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 60–66% (26–31 cases vs. 76–80 cases) and deaths by 62–63% (3 deaths vs. 8 deaths) across all import levels, with total costs of USD 29.1–29.9 million compared to USD 37.4–38.1 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.