Central Africa: Did US aid cuts worsen Ebola outbreak?

Since the turn of the millennium, there has been a new Ebolaoutbreak almost every year. The current epidemic, however, is different.

Most Ebola outbreaks, including a devastating epidemic several years ago that caused at least 11,000 deaths in West Africa between 2014 and 2016, can be traced back to the Zaire strain, for which a vaccine has now been developed. The latest outbreak is, however, caused by the rare Bundibugyo strain, which is named after a region in Uganda where it was first reported in 2007. There is neither a vaccine nor drug to fight this strain, which kills around one in three of those it infects.

The current outbreak in the eastern Democratic Republic of Congo (DRC) and Ugandais the third and already deadliest Bundibugyo-related epidemic so far. As of Wednesday, at least 139 people were thought to have died, with an additional 600 suspected cases, according to the World Health Organization (WHO).

"I'm deeply concerned about the scale and speed of the epidemic," said WHO Director-General Tedros Adhanom at this week's UN General Assembly in the Swiss city of Geneva. He also warned that "these numbers will change as field operations are scaling up, including strengthening surveillance, contact tracing, and laboratory testing."

Ebola: What to know after WHO declares health emergency

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As soon as he became aware of the outbreak, Tedros immediately declared an international health emergency, without first consulting experts, which is customary. This is because the virus had reportedly been spreading unnoticed for several weeks already. Health experts are now racing to contain the virus and putting their own safety at risk in the process. Meanwhile, some are asking whether the outbreak may have been noticed faster if the US government had not drastically reduced its contributions to global health care efforts.

Outbreak bigger than expected

US epidemiologist Eric Feigl-Ding, who was one of the first prominent scientists to warn of the emerging coronavirus pandemic in January 2020, said we are likely only seeing the tip of the iceberg. "[Ebola is] already killing health care workers and it's spread to so many different regions already," he told DW. "With very little testing, we're already finding so many [cases], that means we're just scraping the top and this outbreak is much wider than we thought." He also warned that the latest outbreak was spreading much faster than the 2014 epidemic in Guinea, Sierra Leone and Liberia.

Ebola is transmitted through direct contact with infected people or their bodily fluids. This means the infection risk is more limited than for the SARS‑CoV‑2 virus, which can spread through the air. In theory, therefore, the Bundibugyo variant could be contained by quarantining infected individuals, through large-scale testing and contact tracing.

"The issue is the speed of deployment," Feigl-Ding said, adding that USAID used to have this, when it was on the ground, giving out medication, and funding local health care workers and clinics to do this. "Now USAID is gone. This is clearly one of the examples of what happens when you decimate the health care infrastructure in a lot of these countries."

The US Agency for International Development (USAID) is arguably the best-known example of dismantled US institutions since Donald Trump's return to the White House. In January 2025, the re-elected US president issued an executive order freezing all aid payments for 90 days and ordering a review of how the funds were being used. Many USAID employees were laid off, and 90% of the budget was slashed. While Congress later increased funding again, the temporary interruptions have left their mark around the world. To make matters worse, many European governments, including Germany, have also drastically cut their development aid.

Trump's disruptive cost-cutting measures were also made possible by tech billionaire Elon Musk, who at the time was head of the US Department of Government Efficiency (DOGE). In February 2025, Musk admitted to the US cabinet that he had "accidentally" terminated some programs to contain the Ebola virus "very briefly." The New York Times daily newspaper later reported that not all of the cancelled programs had been restored. It also said that the cuts had made an Ebola outbreak in Uganda worse, according to US embassy staff in the Ugandan capital Kampala.

After his January 2025 inauguration, Trump also initiated the US' withdrawal from the WHO, which became official one year later. Previously, the US was one of the most important donors to the global health body. In 2023 and 2024, US contributions amounted to over $1.2 billion (around €1.03 billion).

In previous Ebola outbreaks, the WHO worked closely together with the US Centers for Disease Control and Prevention (CDC). Yet the US public health agency has also seen drastic cuts under Health Secretary Robert Kennedy Jr, who has claimed to be cutting red tape. In April 2025, Kennedy announced that 25% of the CDC workforce would be laid off and 35% of external contracts terminated. US media outlets later reporter that key staffers tasked with fighting Ebola had been "accidentally" fired and then rehired. The CDC has said that it has over 30 staffers in the Democratic Republic of the Congo (DRC) currently helping to contain the Ebola outbreak.

Tireless work in difficult conditions

"The reduction of resources in the DRC, both humanitarian and health-related, is inevitably harmful for the Congolese population, and to some extent for epidemic prevention and detection," Julie Drouet, country director for the global humanitarian organization Action Against Hunger in the DRC, told DW.

She said that from her point of view several other factors had also contributed to the delayed detection of Ebola cases, including the fact that the "identified strain is not the one usually seen in the DRC."  Initial tests returned negative results as they  focused on the more common Zaire strain, she told DW. "Moreover, the first death occurred within the community rather than in health facilities." This allowed the virus to spread for a relatively long time without  public health officials noticing and sounding the alarm.

The resource-rich provinces of North Kivu, South Kivu and Ituri in eastern DRC are already plagued by violence and instability. The Ebola outbreak has only made matters worse. When armed groups linked to Rwanda advanced in early 2025, locals fled and the virus was able to spread more easily, thereby further complicating the efforts of aid workers.

But aid workers are prepared for such challenging circumstances, Drouet told DW. "We are currently doing everything we can to contain the epidemic. For example, humanitarian air bridges are also being organized to facilitate access and the delivery of the assistance."

The authorities have now also confirmed cases of Ebola in the eastern DRC city of Goma and in the Ugandan capital. Both cities have better infrastructure than Ituri province, where the outbreak began, though both suffer from high population density, which could cause the virus to spread rapidly.

The WHO has provided an initial tranche of $3.9 million to support national health care systems as they battle the Ebola virus outbreak. Health experts are also calling on governments around the world to increase this amount significantly.

With additional reporting from Anthony Howard.

This article was originally written in German.