Can Grassroots Action Prevent the Next Major Disease Outbreak?

Disease at the Door

In 2024, on May 26th, the Democratic Republic of Congo (DRC) reported 7,851 Mpox cases and 384 deaths. South Kivu was hit the hardest, with health centers stretched beyond their limits. Medical staff worked long hours with scarce resources, trying to keep up with the relentless wave of patients. Across the border in Burundi, fear spread almost as fast as the virus. People braced for an outbreak that felt inevitable. Anxiety filled the air. Would their hospitals withstand the pressure? Would their communities be ready?

Outbreaks like these expose the cracks in public health systems. Hospitals struggle, supplies run low, and healthcare workers face exhaustion. The cycle repeats with every new crisis. Yet, there's a way forward.

Instead of waiting for disaster to strike, communities can build defenses from the ground up. Early detection, rapid response teams, and local health training could mean the difference between control and catastrophe. In West Africa, grassroots networks helped curb Ebola’s spread. Could similar models work elsewhere?

The idea isn’t new, but the urgency is. Strengthening public health systems isn’t just about hospitals or vaccines—it’s about people. When communities take charge of their health, they stand a better chance against whatever comes next. The question isn’t if another outbreak will happen. The real question is: Will we be ready?

Jacques, an epidemiologist and Mpox expert with a Save the Children partner in South Kivu Province, DRC, recalled the case of a two-week-old baby who contracted the disease after sharing a room in an overcrowded hospital. The infected patient had not been diagnosed at the time. Stories like this expose the critical gaps in healthcare facilities. Many hospitals in affected regions lack the resources to detect and contain Mpox outbreaks early, allowing infections to spread unchecked before any intervention takes place.

Cholera has followed a similar pattern. In 2023, outbreaks surged across Africa, fueled by poor sanitation, unsafe water, and fragile healthcare systems. Extreme weather made things worse—droughts, heavy rains, and floods disrupted access to clean water, creating the perfect conditions for infection. Eastern and Southern Africa struggled to contain the disease while already dealing with weak infrastructure and overwhelmed medical staff.

By 2024, the Mpox outbreak had escalated dramatically. Across 12 African countries, 17,541 cases and 517 deaths were reported. The DRC alone accounted for 96% of fatalities. The crisis pushed Africa CDC to declare Mpox a Public Health Emergency of Continental Security (PHECS) on August 13, 2024. While this move aimed to coordinate a stronger response, it also triggered broader consequences. Travel restrictions, trade disruptions, and economic slowdowns followed. Social stigma worsened in affected regions, discouraging victims from seeking medical care. Many feared being shunned, leading to underreporting and delayed diagnoses. Public health efforts suffered as a result.

Children and displaced communities have been hit the hardest. The Clade 1b strain, an aggressive new variant, has disproportionately affected children in the DRC and Burundi. As of November 3rd, cases among children in the DRC had surged by over 130%, jumping from about 11,300 suspected cases to 25,600. In Burundi, confirmed child cases skyrocketed from 89 to around 1,100.

These numbers highlight the urgent need for stronger disease surveillance. Early warning systems could flag potential outbreaks before they spiral out of control. More coordinated local responses, alongside international support, would help communities respond faster. Without these improvements, the cycle of crisis and delayed intervention will continue, leaving the most vulnerable populations at risk.

Beyond Hospital Walls

Shifting the focus to grassroots mobilization allows African communities to use local knowledge, trust, and networks to prevent disease outbreaks.

Traditional healers are highly respected and often the first point of contact for many seeking medical help, especially in rural areas where modern healthcare is scarce. Their influence extends beyond treatment—they can bridge the gap between medical professionals and the public. Recognizing this, the World Health Organization supports integrating traditional healers into healthcare systems to strengthen disease prevention and response efforts.

Local leaders and community groups are equally vital in tackling misinformation during outbreaks. Partnering with health organizations, they can organize gatherings to spread accurate information, which helps with early detection and case reporting.

Burundi’s Mpox outbreak in 2024 showed how misinformation can worsen public fear and stigma. Many believed Mpox was another wave of Ebola or COVID-19, leading to panic and isolation of affected families. To combat this, UNICEF worked with Burundi’s Ministry of Health, the WHO, and local organizations to launch risk communication initiatives. Public health campaigns educated communities about Mpox symptoms, transmission, and prevention, reducing fear and encouraging people to seek medical care.

Mozambique faced similar challenges in 2023 after Cyclone Freddy triggered severe flooding, worsening the cholera outbreak. In response, UNICEF and other organizations initiated door-to-door awareness campaigns. Health workers visited households, teaching families how to purify water, maintain hygiene, and recognize cholera symptoms. Vaccination drives followed, targeting high-risk areas and relying on public engagement to boost participation. These localized efforts helped slow the spread of cholera, proving that community involvement is crucial to disease control.

Education plays a major role in preventing outbreaks. During the Ebola crisis in West Africa between 2014 and 2016, door-to-door campaigns, radio broadcasts, and local media in native languages helped communities understand the disease. These efforts changed behaviors and increased early reporting of symptoms, ultimately reducing transmission.

Beyond education, disease surveillance systems can empower communities. An Mpox surveillance reporting protocol was developed for African Union member states to help improve early detection. Simplified case definitions allow community members to identify potential cases in areas with ongoing Mpox transmission. This system strengthens active case-finding efforts and ensures faster response times.

Strong public health systems don’t operate in isolation. Engaging communities in surveillance, education, and prevention ensures that outbreaks are detected earlier and contained more effectively. The more people understand how diseases spread and how to respond, the stronger the region’s defenses become against future health crises.

To strengthen public health systems in Africa, health infrastructures need proper investment for quick response and management of infectious diseases like Mpox, cholera, and other emerging pathogens. 

Investing in laboratories to provide advanced diagnostic tests ensures faster diagnosis and enables targeted treatment. Clinics in rural areas also need to be well-funded to handle routine care and emergencies and lessen the burden on larger hospitals. The skills of healthcare workers act as the cornerstone of effective health systems. Healthcare providers need training programs to handle emerging diseases and keep up with new technologies. Skilled healthcare workers produce the ripple effect of building the public's trust in healthcare systems during disease outbreaks.

Rwanda provides an exemplary model of progress in this area. During the COVID-19 pandemic, the country provided free rapid diagnostic testing in health centers nationwide, ensuring quick detection and management of COVID-19 cases. The country resourcefully drew from its experience in fighting HIV to fight COVID-19. The same machines, infrastructures, and people used for HIV diagnosis were applied for COVID-19 testing. 

In 2016, Rwanda’s government reinforced its reputation for leaning into health tech innovation when it signed a contract with Zipline, a San Francisco-based drone startup, to streamline blood deliveries. Today, Zipline has two hubs in Rwanda; each can make up to 500 deliveries per day. This autonomous aircraft has proven to be faster than driving and has helped to shuttle blood to rural and mountainous areas of the country.

The Africa Centres for Disease Control and Prevention (Africa CDC) continues to play a pivotal role in strengthening health systems in Africa. On a continental level, Africa CDC supports affected countries and the continent during disease outbreaks in strengthening their healthcare systems through training, reinforcing surveillance and laboratory systems, providing pharmaceutical and medical products, and enhancing communication and partnerships.

However, it is common for marginalized communities to face inequality in access to health care and resources during disease crises. To ensure inclusivity, marginalized populations have to be prioritized. Outreach programs and mobile clinics can be set up to care for the needs in these rural areas. The distribution of medical supplies and resources should also be optimized and allocated to marginalized communities.

Africa CDC is using a data-driven approach to track outbreaks in real time. The digital disease surveillance program aims to develop digital surveillance indicators and online disease dashboards based on social media to inform infectious disease surveillance in Africa. It is expected to strengthen real-time surveillance of infectious diseases in Africa, guide interventions, and build capacity in “Big Data” approaches for outbreak prediction, analysis, and prevention.

Prevention Before Cure

Weak surveillance systems and limited diagnostic capacity allowed Mpox cases to go underreported in Burundi and DRC. The delay in response didn’t just strain fragile healthcare systems—it gave the virus room to spread. This isn’t just about Mpox or cholera. It’s the same story across multiple outbreaks. Diseases gain ground when detection is slow and response is reactive instead of proactive. Community engagement isn’t a secondary solution; it’s a necessary first step. Education campaigns reduce stigma, encourage early detection, and give people the information they need to protect themselves.

Grassroots mobilization works because people trust those within their communities. Traditional healers, local leaders, and volunteers can reach vulnerable populations in ways that government agencies and large health organizations can’t. They are the bridge between modern medicine and traditional knowledge. They dispel misinformation, encourage vaccination, and support early case detection. Public health efforts that ignore these networks miss a critical opportunity to improve outcomes.

Health systems in Africa cannot afford to remain stuck in a reactive cycle. Every outbreak highlights the same problem: crisis management comes too late. Instead of repeatedly scrambling to contain infections, governments and organizations should focus on strengthening prevention and resilience. That means investing in education, expanding healthcare access, and building robust early warning systems. Prevention isn’t just more effective—it’s cheaper and saves more lives in the long run.

International collaboration is another essential piece. Africa CDC, WHO, and UNICEF have played a major role in crisis response, but their contributions shouldn’t be limited to emergencies. Partnerships that focus on knowledge-sharing, research, and workforce training improve long-term preparedness. Collaborative vaccine development is already proving its value, showing that when resources and expertise are pooled, public health systems stand a better chance at staying ahead of the next outbreak.

Public health systems in Africa are stretched thin during disease outbreaks. The Mpox virus and cholera resurgence exposed the same weaknesses—gaps in surveillance, fragile health infrastructure, poor access to clean water, and a lack of preventive campaigns. Without intervention, the cycle will repeat. Strengthening healthcare shouldn’t just be about containing crises; it should prevent them from escalating in the first place.

Communities play a crucial role in that effort. Education, grassroots mobilization, and local surveillance systems aren’t secondary solutions—they are the backbone of disease prevention. When traditional healers, local leaders, and community health workers are involved, public health efforts reach deeper and work faster. People are more likely to trust familiar faces than distant institutions. That trust can mean the difference between early detection and a widespread outbreak.

Health systems don’t have to remain fragile. Expanding infrastructure, making healthcare access equitable, and prioritizing prevention over reaction are achievable steps. Countries that invest in these areas won’t just be better prepared for the next outbreak—they’ll reduce the need for crisis management altogether.

Now is the time for governments, NGOs, and community leaders to work together on lasting solutions. Disease outbreaks shouldn’t dictate the urgency of health improvements. A proactive, coordinated approach isn’t just an option; it’s a necessity.