Marburg Virus Disease in Rwanda — Centering Both Evidence and Equity

This Perspective reflects on Rwanda’s remarkable 2024 response to a major Marburg virus disease (MVD) outbreak, which became the third-largest ever but was declared over within three months with a 77% survival rate, the highest recorded for an outbreak of its size. The author attributes this achievement to Rwanda's early detection, robust genomic tracing, trials of investigational tools (including remdesivir and MBP091), and historic investments in local clinical capacity. The use of mechanical ventilation for MVD patients in Africa was unprecedented. Rwanda’s dignified care approach, rooted in solidarity and shaped by lessons from prior epidemics and leaders like Paul Farmer, challenged the false dichotomy between containment and treatment. The piece argues that linking clinical excellence with health equity can reshape global epidemic responses, even in low-income countries, and offers Rwanda’s model as a compelling counterpoint to waning global commitment to pandemic preparedness.

This Perspective reflects on Rwanda’s remarkable 2024 response to a major Marburg virus disease (MVD) outbreak, which became the third-largest ever but was declared over within three months with a 77% survival rate, the highest recorded for an outbreak of its size. The author attributes this achievement to Rwanda's early detection, robust genomic tracing, trials of investigational tools (including remdesivir and MBP091), and historic investments in local clinical capacity. The use of mechanical ventilation for MVD patients in Africa was unprecedented. Rwanda’s dignified care approach, rooted in solidarity and shaped by lessons from prior epidemics and leaders like Paul Farmer, challenged the false dichotomy between containment and treatment. The piece argues that linking clinical excellence with health equity can reshape global epidemic responses, even in low-income countries, and offers Rwanda’s model as a compelling counterpoint to waning global commitment to pandemic preparedness.