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Rwanda’s Marburg Outbreak: The Latest Test of Pandemic Preparedness and Global Health Resilience
By guest contributor Boghuma K. Titanji, MD MSc. DTM&H, PhD
Rwanda is confronting its first-ever outbreak of Marburg virus, with 58 confirmed cases reported by the Ministry of Health. Tragically, 13 people have died, while 12 have recovered. This marks the fifth Marburg virus outbreak on the African continent since 2017, signaling an alarming rise in the frequency of these deadly episodes. Marburg virus was first identified in 1967 during outbreaks among laboratory workers in Germany and the former Yugoslavia exposed to infected research monkeys. The virus belongs to the filovirus family as Ebola virus. Marburg virus disease (MVD) is a severe hemorrhagic fever with an incubation period of 2 to 21 days. Initial symptoms include high fever, headache, muscle pain, fatigue, and gastrointestinal issues such as nausea and diarrhea. In fatal cases, death often occurs within 8-9 days, while survivors face prolonged recovery with lingering health problems. Past outbreaks have shown case fatality rates ranging from 23% to 90%, underscoring the severe toll on health systems and communities.
The increase in Marburg outbreaks in Africa is part of a broader global pattern of zoonotic diseases (those transmitted from animals to humans), that constantly threaten public health. Factors such as climate change, population growth, and human encroachment into wildlife habitats are amplifying the risk of these outbreaks. Although the exact origins of the current outbreak in Kigali, Rwanda’s capital, remain uncertain, the potential for a hemorrhagic virus like Marburg to spread in an urban setting is deeply concerning. The 2014–2016 Ebola Virus Disease (EVD) outbreak in West Africa, which claimed almost 12,000 lives across Sierra Leone, Guinea, and Liberia, serves as a stark reminder of the human and societal cost of delayed responses. Beyond the immediate loss of life, that epidemic left enduring scars, including social stigma, economic disruption, and long-term health complications for survivors.

In contrast to the slow international response during the Ebola outbreak, Rwanda has acted swiftly and decisively to contain the Marburg virus outbreak. This response reflects the significant progress many African countries have made in strengthening their public health systems. Rwanda’s proactive approach—partnering with global public health organizations and showing openness to trialing investigational vaccines and therapies—shows the country’s commitment to outbreak control. The Sabin Institute has secured 700 doses of a single-dose vaccine developed at the National Institutes of Health Vaccine Research Center which is currently being deployed prioritizing frontline healthcare workers. Pharmaceutical companies like Gilead and Mapp Biopharmaceuticals have also contributed by donating doses of experimental treatments, including doses of Remdesivir and the monoclonal antibody MBP-091.
These rapid developments are encouraging, especially in light of the lessons learned from past hemorrhagic virus disease outbreaks. The slow global response to the 2014–2016 Ebola crisis allowed the virus to spread unchecked, leading to unnecessary loss of life and prolonged suffering. When outbreaks of highly lethal viruses like Marburg occur, swift and coordinated global efforts are essential to prevent the situation from spiraling out of control. Just last week, train stations in Hamburg, Germany, were briefly shut down over concerns regarding a suspected case of MVD in a returning traveler from Rwanda. Fortunately, the individual tested negative for MVD, but the incident underscores the heightened anxieties that surround outbreaks of diseases like Ebola and Marburg. The U.S. Centers for Disease Control and Prevention (CDC) has announced plans to begin screening all returning travelers from Rwanda for symptoms of the disease, again highlighting the global attention these outbreaks generate.
The current Marburg outbreak in Rwanda offers an opportunity to apply hard-won lessons from past outbreaks of hemorrhagic virus diseases on the continent. Rapid resource mobilization, equitable access to vaccines and treatments, and strengthened healthcare infrastructure are critical to preventing a large-scale humanitarian disaster. Despite Rwanda’s commendable response, the situation highlights ongoing disparities in outbreak preparedness across Africa. While Rwanda has mobilized resources effectively, neighboring countries like the Democratic Republic of Congo and Burundi are grappling with their own public health challenges, including the Clade I Mpox outbreak, declared a Public Health Emergency of International Concern by the WHO. Efforts to control Mpox through vaccination and contact tracing are ongoing, but the persistence of infectious threats like Mpox and Marburg virus underscores the need for continued vigilance, capacity building, and international collaboration to strengthen public health systems across the continent.
Recognizing that outbreaks may occur simultaneously in the same region should drive investments in vaccine and therapeutic development before crises strike. While there are now two licensed vaccines for Ebola Zaire, their development was only accelerated after the largest Ebola outbreak in history. A 2018 Lancet Global Public Health analysis estimated that advancing just one vaccine to the end of phase 2a for each of 11 epidemic diseases—including Marburg and SARS—would cost between $2.8 and $3.7 billion. In contrast, the global economic burden of COVID-19, a novel disease caused by SARS-CoV-2 for which there was no existing vaccine prior to 2020, is estimated between $8.1 trillion and $15.8 trillion. We have much more to gain by proactively addressing these threats through increased funding for research and development of therapeutics, alongside a One Health approach that protects both the environment and the wildlife we share our planet with.
As we closely monitor the progression of Rwanda’s Marburg virus outbreak, it serves as a critical reminder that no nation is immune to the global threat of infectious diseases. Pathogens know no borders. Rwanda’s resilient health system offers a model for outbreak preparedness and response in the region that should be commended, but it also emphasizes the importance of collective action. The international community must remain engaged, ready to provide resources, and committed to long-term solutions that can prevent and contain future outbreaks of hemorrhagic viruses and other deadly pathogens.
About the author:

Boghuma Kabisen Titanji, MD, PhD, MSc, DTM&H, is a Cameroonian-born physician-scientist and Assistant Professor of Medicine at Emory University in Atlanta, Georgia. She earned her medical degree from the University of Yaoundé I in Cameroon and initially worked as a medical officer before pursuing advanced research training in the United Kingdom. As a recipient of the prestigious Commonwealth Scholarship, Dr. Titanji completed a master’s degree in Tropical Medicine and International Health at the London School of Hygiene and Tropical Medicine, along with a Diploma in Tropical Medicine and Hygiene from the Royal College of Physicians. She later earned a PhD in Virology from University College London.
Dr. Titanji joined Emory University School of Medicine in 2016, where she completed an Internal Medicine residency through the ABIM Research Pathway, followed by a fellowship in Infectious Diseases. Her career is driven by three intersecting passions: translational and clinical research in HIV and emerging infections, science education and communication, and global health equity.
Her current research investigates inflammation as a driver of cardiovascular disease in people with HIV, utilizing cell culture models and systems biology approaches. Dr. Titanji is dedicated to leveraging translational research to enhance the care of individuals living with HIV, promoting global health equity through research capacity building in Africa, and influencing health policy through science communication and advocacy.
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