." A few days later, she announced the total closure of the DR Congo-Uganda border, save for essential crossings.
To epidemiologists, these aggressive containment measures are aimed at interrupting transmission routes before Uganda experiences widespread community spread. But to businesses already struggling with uncertainty, however, the measures feel devastating.
Public health collides with business
Few voices capture that frustration more sharply than Uganda's tourism entrepreneur, Amos Wekesa. "We closed it last year, (and) we are closing it this year," Wekesa wrote on his X handle June 3, a platform he has used to criticize the government's handling of the current Ebola outbreak. "This Ministry of Health has done more harm than good in the last six years with only negative announcements."
Wekesa's statements on his X handle where he has a following of over 170,000 people spread rapidly because they speak to a growing sense of exhaustion inside Uganda's tourism and hospitality sectors. "Everywhere you go, people think you are sick because you are Ugandan," Wekesa, who has since the beginning of this year been promoting the Rwenzori Marathon around the world, added.
In another recent exchange on X, he argued that Uganda cannot repeatedly absorb economic shocks linked to outbreaks originating from neighbouring Congo. "We are next to DRC and next year, Ebola will break out again. This won't stop," he said.
The frustration is economic, but it is also attaching itself politically to the Ministry of Health. With Dr. Aceng gone from the Ministry, much of that anger is now concentrating around Dr Atwine herself.
Public health officials, however, respond from a very different logic system. In one of Wekesa's rants on X, his follower who goes by the name Dr Emmanuel B.K Luyirika attempted to push back sharply against suggestions that the Uganda government should learn to downplay outbreaks to protect economic interests.
"Thinking and focusing on money and business is okay and normal for a businessman," he responded to Wekesa on June 5. "But getting a friend to help you understand why numbers of highly infectious diseases are not treated like numbers of cancer or diabetes should not be hidden."
In quick response, Wekesa said: "You are saying life first and money is useless and knowledge about disease isn't confined to doctors alone. Common sense has it that if you get a disease and it doesn't matter whether infectious or not, you need resources to deal with it. Even Ministry of Health needs money to deal with it."
Wekesa added: "You guys are in a bubble, and you don't get it. We have taxes to pay; we have employees to pay. We have loans to pay. We have suppliers to pay. You think the money the Ministry of Health gets comes from the Uganda Revenue Authority, not businesses?"
But, for epidemiologists and outbreak managers, Dr Luyirika said transparency is not optional. Delayed reporting can mean delayed containment, and hidden transmission chains can mean explosive spread.
"In such infectious disease outbreaks, awareness, alerts and prevention measures cannot be done secretly," he said. "If they are not put in place in time and case numbers are put under wraps, the overall effect can be severe. In such a situation, the ethics of public health take precedence."
Wekesa's outburst is part of the tension which is defining Uganda's Ebola moment. The tourism industry is trying to preserve movement, confidence and continuity. The Ministry of Health is trying to interrupt transmission. And Dr Atwine is standing directly between those competing pressures.
Meanwhile, the outbreak itself continues evolving inside Ituri. Senior officials in the Congolese government, alongside WHO and Africa CDC officials describe an increasingly complex response environment involving insecurity, weak infection-prevention systems, humanitarian displacement and high population mobility. The continental preparedness framework which was unveiled on June 4, warns of "undetected transmission chains," "health care-associated infections," and the possibility of "amplified transmission with repeated importation and geographic spread."
Ugandan officials are particularly worried about population movement along the border corridor. Thousands of Congolese nationals routinely seek medical care in Ugandan health facilities. Trade routes linking Bunia to Uganda remain active. This, perhaps, explains why Uganda's Ministry of Health officials have acted aggressively this time. They are not simply managing confirmed cases already inside Uganda. They are trying to prevent a much larger regional outbreak from becoming deeply embedded inside the country.
The transparency price Uganda is paying
On June 4, during a joint WHO and Africa CDC virtual press briefing, Dr Atwine's update revealed both the confidence and frustration inside Uganda's response system. "Uganda has so far registered 15 positives," she said. "Out of those, 11 are imported and four are our health workers that treated the first case."
She explained that Uganda's quarantine systems are already functioning aggressively. "In Uganda we quarantine all the people who are our contacts," she said. "All these people have been sero-converting in our care." She noted that four patients have already been discharged while hundreds of contacts remain under observation.
But perhaps the most revealing moment came when she began speaking not simply as a technocrat, but almost as a representative of a country feeling punished for transparency. "We feel that we, as a country, have been a victim of transparency and effectiveness in dealing with epidemics," she said. "The more we communicate, the more we are blocked, the more we are locked out, the more our citizens are stopped from travelling," Dr. Atwine said.
Uganda, she insisted, has repeatedly demonstrated one of the strongest outbreak response systems in the region. "We have never exported any single Ebola case outside our country and outside our borders," she said.
WHO officials publicly agree that Uganda's systems remain comparatively strong. "I commend the governments of DRC and Uganda for their leadership, transparency, and decisive action," said Dr Janabi.
WHO has warned against the unintended consequences of international overreaction. "Ebola is not an airborne disease," Dr. Janabi said. "Blanket travel bans do not stop Ebola." Instead, he argued, such measures "disrupt supply chains," "weaken surveillance and contact tracing," and discourage transparency from governments trying to report outbreaks honestly. "We are fighting two outbreaks at once," Dr. Janabi said. "Ebola itself and misinformation -- a virus of its own."
At the centre of all this, Dr Diana Atwine continues working. The irony of her position is impossible to ignore. She is not responsible for the outbreak in Ituri. She is not responsible for the geography that binds Uganda and eastern Congo together through porous borders and constant movement. She is not responsible for the international travel advisories damaging Uganda's tourism economy.
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Yet she has become the figure through whom all these anxieties are being channelled. It is partly because she is visible, but it is also because she has become inseparable from Uganda's epidemic response system itself.
For nearly a decade, surveillance networks, emergency operation centres, laboratory systems, district coordination mechanisms and contact tracing structures have repeatedly activated around her leadership. And by regional standards, those systems are functioning comparatively well again. But effective outbreak management does not necessarily protect officials from public backlash.
If anything, visibility often intensifies it. The more aggressively Uganda responds, the more economically painful some interventions become, and the more transparently officials communicate, the faster fear spreads internationally.
And so, the anger keeps accumulating around the woman most visibly associated with the response. Still, the outbreak itself continues moving according to epidemiological logic, not political frustration. Transmission in Ituri remains active, contact tracing systems continue operating across Uganda's western districts, emergency response structures remain fully activated, and continental coordination mechanisms continue scaling up.
Keeping Ebola fight alive amidst 'punishment'
And inside the Ministry of Health headquarters in Kampala, Dr Atwine continues moving through surveillance reports, quarantine updates and regional alerts; trying to keep Uganda ahead of a virus still travelling through one of Africa's busiest borderlands.
And if Wekesa is grappling for an answer of when this will possibly end, the answer is not straight forward. "It would be too early to give a definitive prognosis," Dr Janabi told The Independent on June 4, during the virtual press briefing.
"At this stage, it is too early to give a very definitive prognosis. As transmission is still dynamic, our case detection is at 45% and response capacities are still being assessed. So, maybe in another two to three weeks, we can have to start to have a protection."
But Dr Janabi quickly added that while he was in Ituri recently, there were "quite a few possible scenarios that showed that it might take the responders four to six months or even nine months to contain the current outbreak. "It's still very early to do the prognosis, but not too early to act. That's why we're already on the ground," he told The Independent.
"We are also dealing with the virus which is less virulent than the other Ebola strains...So, I do think that we need a little bit more time to be able to do exact projection," added Dr Anne Ancia, the WHO Country Representative in the DR Congo.
"For the time being, we are using what the WHO calls the 'no regret' policy. So, we want to make sure that all resources are available on the ground in Bunia and in all health-affected areas to make sure that we can respond to the people that are affected."
"We are looking at numbers, and actually what we have done right now with the availability of diagnostic is having better numbers of confirmed cases and unconfirmed deaths. The second thing that we still need to do is to better understand the extent of the disease because until (we know that) we won't be able to have all suspected and confirmed cases isolated and that all contacts are traced," Dr Ancia told The Independent. The uncertainty which continues to engulf the ministerial boardrooms, border points and trading centres in both DR Congo and Uganda also continues to pile more unwarranted pressure on Dr. Diana Atwine, the face of this year's Ebola outbreak.
