The 2026 Bundibugyo Virus Disease Outbreak:
The 2026 Bundibugyo Virus Disease Outbreak:
Understanding it from a Humanitarian Lens
Understanding it from a Humanitarian Lens
by Chin Wei Ling, University Student (Life Sciences & Public Health)/Intern (CoEPP), September 2025
Fast Read
Fast Read
Ebola outbreaks have occurred across parts of Africa..
Delayed detection contributed to the rapid escalation of the 2026 Ebola Bundibugyo Virus Disease outbreak, which was later declared a Public Health Emergency of International Concern.
Longstanding conflict, unfamiliar response measures and changes to funeral practices have affected public trust.
Infrastructure gaps place healthcare workers and patients at greater risk.
Immediate action includes supporting response efforts by the International Federation of Red Cross and Red Crescent Societies and other humanitarian partners on the ground, while long-term actions include designing preparedness plans with the community in mind.
Introduction
Janet Tobias’s Unseen Enemy (2017) argues that strengths of the 21st century, like rapid urbanisation and human mobility, have turned isolated and local disease outbreaks into global epidemics. The film leaves viewers with a message that a virus anywhere remains a threat everywhere, and the global community remains unprepared.
Nine years after the film’s release, the world has gone through the COVID-19 pandemic, and the World Health Organisation (WHO) has now declared the 2026 Bundibugyo Virus Disease (BVD) outbreak as a Public Health Emergency of International Concern (PHEIC) - proof that the unseen enemy is always present and a reminder that existing vulnerabilities can allow a local outbreak to develop into a much larger crisis.
This commentary serves to trace the journey of the virus from its natural animal reservoir into the human population, and examine how systemic vulnerabilities can breed distrust. Ultimately, it aims to outline how humanitarian networks can work together to move beyond short-term responses towards a trust-based, community-led pandemic preparedness.
The Zoonotic Spillover
As of September 5 2026, the Democratic Republic of the Congo (DRC) has reported 6,250 confirmed cases and more than 3,000 confirmed deaths. While the outbreak has stabilised in neighbouring Uganda, the epidemic has been recognised as the fastest-growing Ebola outbreak on record, with the World Health Organisation’s (WHO) modelling and more than 80% of new cases being detected outside contact lists suggesting the real scale of the outbreak is two to four times larger than official figures1.
To better understand how the 2026 Ebola BVD outbreak became an international public health emergency, we must be on the same page:
The Ebola virus is not a new or re-emerging pathogen. Ebola outbreaks have occurred across parts of Central, East and West Africa. The virus survives long-term inside wild animal populations, especially fruit bats and non-human primates. In between human outbreaks, it remains in circulation within these animal populations. An outbreak begins when a virus crosses the species barrier from an animal to a human, enabling a zoonotic spillover2.
One activity that increases the risk of the spillover is wild bushmeat hunting. However, this practice must be understood from a humanitarian lens. For many communities, wild meat is an important and accessible source of protein rather than simply a matter of choice3.The risk of exposure can arise when an infected animal is hunted, butchered or prepared for consumption. If an animal is infected, direct contact with its fluids allows the virus to enter the human population through micro-abrasions on the handler’s hands, or their eyes, nose, or mouth3.
Introduced into the community by a zoonotic spillover, the strain driving this current outbreak is caused by a rarer BVD variant. Official detection of the first cases occurred after the virus was believed to have been spreading silently in communities for weeks, since early diagnostic tests were optimised for older Ebola virus strains2,4.The current absence of approved vaccines, targeted therapeutic treatment, and local baseline immunity compounded the effects of the outbreak. Additionally, as this commentary aims to explore, the crisis is also worsened by deep structural vulnerabilities and recent cuts to international aid funding.
While international risk is low, it is never zero. When we do not work together to support our foundations, localised outbreaks can also cross borders easily, reminding us that in our interconnected world, diseases are never isolated threats. Therefore it is imperative to understand the factors contributing to the scale of the 2026 Ebola BVD outbreak.
Why this outbreak is different?
The outbreak is heavily concentrated in the Ituri, North Kivu, and South Kivu provinces of the Eastern DRC and is quickly spreading. The region has navigated through three decades of humanitarian challenges and armed conflict. This has resulted in two outcomes:
The displacement of nearly 1 million people5 across porous and unmonitored borders into neighbouring countries, making contact tracing difficult. People crossing borders without legal documentation may face barriers to accessing formal state services and healthcare systems. When individuals in such situations develop early symptoms of Ebola, these barriers may delay their access to testing and care, potentially allowing cases to remain undetected.6,7.
When formal state services are disrupted by long-term insecurity, implementing sudden public health mandates can create friction and uncertainty within the local population8.
Furthermore, the legacy of past Ebola outbreaks, such as the tenth Ebola outbreak (2018-2020) in the DRC, highlights how deeply continuous crises can strain community trust. During this outbreak, frustration over how international aid was deployed led some individuals to view the response with scepticism. For example, a community member in Beni, north-eastern DRC, shared that “Ebola is (viewed as) a business here and not a disease; the people attached to it came to make money … They seek to inflate the number of patients to raise more money to spend excessively in front of our (local authority) eyes.”9
While this belief does not represent that of everybody in the region, such sentiments point to a present feeling of apprehension and mistrust among heavily impacted communities. When a population has already experienced long-term hardship, emergency protocols like quarantine measures and changes to funeral and burial practices can, unfortunately, feel less like medical care and more like an unwanted extension of outside control. These perspectives show that during crises, there is usually a critical gap between the intent of public health programmes and how they are accepted on the ground.
Culture shapes how we navigate life's milestones.
Worldwide, we carry out various cultural traditions to honour and respect our loved ones and strengthen ties. In some cultures, greeting involves hugging and making physical contact to show warmth. In other cultures, sharing food from communal dishes is an act of inclusivity and acceptance. Similarly in some communities in Africa, funeral traditions involve relatives washing, dressing, kissing, and touching the body of a deceased relative. These rituals ensure their loved ones pass peacefully and surviving family members are protected from misfortune10. During an Ebola outbreak, however, these acts of love may increase the risk of virus exposure, accelerating the spread of diseases within a family.
To reduce transmission, authorities restricted funeral wakes and large gatherings and introduced procedures for response teams to manage some burials 5. For families, being unable to give a final farewell or take part in the burial procedure added to their grief. . From focus group interviews conducted with families of victims deceased by the 2014-2015 Sierra Leone West African epidemic, some families shared that they “felt bad because (they) never saw where (their loved ones) were buried” and that they “never set eyes on the corpse nor even visited the burial of (their) loved ones”6. Others were angered by the burial teams involved in the outbreak, sharing that the teams required bribes before collecting the dead bodies and that “they were disrespecting the dead … I hated them for that reason.”6
When people do not trust that burial procedures will respect their family members, some may avoid burial teams or resist response measures. In isolated cases, these tensions have escalated into attacks on Ebola treatment centres 5,6,11. As Unseen Enemy has aptly noted, diseases like Ebola are “not only killing people, but traditions and culture, destroying hope for the future.” This reality invites us to consider how acts of care can unintentionally increase transmission risks during a health crisis. It also highlights the need for measures that keep people safe, while respecting the cultural traditions in which families honour their loved ones.
New Set of Structural Vulnerabilites
For a DRC resident who suspects they have the virus and wishes to seek help, the advised path is to report to the nearest healthcare center. However, there are a new set of structural vulnerabilities present.
The severe underfunding and recent international aid cuts has “reduced the capacity to detect and respond to infectious disease outbreaks”, according to Thomas McHale on 25 May 2026, the public health director at Physicians for Human Rights5. President of Women’s Solidarity for Inclusive Peace and Development, Julienne Lusenge, shared on the same day that only hand sanitisers and a few masks were present and that, despite requests being made, nothing has been received5. Additionally, primary care facilities lack running water for handwashing, sufficient personal protective equipment (PPE), isolated treatment areas, and laboratory test kits12. Healthcare personnel are hence forced to make diagnoses based on non-specific symptoms, placing them at risk of direct transmission13.
The lack of infrastructure also creates three bottlenecks:
Due to slow diagnostic confirmation, potential Ebola patients may choose to return home to unprotected families and community members, unintentionally creating new chains of infection14.
A lack of dedicated ebola treatment centres to physically separate potential Ebola patients and non-Ebola patients can increase the risk of cross-contamination and create a new zone of transmission12.
A reported lack of compensation and rest may compromise the immune system of healthcare workers, placing them at greater risk of contracting the virus or other endemic viruses15.
To understand the challenges health facilities face during an outbreak, it is important to consider the resources available to support their response Historically, international funding served as a protective support for the region. During peacetime, this funding contributed to grassroots disease surveillance networks that serve as early warning systems. Such funding supported critical healthcare infrastructure.
Hence, when these fundings were cut, such systems were removed.
Up to 1.5 million people lost access to primary healthcare in the DRC and 1,000 nutrition centers have been forced to close16.
International NGOs like IRC reduced their health programming from five health areas to two in Ituri (outbreak’s epicenter)16.
Defunding of critical healthcare infrastructure like triage zones and isolation wards16.
Dismantling of the region’s early warning surveillance infrastructure16,17
The removal of such systems leaves frontline personnel to fight against the outbreak without the necessary protective support. For instance, some frontline physicians lack essential PPE18.
Human response is also affected. Without deliberate effort to fund local networks and restore trust, the community will be the most affected. Humanitarian organisation CARE lost one-third of its national staff, most of whom worked directly with the community19. NGOs part of the Bond network (e.g., Oxfam, Tearfund, World Vision) were also forced to close essential programmes in the DRC. The programmes affected include those dedicated to Ebola detection and prevention, and the provision of safe shelter and sanitation to local communities20.
Simultaneously, the funding to support community engagement and build local trust dropped by 90% in the DRC and 76% in Uganda17. Previously, these funds were used to train and employ local leaders and community groups as intermediaries between medical professionals and the local community to communicate factual prevention messages and dispel misinformation. With fewer trusted local networks, it may be more difficult to explain public health measures in ways that respond to community concerns. These communication gap can also create more space for misinformation to spread.
Despite these funding cuts, humanitarian organisations on the ground have been working with the restrained capacity to support the outbreak as much as they can. CARE has been conducting partnerships with local leaders, women’s networks, and community volunteers to combat misinformation as much as possible, alongside providing factual information about the disease and when to seek medical treatment19. Oxfam is also doing its best to provide clean water and sanitation services through collaboration with local partners in epicenters like Bunia21. Similarly, the Red Cross of the Democratic Republic of the Congo and Uganda Red Cross Society are strengthening their community engagement through door-to-door visits and focus group discussions to understand community concerns, combat misinformation, and raise awareness on the disease22,23. National Societies in high-risk countries have also established varying levels of preparedness to prepare for potential spillover, such as the Kenyan Red Cross, South Sudan Red Cross, Burundi Red Cross, Rwanda Red Cross, and the Central African Republic Red Cross24.
To strengthen frontline capacity, specialised Emergency Response Units have also been deployed to affected areas, underpinned by a coordinated rapid response system that dispatched pre-trained personnel across essential operation roles25. Maintaining such deployment-ready specialists from African, European, and North American National Societies ensures that their technical expertise can be immediately mobilised when a public health emergency occurs, and highlights the strong global solidarity and operational unity across the international Red Cross Red Crescent movement.
Authorities on the ground are also trying their best to utilise past experience with the virus to earn community cooperation, with Dr. Marie Roseline Belizaire, the WHO’s Emergency Preparedness and Response Disaster for Africa, sharing strategies the healthcare team deployed are employing. For instance, healthcare teams share information about Ebola with families and work with traditional healers to alert health authorities when someone with symptoms seeks their help18.
The Path Forward
The analysis above underscores two vital takeaways:
Public health interventions cannot occur when a crisis begins. Community-led preparedness and continuous health dialogues during peacetime are also needed. By integrating health education into the communities’ daily lives before an outbreak occurs, it ensures communities are already equipped with knowledge on how to protect themselves and are prepared when an outbreak inevitably occurs. Such integrations were ongoing before the commencement of this outbreak by humanitarian organisations such as the Red Cross of the Democratic Republic of the Congo and Uganda Red Cross Society.
Within the Red Cross and Red Crescent Societies, protecting and building community trust remains our absolute priority. We must understand that without meaningful Risk Communication and Community Engagement (RCCE), local populations may not feel safe relying on the very systems designed to support them.
While humanitarian organisations and healthcare personnel in the affected regions are doing their best, the WHO’s PHEIC declaration is a call for coordinated and immediate action among international partners and partner National Societies:
Actively contribute to humanitarian emergency appeals, such as the IFRC Emergency Appeal, to deliver essential resources directly to the frontlines.
Ensure our public health networks remain informed on the changing operational situation, by tracking international epidemiological updates and participating in regular briefing meetings with global and regional partners.
Align communication strategies with local and international authorities.
Closely monitor public reaction to news releases to gauge information uptake and identify anxiety before misinformation spreads.
When the situation improves,
Our long-term focus must shift toward pandemic preparedness.
One key way to do so is by routinely analysing and maintaining public trust. Within the Red Cross and Red Crescent societies, our primary vehicle for building this capacity is RCCE. Our local volunteers come from the community they serve, hence they find greater acceptance and trust on the ground. It is vital we utilise our unique roles as auxiliaries to the government to maintain a permanent and trusted presence during peacetime and crises. Routine health campaigns can be turned into educational opportunities to transparently share the rationale behind public health guidelines. Importantly, future response plans can also be co-designed with communities. By ensuring emergency preparedness protocols consider human dignity alongside viral containment, we can build a pandemic preparedness framework trusted by communities for the protection of the communities.
Conclusion
The scale of the ongoing 2026 Ebola Bundibugyo Virus Disease (BVD) outbreak is a sobering reminder that medical interventions cannot succeed in the context of public mistrust and structural neglect. Heartbreaking testimonies from families who have gone through such loss and continue to go through these losses, along with the realities of frontline workers expose gaps within a system that ultimately affect the people it’s supposed to serve.
However, the slow recovery of patients18 shows that progress is possible when early intervention is taken and local insights are respected. In the short-term, sister National Societies can support response efforts through funding the IFRC Emergency Appeal and coordinate clear, locally relevant communication. In the longer term, the outbreak reinforces a wider lesson for pandemic preparedness: medical readiness alone is not enough. Preparedness must also strengthen trusted local and regional networks, sustain community engagement between crises, and involve communities in developing the plans intended to support them.
Disclaimer to Note:
Kindly note that the views expressed in the commentary are intended for knowledge-sharing only and do not constitute an official opinion from the Centre.
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