Uganda’s 2025 Ebola-Free Victory, Resilience and Global Prevention Lessons

Uganda was officially declared Ebola-free, marking the end of its sixth Ebola outbreak in just under three months. The outbreak, caused by the Sudan strain of the Ebola virus, began on January 29, 2025, in Kampala and affected five districts, resulting in 14 confirmed cases and four deaths. Uganda’s swift containment of this urban outbreak, despite challenges such as international aid cuts and the absence of approved vaccines, demonstrates a robust public health response and offers critical lessons for global Ebola prevention.

The outbreak was declared on January 29-30, 2025, after a 32-year-old male nurse died at Mulago National Referral Hospital in Kampala. The virus was confirmed as Sudan Ebola Virus Disease (SUDV) by three national laboratories and was genetically linked to a 2012 outbreak in Luwero, Uganda. Unlike the Zaire strain, which has an approved vaccine, the Sudan strain lacks licensed countermeasures, making containment reliant on public health measures and experimental trials. The outbreak spread to five districts being Kampala, Wakiso, Jinja, Mbale, and one other, posing a significant threat due to Kampala’s dense population of over 4 million. By February 7, 2025, new cases ceased, and the last patient was discharged on March 14, initiating a 42-day countdown. On April 26-28, 2025, Uganda’s Ministry of Health announced the end of the outbreak, a testament to the country’s experience with five prior Ebola outbreaks since 2000.

Uganda’s ability to contain the 2025 outbreak in under three months, its shortest Ebola response to date, was driven by a multi-faceted strategy:

Rapid Detection and Genomic Sequencing 

Within 24 hours of the index case’s death, Uganda’s Central Public Health Laboratories confirmed the Sudan strain, and African scientists set a “world speed record” by sequencing the virus, tracing its origins back to the 2012 outbreak. This rapid diagnostic and genomic capability enabled an immediate outbreak declaration on January 30, 2025, activating emergency protocols.

Aggressive Contact Tracing and Quarantine  

The Ministry of Health identified 265 contacts of the index case, placing them under strict 21-day quarantine in Kampala, Jinja, and Mbale. Mobile health teams and district task forces monitored contacts daily, preventing further spread. A surveillance gap, exposed when a four-year-old boy died undiagnosed on February 25, was swiftly addressed by intensifying tracing, adding two districts to the response. By February 27, most contacts had completed their quarantine.

Experimental Vaccine Trial  

On February 3, 2025, Uganda launched a randomized clinical trial for a candidate SUDV vaccine at Mulago Hospital, using a ring vaccination approach to immunize contacts and contacts-of-contacts. Supported by the International AIDS Vaccine Initiative and WHO, the trial drew on lessons from the 2022 outbreak, demonstrating Uganda’s ability to integrate research into crisis response.

Isolation and Treatment  

Confirmed cases were isolated at Mulago Hospital, with suspected cases triaged in temporary units. Supportive care, including rehydration and symptom management, was critical, as no approved SUDV treatments exist. Eight patients were discharged by February 19, and the last patient on March 14, with safe burial practices preventing transmission from the four deaths (two confirmed and two probable).

Public Health Measures

Uganda implemented point-of-entry and exit screenings at airports and borders, which were crucial given Kampala’s role as a transport hub. Community awareness campaigns via radio and local leaders educated the public on Ebola symptoms and prevention, countering misinformation. Healthcare workers used personal protective equipment (PPE), though supply shortages resulting from U.S. aid cuts were mitigated by WHO and local resources.

International and Local Collaboration

Local expertise was evident in Uganda’s laboratories and the Uganda Virus Research Institute, which supported diagnostics and trials. Internationally, the U.S. provided $8 million via the CDC and USAID, despite aid cuts that canceled four contracts, impacting screenings and PPE supplies. The WHO contributed $2 million and technical expertise, while the UN appealed for $11.2 million to support seven high-risk districts. Uganda shared genomic data regionally, aiding preparedness amid Marburg outbreaks in Tanzania and Rwanda.

Urban Setting: Kampala’s high population density risked rapid spread, but targeted interventions in five districts prevented a wider epidemic.

Aid Cuts: The Trump administration’s freeze on USAID funding strained surveillance and PPE supplies, but local and WHO support helped offset this shortfall.

Surveillance Gaps: The delayed diagnosis of a child emphasized the need for improved surveillance, which was quickly addressed through intensified efforts.

By overcoming these challenges, Uganda showcased resilience and innovation in its public health response, setting an example for global health efforts against Ebola and similar infectious diseases.