In 2024, Rwanda faced an unprecedented health challenge when the Marburg virus emerged in the capital, Kigali. This highly infectious disease, which typically has a fatality rate of around 50%, is transmitted through contact with bodily fluids of an infected person and is often fatal without immediate intervention. For Rwanda, this was the first-ever outbreak of Marburg, testing not only the health system’s capabilities but also the nation’s pandemic response strategies.
When the outbreak began, Rwanda’s health minister, Sabin Nsanzimana, was attending the UN General Assembly in New York. Despite initial disbelief, Nsanzimana soon received confirmation of the outbreak. The virus had spread from one of the country’s leading referral hospitals in Kigali, raising alarms. Health authorities faced a critical moment, as conventional outbreak responses typically focused on rural areas and assumed that epidemics would originate outside urban centers. However, this outbreak defied those assumptions.
The response was swift and strategic. Collaborating with the World Health Organization (WHO), Rwanda’s health officials quickly adapted their approach. Rather than relying on the assumption that epidemics would emerge in rural regions, Rwanda focused on strengthening the ability to detect and contain outbreaks wherever they occur. This shift in strategy was crucial in limiting the spread of the virus in the capital and beyond.
Rwanda’s rapid and comprehensive response significantly reduced the death toll from Marburg. With a case fatality rate of 23%, this was the lowest death rate ever recorded in an outbreak of this virus. Nsanzimana credited the success to quick scientific action and efficient coordination among different sectors of government. The country’s health system worked in unison to secure vaccines, medical equipment, and treatments at an unprecedented pace.
“This response shows that, when institutions work together, we can achieve in six days what would normally take six months,” said Nsanzimana. The use of vaccines and medical treatments was pivotal in this rapid response. At the heart of this effort was the collaboration between Rwanda’s health officials, the WHO, and global partners.
Despite the success, the outbreak had devastating consequences. Among the 66 confirmed cases, 15 people died, many of them experienced healthcare workers. Menelas Nkeshimana, head of health workforce development at Rwanda’s Ministry of Health, described the emotional toll, especially when dealing with medical professionals who understood the gravity of Marburg. “Everyone knew Marburg meant death. But we had to keep going. Someone had to be there to help,” he said.
By November 2024, the outbreak was declared over. WHO representative Brian Chirombo highlighted the significance of Rwanda’s robust response, emphasizing the importance of strong leadership, collaboration, and a resilient health system in managing public health emergencies. “The response by Rwanda has shown the world the value of preparedness, teamwork, and trust in building effective healthcare systems,” he stated.
Rwanda’s response to the Marburg outbreak also provided valuable scientific insights. Through genomic sequencing, health officials traced the origins of the virus to bats in mining areas, which helped refine the response. Additionally, the Sabin Vaccine Institute played a key role by delivering investigational vaccines for clinical trials, aiding in the development of potential treatments.
Although no approved vaccines or antiviral treatments currently exist for Marburg, the trials conducted in Rwanda were essential in exploring future treatment options. The scientific approach to the outbreak, coupled with rapid action, helped limit the fatality rate and ultimately saved lives.
Rwanda’s ability to rapidly respond to this crisis underscores the importance of global cooperation, scientific innovation, and strong institutional trust. By cutting bureaucracy, making swift decisions, and acting as one cohesive team, Rwanda demonstrated how effective responses can mitigate the impact of infectious diseases and prevent widespread devastation.
