Comparator
2026 vs 2014 West Africa vs 2018-2020 Kivu
Three major modern Ebola outbreaks compared on strain, scale, geography, vaccine availability, and what made each response difficult.
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Headline comparison
The 2026 outbreak has passed the 2018-2020 Kivu epidemic, and the response options are narrower than in either earlier one.
On case counts, 2026 now stands at 4,073 confirmed cases against 28,616 reported in 2013-2016 and roughly 3,470 to 3,481 in the 2018-2020 Kivu epidemic, which makes it the second-largest Ebola outbreak on record and the largest ever recorded in DRC. The harder problem is pharmacological. The Kivu response succeeded in part because Ervebo and the PALM trial monoclonal antibodies were available; in 2014 no licensed product existed but Zaire-strain trials launched rapidly. The 2026 strain is Bundibugyo, which sits outside every approved product's coverage.
| 2026 DRC + UgandaActive | 2018-2020 Kivu | 2013-2016 West Africa | |
|---|---|---|---|
| Span | Active (declared 17 May 2026) | Aug 2018 - Jun 2020 (~23 months) | Dec 2013 - Jun 2016 (~30 months) |
| Strain | Bundibugyo virus (BDBV) | Zaire ebolavirus (EBOV) | Zaire ebolavirus (EBOV) |
| Geography | Ituri, North Kivu, Haut-Uele, Tshopo, South Kivu (DRC); Kampala (Uganda), declared over 28 July 2026 | North Kivu, Ituri, South Kivu (DRC); Uganda cross-border | Guinea, Liberia, Sierra Leone (with onward to Nigeria, Mali, Senegal) |
| Reported cases | 4,073 | 3,470 | 28,616 |
| Reported deaths | 1,852 | 2,280 | 11,310 |
| Apparent CFR | 45.5% | 65.7% | 39.5% |
| Vaccine available at start | No (Bundibugyo strain; no approved vaccine targets BDBV) | Yes (Ervebo, deployed via ring-vaccination protocol) | No (Ervebo trials began in 2014-15 during the outbreak) |
| Therapeutic available at start | No (Inmazeb, Ebanga target EBOV only) | Yes, late stage (mAb114 and REGN-EB3 deployed under PALM trial) | No approved monoclonal antibody products at start |
| PHEIC declaration | 17 May 2026 | 17 July 2019 (lifted June 2020) | 8 August 2014 (lifted March 2016) |
| Notable response challenge | No vaccine for the active strain; urban transmission in Bunia and Kampala | Armed conflict in eastern DRC; attacks on health workers; community mistrust | Weak health systems in three poor countries; first large urban Ebola spread |
2026 - active PHEIC
Pharmacological response gap is the central problem. Investigational BDBV vaccines (cAd3-EBO and others) exist in pre-clinical or early Phase 1; emergency-use authorisation would be the route. Read more on investigational candidates.
2018-2020 Kivu - resolved
Second-largest Ebola outbreak. PHEIC declared 17 July 2019. Conflict and attacks on responders extended the outbreak to 23 months. Ervebo ring vaccination credited with limiting size despite the security environment.
2013-2016 West Africa - resolved
The largest Ebola outbreak in recorded history and the reason Ervebo, Inmazeb, and Ebanga exist as approved products. The 2014 PHEIC remained in force for 19 months.
Sources: WHO Disease Outbreak News, WHO Ebola situation reports 2013-2016 and 2018-2020, CDC Emerging Infectious Diseases, FDA and EMA product labels for Ervebo, Zabdeno, Mvabea, Inmazeb, and Ebanga. Methodology at /methodology.