From outbreak response to regional readiness: reimagining mRNA vaccine platforms for Ebola preparedness in East Africa

Ebola disease remains a persistent public health threat in East Africa, where zoonotic spillover, cross-border mobility, fragile health systems, and public anxiety intersect. Although licensed vaccines have improved preparedness against Zaire ebolavirus disease, major gaps remain for Sudan and Bundibugyo ebolaviruses, both of which pose significant regional risks. This Perspective argues that mRNA vaccine platforms should be viewed not merely as emergency-response tools but as essential preparedness infrastructure. Their value lies in the ability to rapidly progress from viral sequencing to antigen design, small-scale production, immunological evaluation, and outbreak deployment, reducing delays associated with conventional pathogen-specific vaccine development. However, technological speed alone cannot protect healthcare workers, border populations, or vulnerable rural communities. Effective preparedness requires integration with genomic surveillance, ethical clinical trial readiness, streamlined regulatory pathways, reliable cold-chain systems, community engagement, and meaningful African participation in vaccine manufacturing. A sustainable mRNA preparedness strategy must also address structural challenges affecting scientific innovation in Africa, including dependence on unstable donor funding, declining external support, supply-chain vulnerabilities, and limited domestic investment. We contend that East Africa needs an mRNA-enabled Ebola preparedness ecosystem capable of responding to Sudan, Bundibugyo, and Zaire ebolavirus threats while strengthening surveillance, diagnostics, infection prevention, contact tracing, and safe clinical care. The critical challenge is not simply responding to outbreaks when they occur, but institutionalizing readiness before the next epidemic emerges.