CAPRISA Researchers Sound Alarm on Diagnostic Shortfalls in Bundibugyo Ebola Response

The Centre for the AIDS Programme of Research in South Africa, known as CAPRISA and headquartered at the University of KwaZulu-Natal in Durban, has released a timely commentary in The Lancet calling for urgent investment in reliable point-of-care diagnostics for the ongoing Ebola disease outbreak caused by the Bundibugyo virus. Published on 2 June 2026, the piece authored by Safura Abdool Karim, Sharana Mahomed, Lara Lewis and Salim S Abdool Karim draws on the centre’s decades of experience in infectious disease research to highlight how the absence of suitable rapid tests is hampering containment efforts across affected regions in the Democratic Republic of the Congo and Uganda.

CAPRISA, established in 2002 as a not-for-profit organisation under a National Institutes of Health initiative, has long focused on HIV prevention, treatment and co-infections such as tuberculosis. Its expansion into broader outbreak preparedness reflects the interconnected nature of emerging pathogens and the need for South African institutions to contribute to continental and global health security. The current commentary arrives amid a declared public health emergency of international concern, underscoring the centre’s role in translating laboratory insights into policy-relevant recommendations.

Understanding the Bundibugyo Virus and the 2026 Outbreak Context

The Bundibugyo virus, a member of the Orthoebolavirus genus, differs genetically and antigenically from the more widely studied Zaire ebolavirus. Previous outbreaks occurred in Uganda in 2007–2008 and in the Democratic Republic of the Congo in 2012, yet commercial incentives for specific diagnostics, therapeutics or vaccines have remained limited due to the virus’s relative rarity. The 2026 epidemic, centred in Ituri Province of the Democratic Republic of the Congo with imported cases reaching Kampala, Uganda, has already generated hundreds of suspected cases and dozens of deaths, prompting the World Health Organization to issue a public health emergency of international concern on 17 May 2026.

Health authorities in both countries have activated surveillance and contact-tracing measures, yet laboratory confirmation relies on centralised polymerase chain reaction testing that can take days to yield results. In insecure or remote mining areas where population movement is high, such delays allow chains of transmission to expand before interventions can be deployed. The CAPRISA authors note that initial field samples in the current outbreak tested negative for more common Ebola strains, further complicating early recognition.

Why Reliable Rapid Diagnostics Matter for Outbreak Control

Rapid diagnostic tests, typically lateral-flow assays that deliver results within 15 to 30 minutes at the point of care, enable frontline clinicians to isolate suspected cases, initiate supportive care and trace contacts without waiting for reference laboratory confirmation. For Bundibugyo virus disease, no such validated test exists at scale. Existing Ebola rapid tests target Zaire ebolavirus antigens and show poor cross-reactivity with Bundibugyo, leading to false negatives that erode trust in surveillance systems.

The commentary emphasises that diagnostic delays amplify mortality because patients deteriorate rapidly, often developing haemorrhagic symptoms within days of symptom onset. In settings with limited intensive-care capacity, early identification is the primary tool for reducing case fatality. Moreover, accurate tests support targeted use of experimental countermeasures once candidates advance through clinical evaluation, avoiding wasteful deployment in non-cases.

CAPRISA’s Research Legacy and Its Relevance to the Current Call

Although CAPRISA’s foundational work centres on HIV, the centre has contributed to SARS-CoV-2 diagnostics and tuberculosis resistance testing through studies such as field evaluations of rapid antigen tests during the Delta wave and operational research on GeneXpert MTB/XDR assays. This breadth of experience informs the authors’ assessment that diagnostic development for Bundibugyo virus requires coordinated investment across African research networks rather than reliance on external manufacturers alone.

The University of KwaZulu-Natal affiliation provides CAPRISA with access to high-containment laboratories and a pipeline of postgraduate students trained in virology, immunology and public-health implementation science. Several CAPRISA-affiliated researchers hold joint appointments with the National Institute for Communicable Diseases, facilitating rapid translation of findings into national guidelines.

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Challenges in Developing and Deploying Bundibugyo-Specific Tests

Commercial developers face low return on investment for a pathogen that has caused fewer than a thousand documented cases historically. Regulatory pathways for emergency-use authorisation require robust sensitivity and specificity data, yet outbreak settings offer limited sample volumes for validation. Cold-chain requirements and training needs further constrain deployment in rural clinics across the Democratic Republic of the Congo and Uganda.

The CAPRISA team advocates for a consortium model that pools funding from the Coalition for Epidemic Preparedness Innovations, Africa CDC and national research councils to underwrite development. They also stress the importance of multiplex assays capable of distinguishing Bundibugyo from other haemorrhagic fever pathogens circulating in the same ecological zones.

Implications for South African Higher Education and Research Capacity

The publication reinforces the strategic value of South African centres of excellence in global health. Universities and research institutes in KwaZulu-Natal, Gauteng and the Western Cape are increasingly positioned as hubs for training African scientists in diagnostics development, genomic surveillance and implementation research. Postgraduate programmes at the University of KwaZulu-Natal already incorporate modules on point-of-care technologies, preparing the next generation of researchers to address similar gaps for future threats.

Administrators at institutions hosting CAPRISA-linked projects note that sustained funding for such centres attracts international collaborations and postdoctoral fellows, strengthening the broader higher-education ecosystem. The commentary’s emphasis on African-led solutions also aligns with continental initiatives to build local manufacturing capacity for diagnostics and vaccines.

Stakeholder Perspectives and Regional Response Efforts

Ministries of health in the Democratic Republic of the Congo and Uganda have welcomed the Lancet commentary as a catalyst for renewed advocacy. Africa CDC has declared the outbreak a public health emergency of continental security and is coordinating cross-border surveillance. The World Health Organization continues to support laboratory strengthening while urging accelerated research and development for Bundibugyo countermeasures.

Within South Africa, the Department of Health and the National Institute for Communicable Diseases are monitoring the situation closely, given historical importation risks. CAPRISA’s visibility in high-impact journals enhances the country’s reputation as a contributor to evidence-based outbreak response rather than a passive recipient of external assistance.

Future Outlook and Actionable Recommendations

The authors outline a clear roadmap: prioritise antigen and nucleic-acid amplification tests validated against Bundibugyo virus; integrate diagnostic development into existing African research consortia; and ensure equitable access through technology-transfer agreements. They also call for investment in training community health workers to use and interpret rapid tests accurately, addressing concerns about reliability that have surfaced in previous evaluations of other rapid diagnostic platforms.

For South African universities and research funders, the publication serves as a reminder that capacity built for HIV and COVID-19 can be leveraged for emerging threats. Strengthening diagnostics pipelines will require sustained support for both basic virology and operational research, ensuring that breakthroughs reach primary-care settings where they are most needed.

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Conclusion: Strengthening Africa’s Diagnostic Resilience

CAPRISA’s intervention in The Lancet crystallises a long-standing challenge in global health security: the mismatch between outbreak frequency and diagnostic preparedness for less common pathogens. By grounding their call in the lived experience of African research institutions, the authors move the conversation beyond generic appeals toward concrete, regionally anchored solutions. As the 2026 Bundibugyo outbreak evolves, the responsiveness of the international community will be measured not only by case counts but by the speed with which reliable rapid tests become available to clinicians on the front lines.