By Danny Gotto
As Ebola returns once again to East and Central Africa, the dominant narrative is familiar: a dangerous virus has emerged, health authorities are mobilising, and the international community is monitoring developments closely. Yet this framing misses the central truth of the current outbreak.
Ebola is not simply a biological event. It is a political event.
The recurrence of Ebola in Uganda and the Democratic Republic of Congo reveals not only vulnerabilities in public health systems but also the consequences of decades of political choices made at local, regional, and international levels. The virus may be natural. The conditions that allow it to become a recurring crisis are not.
The current outbreak is unfolding in a world that has deliberately weakened its own capacity to respond. The dismantling of international health infrastructure, shrinking commitments to global health financing, and the retreat of major powers from multilateral cooperation have left the international system less prepared than it should be. At precisely the moment when infectious diseases demand collective action, global politics has moved in the opposite direction.
This trend reflects a deeper problem within the architecture of global health governance. For decades, international health security has been built on a model of dependency rather than sovereignty. Wealthy countries have often funded disease control efforts in poorer countries not because health was viewed as a universal right, but because outbreaks abroad were perceived as risks at home. Funding therefore follows political priorities rather than epidemiological realities.
The result is a system that is reactive, fragile, and inherently unequal. When political priorities shift in Washington, London, Brussels, or other donor capitals, the capacity of health systems in Kampala or Kinshasa changes with them. Entire populations become vulnerable not because their governments changed policy, but because foreign governments changed theirs.
This is not health security. It is health dependency.
The consequences are visible in the long-standing failure to develop vaccines for diseases that primarily affect low-income countries. More than twenty years after the Bundibugyo strain of Ebola was first identified, no licensed vaccine exists. This is not a scientific failure. It is a political failure.
Research and development follow market incentives. Pharmaceutical investment flows toward diseases that promise financial returns. Communities facing recurring outbreaks in some of the world's poorest regions simply do not represent lucrative markets. The outcome is predictable: populations most exposed to deadly diseases remain last in line for medical innovation.
Yet focusing solely on contemporary policy failures risks overlooking an even deeper reality. The geography of Ebola outbreaks is not random.
The regions where Ebola repeatedly emerges are often those most profoundly shaped by centuries of extraction, dispossession, and unequal development. In eastern Congo, where the current outbreak is centred, some of the world's richest mineral deposits coexist with some of the world's poorest communities. This contradiction is not accidental.
Colonial administrations designed institutions to extract resources rather than provide public services. Infrastructure connected mines and export routes, not communities. Health systems, where they existed, were often built to protect colonial economic interests rather than local populations. The political and economic structures established during that period continue to shape contemporary vulnerabilities.
Today, armed groups compete for control over resource-rich territories in eastern Congo. Insecurity limits access to healthcare, disrupts surveillance systems, and prevents frontline workers from reaching affected communities. When a health worker cannot safely transport a blood sample because militias control the roads, the problem is not merely logistical. It is political.
Disease transmission follows pathways shaped by history.
Recognising these historical realities does not absolve contemporary governments of responsibility. Corruption, weak governance, underinvestment in healthcare, and failures of accountability remain significant obstacles to effective disease control. African governments must invest more consistently in public health infrastructure, strengthen surveillance systems, and protect healthcare workers.
But a serious political analysis must reject simplistic explanations that place responsibility exclusively on national governments. The recurring vulnerability of regions such as eastern Congo reflects the interaction between domestic governance failures and international structures that continue to reproduce inequality.
The lesson of this outbreak is therefore larger than Ebola itself.
The world faces a growing number of transnational threats—from pandemics to climate change—that cannot be addressed through ad hoc responses driven by short-term political calculations. Yet global governance remains organised around national interests rather than shared responsibilities. We continue to treat crises as temporary emergencies rather than symptoms of structural problems.
As a result, the international community repeatedly finds itself responding to predictable disasters with surprise.
What is needed is not merely better outbreak management. It is a different political vision of global health. Pandemic preparedness should be financed as a collective public good rather than discretionary foreign aid. Regional institutions such as Africa CDC should be empowered with sustainable funding and genuine political authority. Vaccine development should be guided by public health needs rather than market profitability alone. And conflict prevention must be recognised as a health intervention as much as a security objective.
Ebola's return should force us to confront an uncomfortable reality: the greatest threat is not simply the virus itself. It is our political economy that repeatedly allows preventable crises to become deadly emergencies.
The question facing Uganda, the DRC, and the wider international community is therefore not whether this outbreak can be contained. It probably can. The more important question is whether we are willing to address the political conditions that guarantee another outbreak will follow.
Until we do, Ebola will continue to expose not only weaknesses in health systems, but failures in the way power, resources, and responsibility are organised in the global order.
Danny Gotto is a public health expert and heads the Ugandan NGO Innovations for Development. He is a co-founder of the Kampala Initiative, which advocates for the decolonization of global health policy.
