BY JAEL NAMIGANDA
When the elder brother of Ramathan died from the dreaded Ebola Virus Disease (EVD), he was devastated. He had been the caregiver for his brother, a medical nurse, at the hospital where he was admitted after falling ill. Because his symptoms were not identified in time, he was not immediately isolated. Only after his condition deteriorated further did tests confirm that he had contracted the Sudan Ebola Virus, which soon claimed his life.
“His death prompted the government to declare an outbreak,” recalls Ramathan, a 30-year-old teacher from Kampala. On January 30, 2025, Uganda’s Ministry of Health officially announced an outbreak of Sudan Ebola Virus Disease.
From that moment, events unfolded rapidly. “It was all systems go,” he remembers. Everyone who had come into contact with the late nurse, including family members like Ramathan, was traced, isolated, and tested.
“In a swift move, a medical emergency team arrived at our home in Mbale that same day,” he says. “They took me and two other family members to Mulago National Referral Specialised Hospital. We all tested positive. We spent three weeks in isolation and received treatment before being discharged after testing negative.”
Ramathan and his siblings were among the 12 confirmed cases. Their timely identification and isolation helped Uganda avoid another wave of deaths, destruction, and fear. Within less than three months, the Ministry of Health declared the country Ebola-free.
This rapid containment was remarkable, especially for a country that had long relied heavily on foreign aid to fight outbreaks.
Yet this time, the crisis emerged as the United States Agency for International Development (USAID), a major supporter of Uganda’s Ebola response, had halted all global health funding following policy shifts under President Donald Trump.
The withdrawal of USAID support triggered public concern over how Uganda would manage a disease with a fatality rate historically ranging between 40% and 100% across the Great Lakes region. Still, the outbreak was controlled with minimal cases and only two deaths.
Ramathan remembers the fear when doctors told him the disease had no known cure.
“I had just lost my brother and was in isolation. It was traumatising,” he recalls. “But the care at Mulago gave me hope.” He credits the medical team for saving his life and that of his siblings, saying the treatment was “more than enough.”
According to Ministry of Health data, there were 14 recorded cases, 12 confirmed and two probable.
Of the confirmed cases, two patients died and 10 survived. Ramathan believes his brother might have been saved had he been diagnosed early.
Despite the reduced funding, the 2025 outbreak ended in less than three months, outperforming the September 2022 outbreak that lasted about 69 days and resulted in significantly more cases and deaths, even though it received USD 27 million, including USD 22.3 million from USAID.
In comparison, the World Health Organisation (WHO) raised only USD 6.2 million for the 2025 response.
Dr. Henry Bbosa Kyobe, National Incident Commander for Epidemics at the Ministry of Health, says Uganda’s growing competence in outbreak response helped reduce transmission and prevent deaths.
“Early detection remains the biggest challenge,” he notes. “But once an outbreak is confirmed, we activate the national response mechanisms.”
These include extensive contact tracing, such as locating individuals like Ramathan, whose contacts were spread across Kampala, Mbale, and Wakiso.
Dr. Kyobe says the use of modern tools, such as cell phone data for geospatial mapping, played a vital role in tracking interactions.
Adequate laboratory capacity also ensured quick testing and isolation. For the index case, a blood sample was sent to the Central Emergency Response and Surveillance Laboratory, where real-time PCR results were available in under 24 hours.
Uganda’s network of advanced laboratories, including mobile labs deployed during outbreaks, is a legacy of years of investment in public health emergencies.
“We had remaining stocks of remdesivir from the 2022 outbreak, which proved effective in treating the 10 admitted patients,” he adds.
However, one unanswered question remains: how the male nurse became infected.
“We don’t know how he contracted the virus,” says Dr. Kyobe. “In previous outbreaks, index cases often had links to regions like the DRC. This time, the source is unclear.”
For others, like Sumayiya (name withheld), the experience was equally frightening.
She tested positive days after caring for her younger sister in Kampala.
“My vomit and stool had blood,” she recalls. She was taken to Mulago for treatment. “I thought I was going to die, but the doctors assured me I would be okay.”
Public health expert Dr. Deogratias Sekimpi of the Uganda National Association of Community and Occupational Health says he never doubted the country’s ability to manage the outbreak.
“Since 2000, Uganda has built strong capacity, skilled personnel, laboratories, and emergency systems,” he says. Facilities exist not only in Mulago, but also in Jinja, Mbale, and Porthall.
Dr. Sekimpi agrees that funding is important, but organisation and expertise are even more critical.
“Our past experiences shaped today’s response. That explains the fewer deaths,” he says.
WHO reports that border health measures were reinforced to prevent cross-border spread.
A total of 129 national and international staff supported the response in case investigations, contact tracing, and laboratory testing. More than 1,500 samples were analysed.
Additionally, a randomised clinical trial for a vaccine, using a ring vaccination approach, was launched within four days of the outbreak declaration, despite the absence of a licensed countermeasure for the Sudan Ebola strain.
Dr. Chikwe Ihekweazu, Acting WHO Regional Director for Africa, described the outbreak as “challenging in many ways” and taking place amid “global funding constraints,” but praised Uganda’s leadership in managing health emergencies.
Like many survivors, Ramathan feared community stigma. “But when I returned home, no one treated me differently,” he says. “People are now informed and educated.”
While future outbreaks cannot be prevented entirely, Uganda’s case shows that with swift action, preparedness, and international collaboration, even limited, many lives can be saved.
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