With four African countries reporting filovirus outbreaks in 2025 alone, the World Health Organization has convened a high-level gathering of specialists to update and harmonize how clinicians manage patients infected with some of the world’s deadliest pathogens.
Fifty clinicians, researchers, and public health specialists from around the world gathered in Brazzaville, Republic of Congo, for a five-day Filovirus Disease Optimized Supportive Care Workshop organized by WHO with support from the UK’s Foreign, Commonwealth and Development Office (FCDO). The goal: to review existing clinical guidance, assess new evidence, and produce updated, consensus-based recommendations for managing filovirus disease (FVD) patients in any resource setting.
Africa Bears the Heaviest Burden as Outbreak Frequency Grows
Filoviruses — a family that includes all strains of Ebola virus and Marburg virus — cause severe hemorrhagic fever and carry high case fatality rates. Africa remains the epicenter of filovirus outbreaks, and the frequency of those outbreaks has been increasing in recent years. In 2025, the Democratic Republic of the Congo, Ethiopia, Tanzania, and Uganda each reported outbreaks, underscoring the urgent need for stronger and more consistent clinical response capabilities across the continent.
While vaccine and therapeutic development continues, approved options remain limited. No specific vaccines or treatments are currently approved for Marburg virus disease or Sudan ebolavirus. In that gap, the quality of supportive care — fluid management, monitoring, treatment of complications such as bleeding and renal failure — directly determines whether patients survive.
“Marburg and Ebola are among the most lethal pathogens we face and have significant social, economic and psychological impact on individuals and communities that have been affected,” said Dr. Marie-Roseline Darnycka Belizaire, Director of Emergency Preparedness and Response at WHO’s Regional Office for Africa. “Standardized, evidence-based care is not optional, it is lifesaving.”
From Bedside to Policy: What the Workshop Will Produce
The workshop is structured to deliver practical, field-ready outputs. Experts are working toward a consolidated clinical management guideline that synthesizes the best available evidence and front-line field experience. Alongside that, the group is developing a comprehensive optimized supportive care toolkit designed for use across varied resource environments — a critical consideration given that many FVD outbreaks occur in under-resourced health systems.
Particular focus areas include optimizing fluid therapy, monitoring patients with severe complications, and addressing care needs for high-risk groups including pregnant women and children. Guidance on survivor care is also being addressed, recognizing that FVD can cause lasting health consequences beyond the acute phase.
“Our collective experience in filovirus outbreaks has shown that when supportive care is optimized and standardized, the chance of survival in patients increases,” said Dr. Janet Diaz, Unit Head for Safe and Scalable Care at WHO Headquarters. “A clinical toolkit for frontline clinicians and key performance indicators that policy makers can use to improve quality during outbreaks will also be developed.”
Strengthening Research Readiness During Active Outbreaks
Beyond clinical care protocols, the workshop includes a dedicated one-day training on Good Clinical Practice and WHO core clinical trial standard operating procedures. This component targets principal investigators and research teams, building their capacity to launch ethical and rigorous clinical trials rapidly during an active outbreak — a persistent challenge when time-sensitive data collection must happen amid emergency conditions. Clinical trials remain the primary pathway for evaluating candidate vaccines and therapeutics.
Once finalized, the updated guidance will be disseminated to WHO Member States and integrated into national preparedness planning, training curricula, and simulation exercises.
The increasing frequency of outbreaks, combined with gaps in approved medical countermeasures, places an outsized burden on supportive care as the primary tool available to clinicians in many outbreak settings. Inconsistent clinical standards across countries and facilities have historically contributed to preventable deaths. Efforts to coordinate evidence-based protocols, equip frontline health workers with practical toolkits, and strengthen research infrastructure during outbreaks address critical vulnerabilities in the global health security architecture. For policymakers and public health officials, the outputs of this workshop will offer tangible benchmarks for evaluating and improving clinical response quality during future filovirus events.
Sources and further reading:
WHO convenes global experts in Brazzaville to strengthen clinical care for filovirus diseases – WHO Regional Office for Africa