The Ebola outbreak in the Democratic Republic of Congo and Uganda is not the first the world has faced. But it is the first the world has faced after the Trump administration’s “America First” policy reshaped global health, making the rest of the world more vulnerable.
In 2025, the Trump administration retreated from the international community, eliminating the U.S. Agency for International Development, significantly reducing foreign assistance and withdrawing from the World Health Organization. Those moves deprived the global health system of critical support it had long relied on, creating conditions that have made an effective response to the deadly outbreak more challenging, current and former aid workers told MS NOW.
For decades, USAID worked with local partners and international nongovernmental organizations on the ground (both often funded by U.S. grants and assistance) to prevent and respond to outbreaks. Now, those partners are underfunded, underresourced and understaffed.
When local embassies were unable to absorb all the staffers affected by USAID’s abrupt closure, including specialists like clinical epidemiologists and virologists who prepared for emergencies like this, “those pieces aren’t there anymore,” said Kathleen Borgueta, who managed the East Africa portfolio for USAID’s global health bureau from 2020 to 2025 and spent most of her time in the now-affected region.
“The backbone of our workforce and our ability to respond just isn’t there anymore,” she told MS NOW, adding that the U.S. withdrawal also means systems previously supported by USAID are no longer at their peak capacity.
“What you really lost with USAID is logistics and ability to get s— done.”
Former USAID official
The latest Ebola strain, which has no vaccine or cure, is responsible for more than a thousand suspected and confirmed cases across the Congo and Uganda, with 223 suspected deaths and just 11 confirmed deaths, according to the WHO.
“I’ve heard from colleagues on the ground about specific things that we would have been doing that just haven’t been able to be mobilized at the speed or with the effectiveness that we normally would do,” Borgueta said. She cited getting protective gear where it’s needed, facilitating testing and ensuring samples are transferred at the correct temperature within the correct timelines.
A health worker first reported Ebola symptoms on April 24; the State Department said it was made aware of the outbreak on May 15. According to Congolese officials, the local lab in the Ituri province did not have proper equipment to test for the latest Bundibugyo Ebola strain, instead sending samples to Kinshasa at the incorrect temperature and quantity, which slowed the initial detection process.
“These are really specific, highly technical processes that we had really strong playbooks for,” Borgueta said, “and it’s just very clear from the way this is unfolding that those processes of playbooks and exercises, that we were really working to perfect to be able to respond to things in a matter of hours, have not been fully absorbed and have not been able to meet the need.”
The lag-time between the Congolese government and the WHO becoming aware of the outbreak was “really alarming” — and preventable — in the estimation of another former USAID official who had been working on health in the Congo and was granted anonymity for fear of professional retaliation.
The problem is administrative.
“What you really lost with USAID is logistics and ability to get s— done, the ability to pivot all of our health programs,” the former USAID official told MS NOW, noting the range and depth of USAID’s network. “We were the conveners, and we were the ones that everybody looked to … there’s just nobody on the ground in that way anymore, and we burned our credibility. Nobody’s calling us.”
The State Department has blamed the WHO for the scramble to get aid to the region, despite the fact that, as current and former officials observed, the WHO has no obligation to communicate with the United States since it withdrew from the organization.
“We were late to this because the WHO was a little late to this,” a senior State Department official said during a background press briefing. They said there have been no cuts to Centers for Disease Control and Prevention staff in the region and insisted “the surveillance network is what it always has been.”
While the U.S. still has a CDC network on the ground, the agency had several vacant positions when the outbreak began and nearly all of its staff worked out of the embassy in Kinshasa, on the opposite side of the country from North Kivu and the Ituri province where the outbreak first began.
“This area where this is happening right now is isolated, but also right near borders and a very high conflict area, and it’s a really hard place to get into, and you need to be operating there with people that are trusted by the community,” the former USAID official said. They said that although USAID’s health programs were not in the immediate area, the agency had partners on the ground who understood the local context.
“There was no specific person or program associated with USAID in this region that would have detected this or contributed to a detection framework here, so that’s just like a lie,” the senior State Department official said.
Julianne Weis, who worked for the United Nations during the 2014 Ebola outbreak and later in the global health bureau of USAID, said half of the clinics in North Kivu have closed due to USAID cuts.
“The way that we did outbreak response was by first supporting the primary health care system,” she said.
The State Department noted some Ebola-related USAID contracts continued within the government’s restructured foreign assistance bureau and that it hired some USAID staffers into the department. The most significant change, however, was the department’s investment in the America First Global Health Strategy’s memorandums of understanding, or MOUs, with individual countries, including the Congo and Uganda.
“I think we actually have a better, much better relationship with the health ministries there, who are the primary sort of public health authorities that have to respond to this and contain it for a long period of time,” the senior State Department official said. “It’s the national ministry that’s always going to be responsible for this, and the national health authorities that are going to have to fight this long after the NGO workers have taken their selfies and gone home.”
Weis was skeptical that the MOUs could make a significant difference at this stage, since moving money and implementing an actual plan as part of an agreement would take a significant amount of time.
“There’s no way to use that MOU to respond to this outbreak,” she said, calling the suggestion that NGO workers are there merely to take selfies “deeply disrespectful.”
“We always were working with governments,” she told MS NOW. “CDC again operated at a really high technical level, they do amazing work, but it’s that on-the-ground eyes and ears in the field — that was always USAID, and that’s what they took away.”
But the reality may be more complicated.
“Overall, it’s too early to tell any major difference between how State is doing it and how USAID would have done it,” one current State official, who previously worked for USAID and was not authorized to speak publicly, told MS NOW.
“Early sustained support for health systems and humanitarian response saves lives and helps prevent small outbreaks from becoming much bigger crises.”
Robert Petron Messe, Oxfam official
The official noted the 2014 West Africa outbreak and the previous ones in the Congo are not comparable to the current Ebola outbreak, as the chances USAID staffers would have been in the affected area was “slim to none.”
“The government in Kinshasa was not on this fast enough, and they didn’t raise the flag fast enough,” the official told MS NOW. “The center of the outbreak is an M23-controlled area. The idea that we could flood the zone with responders from across the international community is still to be seen, and probably unlikely in the near future.”
Speaking of the volatile conditions created by Rwanda-backed rebel group M23, Weis said, “A lot of the reason why they’ve been able to expand, again, is this complete dereliction. The U.S. has just absented themselves from this place entirely.”
Research shows that the abrupt withdrawal of USAID led to “a significant and sustained increase in conflict” across regions in Africa most dependent on assistance from the organization.
It’s not just the initial response that’s revealing the cracks caused by the Trump administration’s haphazard withdrawal from the global community: Local organizations began on a back foot due to a lack of resources prior to the recent surge.
U.S. foreign assistance plummeted in the past year, including to the Congo, where total obligations for aid decreased from $1.4 billion in 2024 to $146 million for 2026, according to the latest State Department data.
White House spokesperson Anna Kelly defended the administration’s strategic reforms, adding the U.S. “remains the most generous country in the world” because of the president’s “humanitarian heart.”
“The President’s actions to reform USAID have made our entire global health apparatus more efficient and responsive to potential outbreaks – any insinuations to otherwise made by anonymous, former employees with an axe to grind is false,” Kelly said in a statement.
International aid organization Oxfam in the Congo has not received any funding from the U.S. government since the termination of its last $13.5 million contract in February 2025, despite it being scheduled to run through July 2026. Oxfam is on the ground in northern and southern Kivu, but funding cuts recently forced the closure of its program in the affected area of Bunia.
Robert Petron Messe, Oxfam’s Humanitarian lead in Goma near the outbreak’s epicenter, is feeling the strain of resources, calling the situation in the Congo “extremely alarming.”
Messe noted eastern Congo lost 70% of its humanitarian aid after USAID was shuttered last year.
“This massive loss enhanced the collapse of the humanitarian system, including the country’s fragile health system, meaning medical clinics had to close due to lack of support and shortages of life-saving medication, leaving millions defenseless against preventable diseases like Ebola today,” he told MS NOW.
The U.S. has so far committed at least $32 million in assistance, which, according to the State Department, includes “border screening, aggressive contact tracing, direct patient care, the execution of safe and dignified burials, and the rapid logistical transport of vital personal protective equipment,” as well as $50 million to fund the first 50 clinics in partnership with the U.N. The State Department has surged money and personnel, including a Disaster Assistance Response Team, to the region, with more expected. At least 11 projects have already begun operations in Ebola-affected areas via U.S. funding to the United Nations Office for the Coordination of Humanitarian Affairs.
“We want first responders to understand that the United States is going to step up in a big way, so we’re making a big contribution, so that the organizations can send personnel to the field and understand that the United States is going to provide a lot of financial power and the commitment to get resources to the field to contain this as quickly and efficiently as possible,” the senior State Department official said.
“The reality is that, for me, early sustained support for health systems and humanitarian response saves lives and helps prevent small outbreaks from becoming much bigger crises,” Messe said. “The situation is critical.”
For former USAID officials who have managed outbreaks in the past, it did not have to be this way.
“The way that DOGE approached shutting down USAID was so sudden and not prioritized with what we know is necessary for lifesaving work, and having shocks to the system like that in regions that are already struggling,” Borgueta said. “There’s so many reasons why it is already, under normal circumstances, so hard to implement health programs, but in an emergency outbreak situation like this, it’s just a bit of a powder keg.”
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