The machine was right
When people in Ituri started dying with high fever and bleeding, their samples went to the Provincial Public Health Laboratory in Bunia and into a . The machine said negative.
Days later the same samples came back positive on a that looks for every filovirus at once, run in a reference laboratory. On 22 May the World Health Organization wrote the sentence flat: the GeneXpert platform cannot detect Bundibugyo virus.
The cartridge was not broken. It was looking for sequences from Zaire ebolavirus, because Zaire ebolavirus is what it was designed for, and the samples from Bunia did not contain Zaire ebolavirus. Confirmation and isolation were delayed. The outbreak was found so late that it began with more cases than any Ebola outbreak on record.
The GeneXpert platform cannot detect Bundibugyo virus.World Health Organization, Disease Outbreak News, 22 May 2026
Three doors
Behind these doors sit the three defences the world has against Ebola: a test, a vaccine, a drug. Choose which kind of Ebola arrives.
| Species | Routine field test | Licensed vaccine | Approved drug |
|---|---|---|---|
| Zaire | yes | yes | yes |
| Sudan | no | no | no |
| Bundibugyo | no | no | no |
| Taï Forest | no | no | no |
The flat line is the negative result, the same trace as in the plot at the top.
Four kinds of Ebola make people ill. One of them has all three doors open.
The routine field test is the GeneXpert Ebola cartridge, built for Zaire. The licensed vaccine is Ervebo, indicated for disease caused by Zaire ebolavirus. The approved drugs are Inmazeb and Ebanga, both for Zaire only.
A drug is only proved during an outbreak
Ervebo, Inmazeb and Ebanga were approved on the strength of studies run on people during outbreaks. That is how anyone finds out whether an Ebola vaccine or treatment works: you give it to people who have the disease or are about to be exposed to it, and you compare what happens to them. There is no other place and no other moment to do it.
Ervebo exists because the West African epidemic between 2013 and 2016 left more than 11,000 dead and, with them, enough sick people for a trial. Inmazeb and Ebanga came out of the 2018 to 2020 outbreak in DR Congo.
Both previous Bundibugyo outbreaks were too small for that. The first, in Uganda in 2007 and 2008, had 131 reported cases and 42 deaths. The second, in DR Congo in 2012, had 62 cases and 34 deaths. There were never enough sick people to prove anything, and never enough well people for a manufacturer to sell to.
There is a European document that says this out loud. When the European Medicines Agency recommended the two-dose Ebola vaccine Zabdeno and Mvabea in May 2020, it wrote that the authorisation was granted under exceptional circumstances „because the applicant was able to demonstrate that it is not possible to conduct a randomised controlled study that might generate comprehensive clinical data on the efficacy of the new Ebola vaccine even after authorisation”. The regulator wrote down the trap in 2020 and licensed the product anyway.
Nobody ever bought it. On 1 May 2026 the European Commission withdrew the authorisation at the manufacturer’s request, for commercial reasons. Fourteen days later, DR Congo declared an Ebola outbreak.
| Product | Species covered | Status |
|---|---|---|
| Ervebo | Zaire | authorised in the EU since November 2019 |
| Zabdeno and Mvabea | Zaire | EU authorisation withdrawn on 1 May 2026 |
| Inmazeb | Zaire | approved in the United States, not in the EU |
| Ebanga | Zaire | approved in the United States, not in the EU |
The world’s filovirus kit is not a map of the dangerous viruses. It is a register of the outbreaks that grew large enough to be used as proof.
The window
A treatment can only be proved while there are patients who can enter a trial.Every dot is one reported case.The first two outbreaks ended at 131 and 62 cases.There is no universal threshold: the number needed depends on the treatment, mortality and trial design.
2 July 2026PARTNERS opened in Bunia on 2 July 2026. The epidemiological situation reported for 1–2 July contained 1,481 confirmed cases in DR Congo, Uganda and France.
131 reported cases. 42 deaths.
62 reported cases. 34 deaths.
2,994 confirmed cases. 1,311 confirmed deaths. The latest national data are from 23 July.
2 July: PARTNERS begins enrolling patients.
The third outbreak created the first window in which a trial could begin.
The 2007 and 2012 figures are reported cases from the US CDC. For the current outbreak WHO reports 2,973 confirmed cases in DR Congo as of 23 July, 20 in Uganda as of 21 July and one in France as of 6 July. Historical conventions differ, and the current figure may be revised.
Success destroyed the evidence
4years between the drug and the question still unanswered
In 2022 Uganda had an outbreak of Sudan ebolavirus. There was no approved treatment for Sudan either, so some patients were given MBP134, a pair of antibodies designed to cover several ebolavirus species at once. It was given , outside any trial, because there was nothing else to give.
Uganda stopped the outbreak faster than anyone expected. The outbreak ended before anyone could find out whether the drug had worked.
In July 2026 MBP134 entered the first trial that tests it in patients, in Bunia. Same drug. Same question. Four years in between, and it took another outbreak.
What is being built now
Day 69of 100Day 0 · 17 May 2026Day 100 · 25 August 2026
A clock started when WHO declared the international emergency on 17 May. The target is called the 100 Days Mission, and it asks for tests, treatments and vaccines against a new pathogen to exist within a hundred days of that declaration. Day 100 falls on 25 August 2026.
| Species | Rapid test in the field | Licensed vaccine | Approved treatment |
|---|---|---|---|
| Zaire | GeneXpert cartridge | Ervebo | Inmazeb, Ebanga |
| Sudan | none | none | none |
| Bundibugyo | RADI kit, under validation | none | none |
| Taï Forest | none | none | none |
The flat line is the negative result, the same trace as in the plot at the top. Here it means nothing exists.
- On 2 July the first patient was enrolled in Bunia into PARTNERS, the trial testing MBP134 and remdesivir, separately and together.
- On 14 July EBO-PEP began, giving obeldesivir, a drug taken by mouth, to people who have been exposed to the virus.
- On 1 June, CEPI put money behind three candidate vaccines: up to 3.2 million dollars for IAVI, 8.6 million for Oxford with the Serum Institute of India, 50 million for Moderna.
- On 13 July the University of Oxford announced the world’s first human trial of a Bundibugyo vaccine. Fifty healthy volunteers between 18 and 55, in Oxford. The announcement counts 57 days since the emergency was declared.
On that same 13 July, at Rwampara general hospital inside the epicentre, epidemiologists, case investigators, drivers and gravediggers went on strike because they had not been paid since the outbreak began. On Wednesday staff at Bunia general hospital struck too and blocked the entrance. Confirmed cases were passing 2,000 that week, with 754 dead.
The Oxford trial runs on healthy volunteers in a country with no Ebola. It shows whether the vaccine is safe and whether it raises an immune response. Whether it protects anyone can only be learned where the disease is, which means Ituri, during the outbreak. If the outbreak is stopped first, the vaccine stays unlicensed, and the fourth Bundibugyo outbreak will begin where this one began. Oxford delivered in 57 days. The structure it delivered into is the part that does not hold.
If too few people have your disease, nobody can prove a treatment works, so nobody makes one. Ebola is the most violent version of the logic that decides whether a drug exists for a rare disease on a children’s ward in Bucharest or in Bristol.
Sources
What this is and what it is not
Evidence was searched to 25 July 2026. This covers the regulatory position in the European Union and the United States. There was no clinical review.
What is written here is public information, not medical advice. Anyone who develops a fever after travelling in an area with Ebola should call ahead and say where they have been before walking into a waiting room.
What kinds of claim are here
- documented facthas a primary source, listed below
- a number that movescarries its date beside it
- editorial inferencejoins documented facts and is written as such
The outbreak
- World Health Organization, Disease Outbreak News no. 603, 22 May 2026The GeneXpert platform cannot detect Bundibugyo virus. DR Congo’s 17th Ebola outbreak.
- World Health Organization, daily epidemiological situation, 25 July 20262,994 confirmed cases and 1,311 confirmed deaths in total; national data through 23 July.
- World Health Organization, Disease Outbreak News no. 612, 3 July 20261,481 confirmed cases in the situation reported for 1–2 July.
- World Health Organization, Disease Outbreak News no. 613, 17 July 2026Figures to 15 July, health workers infected, cases treated in France and Germany.
- World Health Organization, emergency declaration, 17 May 2026The date of the public health emergency of international concern.
- Africa CDC, continental emergency declaration, 18 May 2026Public health emergency of continental security.
- Médecins Sans Frontières, outbreak response pageFigures as of 21 July 2026 and the May timeline.
- Associated Press, via Euronews Health, 24 July 2026Patients isolated or hospitalised, contact tracing, the words of Trish Newport.
- Al Jazeera, 15 July 2026The strike at Rwampara and Bunia, and that week’s figures.
- Social Science in Humanitarian Action Platform, Ituri context 2026Armed conflict, displacement, gold mining, health system capacity.
The detection gap
- IPPS, Ebola (Bundibugyo) Day 15, 1 June 2026The negative results at the Bunia laboratory, Altona pan-filovirus tests, the RADI kit, the Africa CDC review of rapid antigen tests.
- IPPS, Ebola (Bundibugyo) Day 45, 1 July 2026Current status of diagnostics, therapeutics and vaccines, and what still does not exist.
Vaccines and treatments
- World Health Organization, emergency guidance on the licensed vaccine, 28 May 2026Ervebo should not be used outside carefully designed research settings.
- World Health Organization, expert advice on candidates, 28 May 2026The prioritised therapeutics and vaccines.
- World Health Organization, PARTNERS trial opens, 2 July 2026First patient enrolled; adaptive trial of MBP134 and remdesivir, separately and together.
- ANRS Maladies infectieuses émergentes, INRB and ALIMA, EBO-PEP launch, 14 July 2026Obeldesivir as post-exposure prophylaxis.
- University of Oxford, world’s first Phase I trial, 13 July 2026ChAdOx1 BDBV, fifty volunteers, 57 days after the emergency was declared.
- CEPI, funding for three candidate vaccines, 1 June 2026The amounts for IAVI, Oxford with the Serum Institute of India, and Moderna.
- European Medicines Agency, Ervebo pageIndication for disease caused by Zaire Ebola virus.
- European Medicines Agency, Zabdeno and Mvabea pagesAuthorisation withdrawn on 1 May 2026 at the holder’s request, for commercial reasons.
- European Medicines Agency, press release, 29 May 2020Authorisation under exceptional circumstances and the regulator’s written reason.
History and virology
- US CDC, History of Ebola OutbreaksUganda 2007: 131 reported cases, 42 deaths. DR Congo 2012: 62 cases, 34 deaths.
- Towner JS et al., PLOS Pathogens 4(11): e1000212, 2008The surface glycoprotein differs between Bundibugyo and Zaire by more than 35% at the amino acid level.
- Mbala-Kingebeni P., Ssewanyana I. et al., Virological.org, from 18 May 2026The initial genomes from this outbreak and the species identification.
Current as of 25 July 2026. The outbreak figures were accurate on the date written beside them.