From reactive trials to regional vaccine sovereignty: a pan-ebolavirus vaccine-readiness framework for East Africa's Sudan virus and Bundibugyo virus threats.

Vaccines have transformed preparedness for Zaire ebolavirus disease, but East Africa still faces recurrent risk from Sudan virus and Bundibugyo virus, for which licensed and routinely deployable vaccines remain unavailable. Uganda's 2025 Sudan virus disease outbreak changed the field because it hosted the first clinical efficacy trial of a Sudan virus vaccine during an active outbreak. That was a major scientific achievement, yet it also exposed a more basic weakness: the region still relies too heavily on outbreak-triggered trial activation rather than on a standing preparedness architecture. We argue that East Africa now needs a pan-ebolavirus vaccine-readiness platform built around the threats it repeatedly faces, and we propose that such a platform should be embedded within the broader filovirus preparedness system rather than treated as a stand-alone vaccine project. Such a platform would link genomic surveillance, prototype vaccine libraries, harmonised ethics and regulatory pathways, adaptive ring-vaccination protocols, cold-chain corridors, community trust systems, African-led data stewardship, and manufacturing partnerships. We further argue that Sudan virus and Bundibugyo virus should no longer be treated as occasional vaccine gaps; they are regional preparedness priorities that also expose persistent therapeutic gaps. A sovereignty-oriented model would not replace global collaboration; it would make that collaboration more balanced by enabling East African institutions to lead trial readiness, deployment, evidence generation, and equitable access before the next spillover occurs.