Projected epidemiologic and economic impact of the 7-1-7 outbreak response framework in Uganda: a stochastic modelling study of Bundibugyo Ebola virus
The 7 1 7 framework (detection 7 days, notification & 1 day, response & 7 days) is a global target for epidemic preparedness, but its prospective value during an active cross border outbreak has not been quantified. Using a stochastic SEIR model parameterised for Uganda with the Bundibugyo Ebola strain and three daily importation probabilities (10%, 30%, and the observed 56%), we compared a rapid 3 1 5 response (detection 3 days, notification 1 day, response 5 days) against a delayed counterfactual (detection 11 days, notification 10 days, response 12 days). The rapid response reduced median cumulative cases by 60 to 66% (26 to 31 cases vs. 76 to 80 cases) and deaths by 62 to 63% (3 deaths vs. 8 deaths) across all import levels, with total costs of USD 29.1 to 29.9 million compared to USD 37.4 to 38.1 million for the delayed scenario. The rapid response was strictly dominant (cost saving and life saving). Variance based Sobol sensitivity analysis identified the case fatality rate, import probability, and basic reproduction number as the most influential parameters, with detection and response delays contributing through interactions. Institutionalising the 7 1 7 framework in Uganda is projected to be highly cost effective and should be supported with sustainable domestic financing, community based surveillance at unofficial border points, three consecutive PCR laboratory capacity, and multilingual risk communication.