The cost of delayed Ebola containment in DR Congo and Uganda
Over US$700 million in additional health financing is urgently needed to prevent a wider regional crisis.
The current Bundibugyo Ebola outbreak in the Democratic Republic of the Congo (DR Congo) and Uganda presents an urgent public health and development challenge for the African Great Lakes region. Although the outbreak is to date far smaller than the 2014–2016 West Africa Ebola epidemic, history demonstrates how quickly localised outbreaks can escalate when containment efforts are delayed and health systems are under strain.
The immediate policy priority is therefore containment. Failure to control transmission risks would not only increase mortality but also impose high economic costs through reduced productivity, heightened fiscal burdens, disrupted trade and investment, and setbacks to long-term development gains.
As of 15 June 2026, DR Congo reported 837 confirmed cases and 196 confirmed Ebola-related deaths, while Uganda reported 19 confirmed cases, two deaths, one probable case and one probable death. So far, no confirmed Bundibugyo Ebola cases have been reported in neighbouring Rwanda or Burundi. Both countries have, nevertheless, heightened surveillance and preparedness measures given the extended connections with eastern DR Congo, especially through the Goma-Rubavu border crossing.
The number of confirmed cases is substantial, highlighting the continuing risk of transmission. Mortality figures should be interpreted cautiously due to the possibility of under-reporting in remote and hard-to-reach areas. This underscores the importance of acting swiftly to contain the outbreak before transmission accelerates and response costs escalate.
Ebola outbreaks can disrupt healthcare services and weaken the capacity of health systems. As health resources are redirected towards emergency response measures, the prevention, diagnosis and treatment of other communicable diseases may suffer, leading to higher incidence and mortality rates. This can reverse hard-won health gains and place additional pressure on already constrained health systems.
Scenario modelling for African Futures indicates that, under a “Delayed-containment” scenario, additional fatalities from other communicable diseases could reach approximately 3 360 in DR Congo and 520 in Uganda by the end of 2026, compared to the business-as-usual (Current Path) forecast. The situation may worsen in 2027, rising to about 4 340 additional deaths in DR Congo and 750 in Uganda.
Without rapid and effective containment, Ebola-related deaths could exceed 3 000 in DR Congo and 500 in Uganda by 2026
While these figures remain below the scale of the 2014–2016 West Africa Ebola epidemic, which resulted in about 11 325 deaths, they underscore the risks associated with delayed intervention.
Containing the outbreak will require a significant increase in public health expenditure. Investments are needed to strengthen disease surveillance, laboratory testing, treatment facilities, community outreach and emergency response systems. These interventions are essential not only to limit transmission but also to restore public confidence and maintain economic activity.
An African Futures “Containment” scenario indicates that government health expenditure in 2026 would need to rise to at least US$1.82 billion in DR Congo and US$1.17 billion in Uganda. This would represent an increase of more than US$540 million above the Current Path forecast in DR Congo and US$170 million in Uganda. Together, the two countries would require at least US$710 million in additional health financing to effectively contain the outbreak.
The benefits of early intervention would be substantial. Under the Containment scenario, additional fatalities from other communicable diseases would remain below 490 in DR Congo and below 30 in Uganda in 2026. The findings demonstrate that early containment is significantly less costly than responding to a larger and more entrenched epidemic later.
The estimated financing requirement is broadly consistent with the US$518 million emergency appeal launched by the United Nations and humanitarian partners. Several governments and development partners have already pledged support. However, crisis financing is often reactive and temporary. The current outbreak, therefore, highlights the need for more systematic investment in epidemic preparedness, surveillance systems, laboratory infrastructure, community health workers and rapid-response capacity.
Additional health spending, however, should not come at the expense of other development priorities. African governments are often forced to divert resources from other public spending needs, including education, social protection, food security and infrastructure during crises. This risks undermining long-term development outcomes and shifting the burden of the emergency onto vulnerable populations. The challenge is therefore not only to mobilise emergency financing, but also to secure additional, flexible resources that allow governments to respond without compromising broader development objectives.
Beyond the health sector, Ebola can also discourage market participation due to increased uncertainty and fear of infection. Border restrictions, reduced travel and disruptions to transport networks further constrain trade, services and agricultural activity. These effects are particularly significant in Africa’s Great Lakes region, where communities heavily rely on cross-border economic and social ties. If containment efforts are delayed, the region could face a dual shock of rising communicable disease fatalities alongside slower economic growth.
In many cases, economic activity does not disappear entirely but shifts into informal and unmonitored channels as households seek to preserve incomes and livelihoods. As informality increases, governments collect less revenue from customs duties, corporate taxes and other domestic sources.
The African Futures modelling shows that, in 2026, DR Congo could lose around US$70 million in government revenue, while Uganda could lose approximately US$60 million due to reduced formal economic activity, increased informality and the fiscal strain of financing the outbreak response. These revenue losses would come at a time when governments are under growing pressure to finance emergency health interventions while sustaining critical development spending.
DR Congo and Uganda could lose a combined US$130 million in government revenues in 2026
Four key policy implications emerge from these findings.
First, early containment will be far less costly than the burden that would follow uncontrolled escalation. Rapid intervention saves lives, reduces economic disruption and lowers long-term fiscal costs.
Second, emergency health financing must be mobilised quickly and should be additional to existing development resources. This will help ensure that governments are not forced to divert funding from other essential development initiatives to respond to a public health emergency.
Third, response measures should protect livelihoods and formal economic activity wherever possible, particularly in border communities that depend heavily on trade and mobility.
Finally, the outbreak reinforces the importance of investing in resilient health systems before crises occur. Strong surveillance networks, laboratory systems, community health workers and cross-border preparedness mechanisms remain among the most effective safeguards against future epidemics.
The African Development Bank and other development partners can play a critical role by mobilising rapid-response financing, supporting health-system resilience and strengthening regional preparedness efforts. A coordinated response today would not only reduce fatalities and limit economic disruption but also strengthen the region's capacity to manage future health shocks.
The strategic lesson is that epidemic preparedness is not merely a health priority. It is a development, fiscal stability and regional resilience imperative.
Image: UN Photo-Martine Perret/Flickr
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