The world breathed a sigh of relief when West Africa’s Ebola outbreak came to an end earlier this year, closing the books on the largest and most deadly epidemic in history.
More than 28,500 people were infected and more than 11,000 died in just two years.
But while the outbreak might already feel like a distant memory, Ebola and other viral hemorrhagic fevers are still a fact of life across communities in Africa.
For researchers in Uganda — a country that has experienced five Ebola outbreaks — the threat of the disease that kills between 50 and 90 percent of all those infected, isn’t just a possibility pulled from 1995 bestseller, "The Hot Zone." For them, another outbreak of Ebola is almost certain.
Luckily, so is finding a cure.
Uganda is especially susceptible to viral hemorrhagic fevers — a group of animal and human diseases transmitted by bodily fluids and known for causing profuse bleeding, high fevers and an almost unprecedented mortality rate.
Currently, there is no vaccine for Ebola, which disproportionally affects poor and vulnerable communities in Africa, many that don’t have access to medical treatment. Ugandan researcher Dr. Francis Kiweewa wants to change that.
Kiweewa is involved in three clinical trials in Uganda that aim to protect patients living in Ebola-endemic regions using proteins derived from different strains of Ebola.
Despite the clear need for a vaccine, Kiweewa said getting the vaccine developed hasn’t been easy.
“Until the recent Ebola outbreak in West Africa, Ebola affects only a handful of people, mainly in poor countries, every year,” he said. “Many pharmaceutical companies lack the interest to pursue a vaccine program for a disease that affects only a handful of people per year among communities that will hardly be able to pay for the product.”
Additionally, the complexity of such outbreaks, which can claim lives quickly and then disappear for years or even decades, as well as the lack of funding for Ebola research (most research in Uganda is funded by external donors, not the government) further complicates vaccine development, Kiweewa said.
Several Ebola vaccines have been tested in the past, but the United States Food and Drug Administration has yet to approve any for human use.
While Kiweewa remains optimistic about Uganda’s vaccine trials, he’s also quick to admit it could be months or even years before any vaccine is widely available.
Which begs the question: Is Uganda prepared for an outbreak before a vaccine is developed? Steven Aisu, head of the Central Public Health Laboratories of Uganda, says yes. In fact, he’s preparing for an outbreak right now.
If you drive 45 minutes outside Uganda’s capital of Kampala, past the undulating hills overlooking a mix of modern concrete buildings and thatched-roof homes, eventually you’ll see something rather different: a new, multimillion-dollar glass and steel building containing Uganda’s best disease monitoring and testing services.
Funded by Uganda’s Ministry of Health and the Center for Injury Prevention and Control, the newly constructed Central Public Health Laboratories of Uganda is home to Uganda's leading Ebola researchers including Aisu, a hematology specialist and key point of contact during outbreaks in the country.
Aisu has worked in the health field since 1980 and was one of the first to respond during Uganda’s major Ebola outbreak in 2001.
That outbreak, which infected 425 and killed 224 “took us by surprise,” he said. But as the number of cases ebbed and flowed, Aisu and his team were able to learn more about the transmission of the disease and how to control it.
Aisu and his team eventually helped develop a surveillance system that escalates suspected cases from a district level to regional and countrywide platforms using an internal text messaging system.
“Now, if there’s anyone who falls sick with any kind of bleeding, the district notifies the surveillance department,” he said.
Despite this surveillance network, Aisu said controlling viral hemorrhagic fever outbreaks in Uganda remains difficult, particularly because of porous borders with countries like the Democratic Republic of Congo.
So how often does Aisu receive a report about a possible Ebola outbreak?
“Depends on the season,” he said. “But at least once a month.”
Despite that frequency, Uganda has not actually faced a confirmed case of Ebola since January 2013 — a fact that makes Kiweewa optimistic an Ebola vaccine will arrive before another outbreak.
“Some vaccine strategies are giving very positive results,” he said. “So, I am very confident that an Ebola vaccine will be found soon.”