The Democratic Republic of Congo (DRC) and Uganda are currently grappling with an outbreak of the Bundibugyo virus disease (BVD), a form of Ebola, which has prompted the World Health Organization (WHO) to declare it a Public Health Emergency of International Concern (PHEIC) on May 17, 2026. This declaration, made under the International Health Regulations (2005), signifies the grave risk of international spread, especially following confirmed cross-border transmissions. This marks the DRC’s 17th encounter with an Ebola outbreak, underscoring the ongoing health challenges in the region. ## Understanding Bundibugyo Ebola Virus Disease Bundibugyo virus disease is one of several types of Ebola virus disease, a severe, often fatal illness affecting humans and other primates. Named after the Bundibugyo District in Uganda where it was first identified in 2007, this particular strain presents symptoms similar to other Ebola types, including fever, severe headache, muscle pain, weakness, fatigue, diarrhea, vomiting, stomach pain, and unexplained bruising or bleeding. The virus spreads to humans through contact with infected animals, such as fruit bats or non-human primates, and then spreads among humans through direct contact with blood, body fluids, and organs of an infected person, or with surfaces and materials contaminated with these fluids. The incubation period, the time from infection to the onset of symptoms, typically ranges from 2 to 21 days. While the Zaire strain of Ebola often receives more attention due to its higher fatality rate and the availability of approved vaccines, the Bundibugyo strain also poses a significant threat. Historically, it has carried a fatality rate of about 25-30%. Crucially, unlike the Zaire ebolavirus, there is currently no approved specific vaccine for the Bundibugyo strain, making robust public health measures, infection prevention, and rapid response even more critical. ## Why a Public Health Emergency of International Concern (PHEIC)? The WHO's declaration of a PHEIC is a rare and serious step, indicating an extraordinary event that constitutes a public health risk to other states through the international spread of disease and potentially requires a coordinated international response. In this instance, the confirmed cross-border transmission between DRC and Uganda, coupled with the high mobility of populations in the region, elevated the risk of wider regional and potentially global spread. Such a declaration mobilizes international resources, attention, and coordination, guiding countries on necessary actions, including travel advisories and health system strengthening. While the WHO advises against general travel and trade restrictions that can hinder humanitarian efforts, some border crossings between DRC and its neighbors have implemented closures. However, humanitarian aid, emergency services, cargo, and other authorized movements are approved to continue, balancing public health safety with essential operational needs. ## Prioritizing Regional Readiness and Response Given the high regional risk, WHO has categorized countries for targeted preparedness and response efforts. Priority 1 countries, facing the most immediate threat, include DRC, Uganda, South Sudan, Burundi, and Rwanda. These nations share borders or have significant population movement with affected areas. Priority 2 countries, while at a slightly lower immediate risk, still require heightened vigilance and readiness. This group comprises Angola, Central African Republic, Ethiopia, Kenya, Republic of Congo, United Republic of Tanzania, and Zambia. This strategic prioritization ensures resources and support are directed where they are most urgently needed to prevent further spread. ## IOM's Pivotal Role in the Response The International Organization for Migration (IOM) plays a critical role in addressing outbreaks within highly mobile populations and at points of entry. Their current response to the Bundibugyo outbreak focuses on several key areas: ### Strengthening Border Health and Mobility Monitoring Recognizing that population movement is a major factor in disease spread, IOM has expanded its mobility mapping and analysis across affected and at-risk countries. Their Displacement Tracking Matrix (DTM) teams gather data to identify priority entry points, high-risk travel routes, and vulnerable locations, informing public health measures and operational planning in Uganda, DRC, and South Sudan. This data-driven approach allows for targeted interventions, such as health screening at busy border crossings, bus stations, and airports. ### Disease Surveillance and Infection Prevention IOM supports robust surveillance activities at points of entry (PoEs) in multiple countries. This includes not only screening travelers but also strengthening infrastructure, ensuring proper infection prevention and control (IPC) measures are in place, and supporting community-based surveillance to detect and report new cases quickly. For example, in Uganda, IOM aids flow monitoring and screening at several border points and airports, alongside enhancing community-based surveillance in four high-risk districts. In South Sudan, IOM supports surveillance and IPC activities at five key entry points, including providing IPC supplies to Juba International Airport. Burundi has seen IOM conduct capacity assessments at border locations with DRC and plan training for frontline health personnel. Rwanda has benefited from IOM upgrading PoE infrastructure, strengthening surveillance systems, and supporting simulation exercises with the Rwanda Biomedical Center to boost IPC readiness. ### Risk Communication and Community Engagement Effective risk communication and community engagement (RCCE) are cornerstones of any successful outbreak response. IOM works to ensure communities understand the risks of BVD, how to protect themselves, and the importance of reporting symptoms. This involves dispelling misinformation and building trust, which is particularly challenging in areas experiencing insecurity and displacement, such as eastern DRC. In these complex environments, continuous cross-border movement and strained conditions in displacement settings significantly increase the risk of regional spread and complicate surveillance efforts. ## Overcoming Challenges and Resource Gaps The outbreak response faces significant hurdles, including ongoing insecurity, large-scale displacement, and the inherent challenges of tracking a mobile population. To bolster its capacity, IOM has deployed emergency health personnel, accelerated staffing, procurement, logistics, and field coordination in high-risk areas. However, these efforts are constrained by substantial funding gaps. Critical needs include enhanced community-based surveillance, expanded risk communication initiatives, crucial mental health and psychosocial support (MHPSS) for affected individuals and frontline workers, robust infection prevention and control (IPC) measures, and improved water, sanitation, and hygiene (WASH) facilities. Additionally, logistical support, adequate staffing, and continued mobility monitoring are essential to scale up operations effectively and contain the spread of the Bundibugyo virus. The global health community, including organizations like IOM and WHO, is working tirelessly to manage this evolving public health crisis. However, sustained international support and funding are vital to strengthen preparedness and response capacities, protect vulnerable communities, and ultimately bring this dangerous outbreak under control, preventing further regional and potentially global impact. ## Moving Forward: A Coordinated Global Effort Containing the Bundibugyo Ebola outbreak demands a sustained, multi-faceted approach. This includes not only direct medical intervention but also strengthening fragile health systems, addressing the social determinants of health, and fostering genuine community partnership. The lessons learned from previous Ebola outbreaks, particularly the importance of rapid response, meticulous contact tracing, and effective community engagement, are more relevant than ever. As the world watches, the coordinated efforts of international bodies, national governments, and local communities will determine the trajectory of this challenging public health emergency.