Traditionally, Africa has been seen as a recipient of global health interventions rather than a leader in medical research, but Uganda’s Ebola vaccine trial is changing that narrative, and represents a major landmark for Africa’s scientific community.
In late January 2025, a nurse at Mulago National Referral Hospital in Uganda collapsed at work, showing symptoms that had been mistaken for malaria. Within days, he was dead. His diagnosis—confirmed only after his passing—was Ebola. His case became the first confirmed fatality in the outbreak, prompting health authorities in Kampala to declare an emergency and move swiftly to contain the virus before it spread further. It was the country’s first Ebola outbreak in two years.
The healthcare worker’s widow, a midwife named Afiya (name changed to protect privacy), was left to care for their two young children alone. She, too, tested positive for Ebola, along with the youngest child. “I was already in shock that my man had died. I thought, now the whole family is going to have Ebola, because I know how it spreads. I felt like God had betrayed me at that moment.” After several weeks in isolation and receiving treatment, Afiya and her one-year-old were discharged from hospital. But they returned to a community that no longer embraced them. Neighbors whispered, pointing at them in the streets, some actively avoided them. Sadly, so did family. “They turned against me,” she laments. “They sent away my people from the funeral, threatening them, telling them that I should never go back because I will get killed. I have not stepped there ever since. It’s been very traumatic.”
In Uganda, as in many parts of Africa, burial traditions involve washing and preparing the body—a practice that becomes particularly dangerous during an Ebola outbreak. The virus remains highly infectious—if not more so—after death, posing an extreme risk to those who come into contact with the body. To combat this, health officials have introduced “safe and dignified burials”, designed to allow families to grieve while minimizing contact with the deceased. However, implementing these measures has proven difficult, particularly in rural areas where traditional customs are deeply ingrained.
The outbreak that claimed the life of Afiya’s husband is now the focal point of a groundbreaking vaccine trial. The Sudan strain of Ebola, which has plagued Uganda for decades, is different from the better-known Zaire strain.
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“Ebola has a number of strains. The major difference is in their genetic composition and immune response,” explains the Executive Director of the Uganda Virus Research Institute (UVRI), Prof Pontiano Kaleebu.
The vaccine that successfully controlled the Zaire strain does not work against the Sudan variant, making this new vaccine an urgent necessity. While it mimics its predecessor with regards to minimal side-effects like mild fever and soreness at the injection site, the new inoculation is more conducive for use in African settings, as Prof Joseph Okeibunor, a scientist in the Emergency Prevention and Response Program at the World Health Organization (WHO), explains.
“Previous vaccines required ultra-cold storage between-60 degrees to -80 degrees centigrade. The new vaccine is designed to be stored between 2 to 8 degrees centigrade, aligning it more to our environment.”
Beyond the logistical and medical hurdles, there are for- midable challenges such as misinformation and distrust, compounded by the global wave of vaccine skepticism during the Covid-19 pandemic that has created an atmosphere where many people fear being part of a clinical trial.
“People think they are being used as guinea pigs. Some believe that vaccines are used to depopulate African countries. But, of course, the whole idea is to gather knowledge that will help us to improve health security for one and all,” says Okeibunor.
An aggressive awareness campaign has been launched, making use of radio announcements, venturing into churches and mosques, and leveraging community leadership. “A trusted message comes from a trusted messenger,” explains Dr Mosoka Fallah, Acting Director for the Science and Innovation Directorate at the Africa Centers for Disease Control and Prevention (CDC).
“It’s about getting to the community, hearing from them, making them a part of the co-creation of the messages.”
In some areas, however, hesitancy remains. “Most Africans still believe in traditional healers, so they might go to them for the treatment of the virus,” Fallah notes. “Then by the time we pick it up in the healthcare facility, it’s already too late.” Even among those who understand the need for an Ebola vaccine, the idea of taking an experimental drug is daunting. “It’s difficult to get people to consent, especially in the middle of an outbreak when fear is high,” Kaleebu says. “We have to assure them that their safety is our top priority.”
Some healthcare workers have also been hesitant. “I encountered a doctor, a physician, who refused to be vaccinated in this very Ebola outbreak,” reveals Okeibunor. “He’s not actively telling others to avoid it, but he declined it himself.” Despite these challenges, the Ebola vaccine trial represents a major milestone for Africa’s scientific community. Traditionally, Africa has been seen as a recipient of global health interventions rather than a leader in medical research, but this trial is changing that narrative.
“This is an African-led initiative, with African researchers and institutions at the forefront,” Kaleebu declares. “If this vaccine proves effective, it could set the stage for Africa to take a leading role in dis- ease prevention, not just for Ebola but for other emerging diseases,” says Fallah. “We are devel- oping the expertise and infrastructure needed to respond to outbreaks quickly and effectively.” Uganda’s Ebola vaccine trial is more than just a response to the current outbreak—it is a sign of Africa’s growing capacity to tackle public health challenges on its own terms, as well as a testament to the resilience of communities like the one that Afiya and her children must nownavigate on their own. For her, the vaccine came too late to save her husband, but she hopes it will spare others the same pain. “I think about my loved one, I think about the responsibilities I was left with,” she says. “But if this vaccine can save lives, maybe his death won’t be in vain…”
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