Uganda’s Effective Ebola Response: The Case for Global Health System Investments

At this time of year, many of us will reflect on 2022 and plan for the year
ahead. And what a year it has been for Uganda, especially for public health. We
rose from the worst effects of COVID-19 only to confront Ebola. Today is the
International Day of Epidemic Preparedness. Thus, it is fitting that as we emerge
from the worst of the current Ebola Virus Disease (EVD) outbreak, we look ahead.
While we continue our countdown to January 11, when we can declare an end to
the Ebola outbreak, we must use the lessons learned to prepare for future

There are three areas of focus to prioritize: investigate the human behaviors
that led to this outbreak’s origins; create capacity for a speedier response in the
future; and establish the structures, protocols, and partnerships to support research
into promising vaccines and therapeutics to ensure prompt medical care during the
next outbreak.

Uganda has a rich history of being a site for infectious disease research,
from the Rockefeller studies on Yellow Fever in western Uganda in the early 20th
century, to research that first isolated the Zika virus in the eponymous forest of
central Uganda in 1947. Alongside this remarkable capacity to identify novel
pathogens, the country was an early adopter of the Global Health Security Agenda
(GHSA), an international effort launched in 2014 to strengthen the world’s ability
to prevent, detect, and effectively respond to infectious disease threats. With U.S.
support, in 2013, Uganda established a national Public Health Emergency Operations Center and strengthened a network of national laboratories ready to respond to infectious disease outbreaks.

I appreciate the strong and productive partnership that we have established
with the Government of Uganda. Minister of Health, Dr. Jane Ruth Aceng,
mandated at the beginning of the outbreak that Uganda would lead the response,
and all parties, including a multitude of local and international partners, lent
support and expertise to the Uganda-led efforts. The Government of Uganda
financially supported the local governments at the epicenter of the outbreak, and
the donor community helped identify creative ways to unlock resources and
mobilize well-positioned organizations.

No outbreak response is ever perfect, and there are always lessons to be
learned. An effective response requires early, sustained, and clear coordination
and collaboration. It also requires government leadership accompanied by
engagement by the international community, partners, and donors. These
participants must create the space for local leaders and experts to take the helm at
the community level. When international partners recognize that the host country
government is in the lead, we can reduce confusion, standardize patient care, and
clear the path for critical community outreach, surveillance, and lab work.

Moving forward, the global community must invest in long-term
partnerships that help governments strengthen health systems. Donors must be
held accountable for collaborating and coordinating with the local government and
ensure that resources are used with long-term strategies in mind. By conducting
thorough after-action reviews, we can learn what worked and what must be
improved in future outbreaks. If we truly believe that a threat anywhere is a threat
everywhere – which it is – then we have a responsibility to invest in long-term
solutions that will serve not only a country in acute need, but ultimately establish a
stronger global system for combatting the ravages of unchecked disease epidemics.
As we mark the International Day of Epidemic Preparedness, let us resolve
to apply the lessons we have learned, so we can make Uganda, the region, and the
world a safer place where every man, woman, and child can thrive.