The rapidly expanding Ebola outbreak in the Democratic Republic of Congo and Uganda is drawing renewed attention to the Trump administration’s dismantling of global health and disease surveillance infrastructure after public health experts, former USAID officials, and outbreak responders warned for more than a year that deep cuts to international aid and epidemic response programs would weaken the world’s ability to detect and contain deadly viruses.
The World Health Organization declared the outbreak an international public health emergency after more than 131 people died and hundreds more became infected or were suspected of infection across northeastern Congo near the Ugandan border. Health officials believe the virus may have circulated undetected for as long as six to eight weeks before laboratory testing confirmed the outbreak, raising concerns that critical detection systems failed during the early stages of spread.
The outbreak has also revived scrutiny of the Trump administration’s Department of Government Efficiency initiative, known as DOGE, which was led by billionaire Elon Musk and tasked with aggressively cutting federal agencies and international programs throughout early 2025. During a cabinet meeting in February 2025, Musk publicly acknowledged that Ebola prevention funding had been canceled during DOGE’s sweeping reductions.
“I think we all want Ebola prevention,” Musk said while describing the cuts, which he characterized as an accidental mistake that had been corrected immediately. Musk also claimed there had been “no interruptions” to Ebola prevention programs after the funding was restored.
Subsequent reporting from current and former public health officials directly contradicted those assurances. The Washington Post later reported that USAID’s Ebola prevention efforts had been “largely halted” after DOGE moved to dismantle the global assistance agency and freeze outgoing payments. Former officials involved in Ebola response efforts said critical systems were never meaningfully restored.
“I disagree fully, completely, wholly, that they recognized the mistake and put it back,” Dr. Craig Spencer, an emergency physician and professor at Brown University School of Public Health who worked on Ebola outbreaks in Africa for more than a decade, told NPR.
Spencer described widespread disruptions to international coordination systems that had previously formed the backbone of outbreak response efforts. According to Spencer, CDC officials were no longer permitted to attend World Health Organization meetings during outbreaks, something he said had occurred during every prior Ebola response.
“From top to bottom, none of the things that they have canceled have been put back in place,” Spencer said.
The current outbreak is especially alarming to health experts because of the scale of transmission already underway at the time authorities formally identified the virus. Ebola kills roughly half of those it infects, and outbreaks are typically declared after only a relatively small number of confirmed cases. NPR reported that a previous outbreak in the Democratic Republic of Congo in 2024 was declared after just 28 cases, though 45 people eventually died during that outbreak.
By contrast, health officials say the current outbreak appears to have gained substantial momentum before confirmation. Jeremy Konyndyk, who previously led Ebola response efforts at USAID during the Obama administration and now serves as president of Refugees International, warned that the outbreak’s trajectory resembles the early stages of the devastating 2014 West Africa epidemic.
“I’m very, very worried,” Konyndyk told NPR. “If I compare this to past outbreaks, this one has more momentum at point – at time of detection than the huge West Africa outbreak in 2014 did.”
More than 11,000 people died during the 2014 outbreak.
Part of the difficulty in detecting the current outbreak stems from the specific strain involved. Health officials say the virus spreading through the region is the rare Bundibugyo strain of Ebola, which standard field tests frequently fail to identify. NPR reported that samples had to be sent to larger laboratories for confirmation, slowing official recognition of the outbreak and allowing the virus additional time to spread through multiple health zones.
Former outbreak officials and humanitarian experts, however, say technical challenges alone cannot explain the delays. For decades, USAID personnel, CDC teams, humanitarian aid organizations, and local health workers formed a layered surveillance network throughout the Democratic Republic of Congo, particularly in remote regions vulnerable to recurring outbreaks. Those systems included field monitoring, sample transportation, laboratory coordination, and communication networks capable of flagging unusual illnesses before they spread widely.
The Democratic Republic of Congo has long been considered one of the world’s most important infectious disease surveillance zones because of its dense forests, isolated mining regions, population displacement, and ongoing armed conflict. Public health officials say those same conditions now make containment significantly more difficult.
The Trump administration’s cuts dramatically reduced the personnel available to manage those operations. HealthDay News reported in March 2025 that USAID previously maintained more than 50 staff members dedicated to outbreak response. After DOGE reductions, only six staffers reportedly remained to manage preparedness efforts related to Ebola, Marburg virus, mpox, and bird flu.
Konyndyk told NPR that the dismantling of USAID went far beyond staffing cuts and effectively erased the agency’s emergency response capacity.
“The whole disaster response capability at USAID no longer exists,” he said. “All of those people are gone. The operation centers that they worked out of are shut down. They can’t even access the Ronald Reagan Building where those operation centers sit. That lease has been handed over to Customs and Border Protection.”
The geography of the outbreak has intensified concerns about the loss of humanitarian infrastructure. Cases are concentrated in remote mining areas affected by violence and instability where government access is limited. In such regions, humanitarian organizations often function as informal disease surveillance networks because aid workers are able to reach communities that government officials cannot.
NPR reported that humanitarian aid funding in the Democratic Republic of Congo fell by nearly 80% during the Trump administration, a reduction that experts say likely weakened those informal monitoring systems. Bloomberg later reported that by the time laboratory testing confirmed Ebola, unexplained illnesses and deaths had already spread across multiple regions near the Ugandan border.
The report noted that aid-supported health systems often perform multiple functions simultaneously, including transporting laboratory samples, monitoring unusual illnesses, and maintaining communication between remote clinics and national health authorities. Public health experts warned that when funding disappears, those interconnected systems can deteriorate rapidly.
The Trump administration has denied that its restructuring of USAID harmed outbreak response capabilities. According to NPR, the State Department said it was false to claim that USAID reforms negatively affected the government’s ability to respond to Ebola. During a press briefing Sunday, CDC Ebola response manager Satish Pillai did not directly answer questions about whether the cuts contributed to delayed detection of the outbreak, though he acknowledged that the CDC only learned about the first confirmed case one day before the outbreak was publicly announced.
Pillai said “difficult conditions on the ground” contributed to the delays.
Public health advocates say the outbreak illustrates broader vulnerabilities created by reductions in disease preparedness programs, research funding, and international coordination. Leslie Dach, founder and chair of Protect Our Care and former Health and Human Services global Ebola coordinator during the Obama administration, warned that weakened surveillance systems could leave both foreign and domestic populations exposed to greater risks.
“If history is any guide, the administration must be fully vigilant and prepared to deal with the potential of this deadly disease reaching America’s shores, or the situation could get ugly fast,” Dach said in a statement Monday.
“Without proper procedures and guardrails in place, people could get very sick and die,” Dach continued. “But Donald Trump has deliberately left us the opposite of prepared by gutting Ebola and pandemic-preparedness infrastructure at home and abroad. The CDC is now flying blind after Trump and Republicans shuttered USAID and cut themselves off from WHO’s global resources—destroying our disease surveillance and response capability just so billionaires could have another tax break.”
Dach also linked the current outbreak to a broader erosion of public health infrastructure during the Trump administration.
“Whether it’s measles, Hantavirus, or Ebola,” he said, “the deep Trump cuts to research, public health staff and infrastructure have left the nation ten steps behind–always putting out public health fires rather than preventing them.”
Warnings about the consequences of the cuts emerged long before the current outbreak intensified. During the initial DOGE reductions in February 2025, Sen. Patty Murray criticized the administration’s handling of infectious disease preparedness and warned that dismantling response systems could eventually produce deadly consequences.
“If Ebola, Margurg, or any other infectious disease makes it to our shores, it will be thanks to Elon and Trump—two billionaires without a clue, who are positively smug about their own ignorance.”
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