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Leveraging the structures of the COVID-19 pandemic response for successful control of Ebola in Uganda

Nature Medicine volume 29, pages 1892–1893 (2023)Cite this article

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This epidemic presented unique challenges that the Uganda government had not faced before. Mubende district — the epicenter of the epidemic — is traversed by a major highway that connects Uganda to the neighboring countries of Democratic Republic of Congo (DRC), Rwanda, Tanzania, and Kenya. Mubende district is also only 150 kilometers (a 3-hour drive) from the capital city, Kampala (population 3.8 million), which eventually experienced spread of the virus. This connectivity required unique approaches to stop transmission in the densely populated urban and peri-urban areas, and to avert international spread through the highly active air and ground transportation networks. The epicenter also has mining activities and diverse communities from neighboring countries, which presented cultural challenges for risk communication and community engagement, and further increased the potential for regional spread. These factors led the WHO to classify the threat as category 3, warning that the epidemic was likely to spread across international borders7. The successful control of the epidemic within 113 days, without locking down the capital city, was guided by two factors: lessons from the COVID-19 pandemic, and recent successes in responding to EVD epidemics in DRC.

The global response to the COVID-19 pandemic exposed the weakness of overreliance on multilateral responses to global threats, because every country — high- and low-income alike — was forced to rapidly develop individual pandemic-response structures. As pointed out by WHO and the Africa Centres for Disease Control and Prevention (CDC), the support given to global public-health agencies such as WHO and to low- and middle-income countries (LMICs) diminished, resulting in inequities in the supply of key biomedical items such as personal protective equipment and medical countermeasures required for the pandemic response8,9. The pandemic showed that regional collaboration needs to be created, supported, and sustained in order to assure emergency capacity for the distribution of supplies, as well as collaborative development of expertise, funding, and infrastructure for an effective regional response.

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Authors and Affiliations

  1. Uganda Ministry of Health, Kampala, Uganda

    Henry Kyobe Bosa, Richard Kabanda, Henry Mwebesa, Diana Atwine & Jane Ruth Aceng

  2. Makerere University Lung Institute, Kampala, Uganda

    Henry Kyobe Bosa, Misaki Wayengera, Bruce Kirenga & Winters Muttamba

  3. Kellogg College, University of Oxford, Oxford, UK

    Henry Kyobe Bosa

  4. Paul G. Allen School for Global Health, Washington State University, Pullman, WA, USA

    M. Kariuki Njenga, Jeanette Dawa, Eric Osoro & Isaac Ngere

  5. Washington State University Global Health Program, Nairobi, Kenya

    M. Kariuki Njenga, Jeanette Dawa, Eric Osoro & Isaac Ngere

  6. Departments of Pathology, Immunology & Molecular Biology, Makerere University, Kampala, Uganda

    Misaki Wayengera

  7. Department of Medicine, Makerere University, Kampala, Uganda

    Bruce Kirenga

  8. Division of Infection and Global Health, University of St Andrews, St Andrews, UK

    Winters Muttamba

  9. Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Robert F. Breiman

  10. Africa Centre for Global Health and Social Transformation, Kampala, Uganda

    Francis Omaswa

  11. Busitema University, Tororo, Uganda

    Samuel Okware

  12. World Health Organization, Kampala, Uganda

    Yonas Tegegn Woldemariam

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  1. Henry Kyobe Bosa
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  2. M. Kariuki Njenga
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Corresponding author

Correspondence to Henry Kyobe Bosa.

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Competing interests

H.K.B., R.K., H.M., D.A. and J.R.A. are employees of the Ministry of Health, Government of Uganda. F.O. is an employee of the Africa Center for Global Health and Social Transformation, Uganda. Y.T.W. is an employee of the World Health Organization. All other authors declare no competing interests.

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Kyobe Bosa, H., Njenga, M.K., Wayengera, M. et al. Leveraging the structures of the COVID-19 pandemic response for successful control of Ebola in Uganda. Nat Med 29, 1892–1893 (2023). https://doi.org/10.1038/s41591-023-02395-4

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