Community event-based surveillance as trust infrastructure for Bundibugyo Ebola response.

The 2026 outbreak of Ebola caused by Bundibugyo virus disease in the Democratic Republic of the Congo and Uganda highlights persistent gaps in centralized outbreak surveillance, particularly in settings affected by insecurity, displacement, cross-border mobility, community mistrust, and limited disease-specific countermeasures. Community event-based surveillance (CEBS) offers a practical approach for strengthening case-finding while building trust. CEBS relies on trained, equipped, and compensated community members to report trigger events that may indicate hidden transmission, linking local alerts to rapid verification, referral, household support, and formal outbreak response. Sierra Leone's experience during the 2014-16 West African Ebola epidemic provides an important model: CEBS was piloted in Bo District and later scaled through the Ebola Response Consortium, generating alerts that contributed to detection of confirmed Ebola cases, including cases with no known epidemiological link at detection. For the current Bundibugyo outbreak, CEBS should be adapted as a locally governed extension of health-zone and district surveillance structures. Funded well, CEBS can improve timely detection, link households to care, reinforce community trust and strengthen preparedness beyond a single outbreak.