Marburg Virus Disease in Rwanda — Centering Both Evidence and Equity

Rwanda’s rapid containment of the 2024 Marburg virus disease (MVD) outbreak demonstrated a transformative model for epidemic response, contrasting historical trends. The outbreak began in September 2024, with 25 cases diagnosed in Kigali within days, raising concerns about widespread transmission. However, Rwanda achieved unprecedented containment in under three months, recording the lowest case fatality rate (CFR) for an MVD outbreak of this size (23%).

Historical MVD outbreaks—including the 1967 Germany outbreak (CFR: 22.7%) and 2005 Angola outbreak (CFR: 90%) highlight disparities in care standards. Prior approaches often relied on containment measures rather than high-quality treatment, leading to high mortality rates. Rwanda, however, prioritized clinical excellence, incorporating early supportive care, mechanical ventilation (first use for MVD in Africa), and genomic surveillance.

Collaborations between Rwandan health authorities and international researchers facilitated the first trials of a Marburg glycoprotein vaccine and experimental therapies, including remdesivir and monoclonal antibody MBP091. Unlike past siloed interventions, Rwanda embedded these trials within comprehensive care protocols, encouraging early medical evaluation and reducing secondary transmissions.

Rwanda’s rapid containment of the 2024 Marburg virus disease (MVD) outbreak demonstrated a transformative model for epidemic response, contrasting historical trends. The outbreak began in September 2024, with 25 cases diagnosed in Kigali within days, raising concerns about widespread transmission. However, Rwanda achieved unprecedented containment in under three months, recording the lowest case fatality rate (CFR) for an MVD outbreak of this size (23%).

Historical MVD outbreaks—including the 1967 Germany outbreak (CFR: 22.7%) and 2005 Angola outbreak (CFR: 90%) highlight disparities in care standards. Prior approaches often relied on containment measures rather than high-quality treatment, leading to high mortality rates. Rwanda, however, prioritized clinical excellence, incorporating early supportive care, mechanical ventilation (first use for MVD in Africa), and genomic surveillance.

Collaborations between Rwandan health authorities and international researchers facilitated the first trials of a Marburg glycoprotein vaccine and experimental therapies, including remdesivir and monoclonal antibody MBP091. Unlike past siloed interventions, Rwanda embedded these trials within comprehensive care protocols, encouraging early medical evaluation and reducing secondary transmissions.