Building equitable epidemic response: the Interdisciplinary Consortium for Epidemics Research (ICER) position on Bundibugyo ebolavirus and regional preparedness in sub-Saharan Africa.

Abstract

The 2014-16 West African Ebola epidemic exposed consequences of weak regional preparedness and limited local scientific leadership. The Bundibugyo ebolavirus (BDBV) outbreak in the Democratic Republic of the Congo (DRC), with spill over into Uganda threatens to follow the same trend. Beyond the immediate response, this crisis is a defining moment for a question the region can no longer defer: who leads the science when Africa faces epidemics? As a scientific response, we argue for an immediate, regionally led research programme. To do this, ICER makes five priority positions: 1) Conduct of hypothesis-driven research as BDBV is understudied and yet is a high-risk and not a benign strain pathogen, 2) Rapid regional expansion is a realistic scenario, hence respective governments' preparedness frameworks must expedite to accommodate such an expansion, 3) African-led science is essential to an effective response, not merely an equity aspiration but a preparedness imperative, 4) Diagnostic, therapeutic, and vaccine development for BDBV cannot await commercial incentives and must be initiated proactively by public institutions, 5) An equitable partnership encompassing local leadership, fair authorship, capacity enhancement, and benefit sharing, is a prerequisite to be negotiated before research begins, and not an afterthought.