The Ugandan city where the race for a new Ebola vaccine will be won or lost

The small Ugandan city of Masaka is known mostly for its coffee, grown on rich volcanic soils that produce beans which have a caramel-chocolate flavour.

The small Ugandan city of Masaka is known mostly for its coffee, grown on rich volcanic soils that produce beans which have a caramel-chocolate flavour. But it will soon be known for something very different: it is here where the UK's bid to be first to produce a new Ebola vaccine will be won or lost. In the coming weeks, 110 volunteers in Masaka are set to receive an experimental shot against the rare Bundibugyo species of Ebola, the deadly haemorrhagic fever currently spreading in Africa.

The Phase I trial, designed primarily to establish whether the jab is safe, is a vital step towards creating a much-needed vaccine. The vaccine is being developed by the Oxford Vaccine Group, the same team at Oxford University that helped to develop the AstraZeneca Covid-19 jab used during the pandemic. There are two other vaccines also in the race, one from Moderna and another from the non-profit biotech firm IAVI.

Overall, Britain has committed £29 million to the Ebola response, with further funding expected. Some of that money will go into supporting the trial. The study is a collaboration between the University of Oxford and a leading research unit in Uganda, a branch of the UK's Medical Research Council (MRC) that is situated inside the Ugandan Virus Research Institute (UVRI).

"It's fantastic that in the UK we've got the capability to contribute to this effort," Baroness Chapman of Darlington, the development minister, told The Telegraph during a visit to the MRC's laboratories. The main campus from which the Ugandan trial is being overseen is based in Entebbe, a city that hugs the coast of Lake Victoria. On its pristine and sprawling grounds, it is obvious that anxieties over Ebola are high.

The Ugandan government has recently banned handshakes and hugs to stop the virus spreading. Everyone now greets each other with an awkward bump of the elbow. Large gatherings have also been prohibited, although that didn't stop anyone from crowding into bars and pubs to watch the DR Congo-England match, which took place during The Telegraph's visit.

So far, Uganda has only had 20 cases of the virus. The main epidemic is in the neighbouring country of the Democratic Republic of Congo. In just two months, 1,700 cases have been recorded in the DRC, in what has now been formally classified as the fastest-growing Ebola outbreak in history.

Efforts to contain the disease have been hampered by a range of factors from ongoing conflict between dozens of armed militias in Eastern Congo to attacks on healthcare workers and treatment centres. Conspiracy theories abound. While Uganda has reported far fewer cases, it shares a long, porous border with the DRC, crossed by thousands of people every day, meaning it remains at risk.

Yet Uganda is no stranger to Ebola, and its wealth of experience in dealing with haemorrhagic fever outbreaks is one of the many reasons the country was chosen to host the first human trial for Bundibugyo. This is Uganda's seventh Ebola outbreak, and scientists here have spent decades studying the virus and testing experimental vaccines. "It's part of our mandate to do research that will lead to interventions," Professor Pontiano Kaleebu, director of viral pathogen research at the MRC Unit, told The Telegraph.

"Even if the vaccine is not ours, we will participate in the clinical trials because it is very important. We want to control and manage this infection." Although vaccines already exist for Ebola, none are approved for the Bundibugyo species currently spreading in the region.

Why that is is fairly straightforward: Ebola is not a lucrative business. Unlike influenza vaccines, which are bought in bulk every year, the market for Ebola vaccines is much smaller. They are used only in emergencies and only then among those at highest risk.

Masaka, which is in southern Uganda, is an ideal location for the trial, according to those involved. The MRC Unit runs a large research outpost in Masaka, where it has worked for more than 40 years. The Masaka station was once home to Africa's largest-ever HIV trial, and there have been several other studies there on new vaccines, including for diseases like tuberculosis, Covid-19, and other strains of Ebola.

The scientists say they have built up strong relationships with communities in and around Masaka, which are essential when asking volunteers to take part in clinical trials. The team will shortly be required to present their ethical case to Uganda's National Ethics Committee, in which they will need to prove that participants have given informed consent and understand the risks involved. "The communities there understand the value of research for the general good, not just for themselves, and our structures for community engagement are fairly robust," Professor Moffat Nyirenda, director of the MRC Unit, said.

A parallel trial in Oxford will start at the same time. The aim of both will be to see if humans can tolerate the vaccine safely, what side effects it produces, and if antibodies against Ebola virus are produced in their blood. The reason why the jab is being safety tested both in the UK and Uganda is that it's important that it includes local people and their specific genetics.

"If [the Oxford vaccine] is going to be used, this is where it's going to be, so it's important it's tested here," Professor Nyirenda said. Genetics, environment, and previous exposure to pathogens all affect how a jab works in practice. For example, research shows the BCG shot against tuberculosis is curiously far less effective on people living close to the equator than those who live far from it.

Once approvals have been finalised, the 110 volunteers in Maska will be divided into three groups. It will be the first time the vaccine, which has recently been tested in animals, will be used in humans. One cohort will be given a single dose of the Oxford shot.

Another will receive two doses, administered a few weeks apart, to see if this has any effect on safety. A third and final group will consist of volunteers who have previously had the Zaire Ebola vaccine, the only species of the virus for which an approved shot exists, so that researchers can test for any cross-reactivity between the two jabs. More than 350,000 people in Africa have received the Zaire shot, so scientists need to understand whether previous vaccination could affect the safety of the new Bundibugyo vaccine.

Every volunteer involved in both Uganda and Oxford will be monitored intensively for the next several months to check for side effects. They will keep detailed medical diaries, recording any symptoms such as fever, vomiting or swelling around the injection site. Doctors will review them daily during the first week before moving to weekly follow-up appointments where they will take their blood and test it for things like healthy liver, kidney, and heart function.

If the results are positive, it is hoped that the Oxford jab can move into a larger clinical trial as soon as October, involving much larger numbers of people who are directly exposed to the virus. It would be run under an emergency use license, which allows an experimental vaccine to be used during an active epidemic. A similar emergency trial was run by the pharmaceutical company Merck during the 2014 West Africa Ebola outbreak, caused by the Zaire strain, and was ultimately credited with bringing the outbreak, which killed 11,000 people, to an end.

The Oxford vaccine itself is being made by the Serum Institute in India, who are understood to be making large batches of the shot already so that it can be available immediately for a phase III roll-out, if the trial is successful. But while scientists are optimistic that the jab will prove safe and effective, the platform it's built on carries unavoidable baggage. ChAdOx, the platform used in the AstraZeneca Covid jab, works by using a modified common cold virus that naturally infects chimpanzees, adapted to carry genetic instructions into human body cells.

Those instructions prompt the immune system to recognise a specific pathogen and prepare to fight it if it is encountered in the future. But during the pandemic, the Oxford-AstraZeneca shot was linked to a rare immune reaction that caused dangerous blood clots in some recipients and was withdrawn from use in Britain and many other countries around the world. At least 81 deaths in the UK are suspected to have been linked to the AstraZeneca shot, according to official figures released by the Medicines and Healthcare products Regulatory Agency (MHRA).

It's still unclear if the blood clot issue is related to the platform, or was a one-off. Many other vaccines have used ChAdOx, including those for malaria and the plague, and ultimately the issue boils down to a balance of benefit and risk. During Covid, other vaccines were available, and Covid itself presented a very low risk to young people from whom the vaccines were first withdrawn.

Ebola is very different. It presents a huge fatality risk to anyone who catches it, completely changing the risk-reward equation and perhaps playing to the ChAdOx platform's strengths. The platform is said to be highly adaptable.

Scientists can quickly swap the vaccine's genetic code to match new and emerging pathogens, meaning they are able to manufacture the jabs incredibly quickly. The team at Oxford says they can produce a vaccine ready for clinical trials within just 60 days of a new virus being identified. "The bottom line is no one would be considering this vaccine if the harm was so high that it would outweigh the benefits.

We will be open with the trial participants, and there will be very, very rigorous monitoring for safety," said Professor Eugene Ruzagira, the trial's chief investigator. The Oxford jab set to be tested in Uganda is one of three promising vaccine candidates that have received millions of dollars in funding from the not-for-profit organisation, the Coalition for Epidemic Preparedness Innovations (CEPI). CEPI has also given funding to pharmaceutical giant Moderna and biotech organisation IAVI, both of which already had early-stage Bundibugyo vaccines in development.

The IAVI candidate is currently at an earlier stage of development, and is expected to take between 7-9 months before it can reach clinical trials, according to the World Health Organization (WHO). Moderna is meanwhile developing an mRNA vaccine for Bundibugyo Ebola. Staff at the MRC in Uganda told The Telegraph Moderna had contacted them to discuss the possibility of running their own trials with the unit, but that the development is not yet as advanced as Oxford's.

For people in the DRC and Uganda, the race is a good thing. It's likely that within a year, at least one of the three jabs will have passed the trials, proving both safe and effective and will become available to bring the outbreak under control. Many healthcare workers and scientists interviewed by The Telegraph have had first-hand experiences with Ebola and know all too well the devastating toll it takes.

Alliupo Martha, a nurse at Mulago Hospital in Kampala who is shortly being dispatched to Bunia, the Congolese epicentre of the outbreak, treated a patient infected with Ebola last year. "I've seen patients cry before, but never tears of blood," she said, describing how the victim bled from multiple parts of his body before dying. Baroness Chapman said of Britain's involvement in the trial: "Even if we're not the first to cross the line, that's okay.

"We would have still learnt and continued, and one of the things that I see all the time is just how brilliantly collaborative researchers and scientists are on vaccines, in particular. The scientists just want to get on and solve the problem." Protect yourself and your family by learning more about Global Health Security