Assessing Africa's readiness for Marburg virus outbreaks: A review of surveillance, response, and infrastructure needs

Abstract

Marburg virus disease (MVD) poses a critical public health threat to Africa, with mortality rates ranging from 24 to 100% and limited treatment options. Recent outbreaks across multiple African countries highlight the continent's vulnerability to this deadly pathogen, necessitating comprehensive assessment of preparedness capabilities. This narrative review evaluated Africa's current readiness for MVD outbreaks by examining surveillance systems, healthcare infrastructure, response protocols, and identifying critical preparedness gaps. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar. Search terms included "Marburg virus," "Africa," "outbreak," "preparedness," "surveillance," and "response." Additional sources from WHO, Africa CDC, and national health ministries were included. Data extraction focused on epidemiological characteristics, preparedness measures, challenges, and recommendations. Analysis revealed significant preparedness gaps including inadequate surveillance systems in high-risk regions, limited laboratory diagnostic capacity, insufficient healthcare infrastructure in remote areas, inconsistent funding mechanisms, and weak cross-border coordination. Cultural barriers, lack of community awareness, and absence of licensed vaccines further compound these challenges. While some improvements have emerged from Ebola outbreak experiences, MVD-specific protocols and biosafety requirements remain underdeveloped. Africa requires urgent, coordinated action to strengthen MVD preparedness through enhanced surveillance networks, healthcare capacity building, community engagement programs, regional cooperation frameworks, and accelerated vaccine development. A multi-faceted approach combining infrastructure investment, policy development, and sustained international collaboration is essential to prevent widespread epidemics and protect public health across the continent.