Donor dependency and pandemic readiness: insights from the 2026 Ebola Bundibugyo outbreak in the East African community.

The 2026 Bundibugyo virus disease (BVD) outbreak has exposed persistent weaknesses in health-security preparedness across the East African Community (EAC). Although regional preparedness has improved, major gaps remain in early detection, cross-border collaboration and surveillance, laboratory capacity, infection prevention and control, and community engagement. These vulnerabilities have been intensified by declining external health-security funding since 2025, incomplete implementation of domestic health-financing commitments, and the fragility of systems that were built with substantial donor support but not fully institutionalized. Drawing on the current outbreak and the extensive experience with Ebola virus disease in the Democratic Republic of the Congo (DRC), this Perspective argues that the outbreak should be understood not only as an infectious-disease emergency but also as a stress test for donor-supported preparedness systems. It calls for phased transitions from donor-supported functions toward sustained domestic and regional financing, permanent cross-border surveillance, strengthened peripheral laboratory capacity, institutionalized community-based preparedness, and outbreak-ready clinical research platforms.