The Ebola Outbreak and the Need for Stronger Global Health Governance 

On 17 May 2026, the World Health Organization (WHO) declared the Ebola outbreak in the Democratic Republic of the Congo (DRC) and Uganda a public health emergency of international concern (PHEIC), noting that while the overall global risk remains low, national and regional risks are elevated due to ongoing transmission, population movement, weak health infrastructure, and the outbreak’s emergence in conflict-affected areas.  

Although Ebola virus disease (EVD) outbreaks occurred periodically over the past several decades, the current Ebola outbreak in the DRC and Uganda is exposing persistent vulnerabilities within emergency financing, emergency preparedness and coordination at national, regional and global health security systems. It is transpiring in a global context defined by constrained humanitarian financing, geopolitical fragmentation, conflict, and growing pressure on already overstretched health systems. 

The outbreak is caused by the Bundibugyo strain of Ebola virus disease, which is a severe viral haemorrhagic fever transmitted through direct contact with infected bodily fluids, contaminated materials or infected animals. Unlike the more widely known Zaire Ebola strain that drove the large West Africa epidemic from 2014 to 2016, there are currently no approved vaccines for the Bundibugyo strain. Existing rapid diagnostic kits were initially targeted primarily toward the Zaire strain, creating additional operational challenges for rapid identification and response during the early stages of the outbreak. 

At present, according to WHO, the likelihood of widespread international transmission, remains low, as the outbreak is limited to DRC with confirmed exportation of cases to Uganda. However, the situation is also unfolding at a time when humanitarian systems are already under significant strain due to multiple concurrent crises, including conflicts, displacement, food insecurity, climate-related emergencies, and declining development assistance for health. As a result, the outbreak is not only a public health emergency but also raises questions about regional coordination, financing, and the future of global health governance. 

Humanitarian Aid 

The current Ebola outbreak carries implications that extend beyond the immediate public health response. While geographically concentrated, the outbreak reflects broader structural challenges affecting health security, humanitarian coordination and international preparedness in an increasingly interconnected world. 

For the affected countries, the outbreak reinforces the importance of sustained investment in strengthening public health systems, particularly collaborative surveillance, laboratory capacity and rapid response mechanisms, with an emphasis on community engagement which remains a key component of preparedness and response efforts. Previous outbreaks have consistently demonstrated that delayed detection and weak local health infrastructure significantly increase both the duration and cost of outbreak response efforts. In volatile environments, these challenges are often compounded by insecurity, population displacement and weak governance structures. 

For humanitarian actors, the outbreak reflects growing pressure on an already overstretched health financing environment. Global relief systems are responding to multiple simultaneous crises, ranging from conflicts and climate-related emergencies to food insecurity. In this context, outbreak response efforts increasingly compete for limited operational and financial resources.  

This also brings attention to the sustainability of current outbreak financing models and their often reactive orientation. There is a growing need for sustained investment to build the surveillance and workforce systems and cross-border coordination that meaningful preparedness requires. The Pandemic Fund is an example of a medium to long-term financial resource that was set up in 2022, as part of the lessons learned from the COVID-19 pandemic. This fund was established to help low and middle-income countries to strengthen their pandemic prevention response capabilities.  

The current Ebola outbreak reinforces the continued importance of such investments. It is also beneficial to put in place mechanisms for faster access to flexible emergency financing that can support early response efforts before outbreaks escalate. The small number of secondary transmissions to Europe and North America that occurred during the 2014-2016 West African Ebola epidemic highlights Ebola’s continued risk to highly connected economies and international transit hubs beyond affected regions. In light of this, countries with significant aviation, trade and labor connectivity should continue to prioritize robust healthcare infrastructure to detect and contain outbreaks before they escalate.  

Furthermore, the response to COVID-19 demonstrated how quickly localized health threats can generate wider operational, economic and political consequences through global mobility and interconnected supply chains. Health security is therefore closely linked to economic resilience, transport continuity, and national preparedness, and reinforces the importance of balancing outbreak preparedness with the continuity of trade, travel and economic activity, particularly in highly interconnected regions where disruptions can have wider regional and global implications. Supporting affected countries in their response and preparedness efforts is crucial as this helps reduce risks and strengthens health security both at home and abroad.  

At the international level, this outbreak should accelerate ongoing shifts in global health governance toward stronger regional coordination and greater emphasis on Global South leadership, with the advantage of having more context-sensitive, inclusive, and responsive approaches to outbreak preparedness and response. For instance, institutions such as the Africa Centres for Disease Control and Prevention (Africa CDC) and the WHO regional offices continue to play an increasingly visible role in driving regional response to health emergencies. This reflects broader calls for locally led approaches to health emergencies. 

The evolving landscape may also create greater space for emerging actors and the Global South to expand engagement in humanitarian response and health diplomacy. Health diplomacy, in this context, refers to the ways in which countries and a wide range of actors engage, cooperate and negotiate to improve health security and population health that have cross-border implications. Beyond traditional donor models, there is increasing interest in approaches that combine financing, diplomacy, technical cooperation, and regional convening and cooperation, reshaping who leads and who decides in global health governance.

Risks and Trajectories 

Over the coming months, the Ebola outbreak will require close monitoring, particularly in areas where structural vulnerabilities may complicate response efforts. Factors such as delayed detection, weak contact tracing systems, insecurity and healthcare-seeking behavior across borders may increase the difficulty of containing transmission in affected areas. The DRC and Uganda are characterized by high regional movement and substantial informal trade activity. Sustained coordination between national authorities, regional institutions and international partners will therefore remain imperative and countries need to work together on coordination and response rather than acting independently. 

Furthermore, public trust remains a critical dimension of outbreak response, especially if response efforts are perceived as externally driven or insufficiently responsive to community concerns. In previous Ebola outbreaks, mistrust and misinformation contributed to resistance against healthcare workers, treatment centers and vaccination campaigns. However, the outbreak may create opportunities for important shifts in how outbreak preparedness and humanitarian financing are approached. Growing recognition of the limitations of reactive emergency funding models could accelerate discussions around stronger long-term investments in preparedness and health system resilience. 

The outbreak could also accelerate South-South cooperation in health security and stronger regional coordination mechanisms. For this current outbreak, regional coordination meetings have already been convened, but they must now lead to concrete, real-time action on the ground. Finally, as traditional donor models face increasing pressure, emerging actors with financial resources, diplomatic influence, and convening power may play a larger role in shaping future health governance frameworks. 

Recommendations 

Increase Long-Term Investment in Health Systems and Human Resource Capacity 

Countries and international partners should prioritize long-term investments in surveillance systems, laboratory infrastructure, workforce development and primary healthcare rather than relying predominantly on reactive short-term humanitarian response mechanisms. The continuity of essential healthcare services, particularly for vulnerable and marginalized populations such as women, children, and people with chronic illnesses, must be taken into consideration during planning and responding to outbreaks as indirect disruptions to healthcare services can generate significant secondary health impacts. 

Integrate Health Security into National Preparedness Planning 

Countries with high levels of global connectivity should increasingly integrate health security into broader national preparedness planning, including investments in strengthening surveillance systems such as community-based surveillance, emergency coordination mechanisms, real-time public health communication, and collaboration between health, transport, and border authorities. 

Support South-South Cooperation and Global Health Diplomacy Efforts  

The evolving global health landscape presents opportunities to expand engagement in global health diplomacy through strategic convening, technical cooperation, preparedness financing and support for regional response initiatives. This may include supporting stronger collaboration between institutions in the Global South and contributing to more coordinated international preparedness efforts.  

Promote Sustainable Global Health Financing  

The outbreak also reinforces the need for broader international discussions around the future of health financing, preparedness investments and equitable participation in global health governance, particularly as development assistance for health faces increasing pressure globally. 

Conclusion 

The recent Ebola outbreak serves as a reminder that infectious disease threats emerging in fragile settings are no longer isolated humanitarian events. In a world shaped by globalization, geopolitical uncertainty and constrained health financing, localised outbreaks can rapidly evolve into broader regional and international concerns. 

The outbreak also highlights growing pressure on existing humanitarian and global health financing models, many of which remain reactive and fragmented despite repeated calls for more sustainable preparedness investments. More broadly, the situation reflects wider shifts taking place across global health governance, including greater emphasis on regional coordination and more locally driven approaches to outbreak response. 

How governments, humanitarian actors, regional institutions, and international partners respond over the coming months will be consequential.  The implications extend beyond containing this outbreak, but to the broader trajectory of global health governance. The decisions made now, around financing, regional ownership, and the sustainability of health systems, will echo well beyond this crisis, shaping the resilience and architecture of international health cooperation for years to come.