None of us have enough funding.
In the forests of northeastern Congo, a virus moved quietly for nearly a month before the world took notice — and by then, more than a hundred people were dead. The delay was not merely biological; it was institutional, the consequence of dismantled agencies, withdrawn funding, and severed relationships that once formed the connective tissue of global disease response. What is unfolding in Ituri Province is not only an Ebola outbreak but a reckoning with what happens when the architecture of prevention is taken apart piece by piece, and the cost is counted only after the dying has begun.
- An unusual Ebola strain with no vaccine or treatment circulated undetected for nearly a month, reaching nearly 600 suspected cases and over 100 deaths before a formal declaration was made.
- The detection gap traces directly to gutted infrastructure: USAID dismantled, CDC budgets cut, WHO funding withdrawn, and health aid to DRC and Uganda eliminated — each cut compounding the last.
- Aid workers are now airlifting gloves and hospital gowns to facilities that once kept them stocked, operating what one official called 'a very small checkbook' where robust preparedness programs once stood.
- The State Department disputes the link between its cuts and the delayed response, pointing to continued CDC presence and carried-over programs — but former officials say the institutional knowledge, local relationships, and coordinating power are simply gone.
- An emergency package of $23 million has been announced, but experts warn it arrives after the early-warning infrastructure it was meant to support has already been systematically dismantled.
In the remote reaches of Ituri Province in northeastern Democratic Republic of the Congo, an Ebola virus was spreading silently for weeks. The first death came on April 20. The official declaration came on May 15. In that gap of nearly a month, more than a hundred people died and nearly six hundred suspected cases accumulated. The strain was unusual — no vaccine exists for it — and samples had to travel over a thousand miles to Kinshasa for confirmation because local testing capacity did not exist.
Aid workers and public health experts are now asking whether this had to happen. They point to a cascade of decisions made in Washington: the Trump administration's withdrawal from the World Health Organization, the dismantling of USAID, cuts to the CDC, and the reduction of health aid to both the DRC and Uganda. Taken together, these moves hollowed out the surveillance infrastructure designed to catch outbreaks early.
The International Rescue Committee, operating on the ground, was direct: weakened disease surveillance following severe funding cuts contributed to the delayed detection. Before March 2025, the US government funded much of the IRC's outbreak preparedness work in eastern DRC. That funding ended. Now responders are airlifting basic protective equipment to facilities that would once have had it stocked. The IRC's country director described mounting an emergency response with a very small checkbook.
The State Department has pushed back, arguing that no specific USAID program would have caught this outbreak and that Ebola management work continued after USAID's dissolution. But two former USAID officials told CNN that the people with deep Ebola experience were fired when the agency was dissolved — and with them went the relationships, coordination networks, and institutional trust that one former official called the glue holding together health authorities, NGOs, and donors.
The CDC is also stretched thin. One expert on the response described the agency as incredibly short-staffed, with numerous specialists fired, retired, or resigned without replacement. Roughly $700 million in PEPFAR funding has been withheld from the CDC this year, depleting the same teams and systems that respond to outbreaks across east and central Africa.
The US has since announced $23 million in emergency assistance to support surveillance, laboratory capacity, and treatment clinics. But health experts note the painful irony: the emergency response is being mounted after the infrastructure that would have prevented the emergency was already taken apart. As one aid official put it plainly, none of them have enough funding — and the question now is whether a hastily assembled response can contain a virus that has already had weeks to move through a region whose defenses were quietly dismantled long before the first case was confirmed.
In the remote rural areas of Ituri Province in northeastern Democratic Republic of the Congo, a virus was circulating silently for weeks before anyone knew it was there. The first death linked to this Ebola outbreak occurred on April 20, but the disease wasn't officially declared until May 15—a gap of nearly a month that allowed the virus to spread unchecked. By the time health authorities confirmed what they were dealing with, more than a hundred people were dead and nearly six hundred suspected cases had accumulated across the region. The strain itself was unusual, one for which no vaccine or specific treatment exists, and it required samples to travel more than a thousand miles to a laboratory in Kinshasa for confirmation because local testing capacity didn't exist.
Now, as the outbreak accelerates, aid workers and public health experts are asking a harder question: Did it have to spread this far? They point to a series of decisions made in Washington over the past year and a half that, they argue, left the world's disease surveillance systems weaker than they should have been. The Trump administration withdrew funding from the World Health Organization, dismantled the US Agency for International Development, cut budgets at the Centers for Disease Control and Prevention, and reduced health aid flowing to both the DRC and Uganda. Each of these moves, taken separately, might have been manageable. Together, they created gaps in the infrastructure that catches outbreaks early.
The International Rescue Committee, which has teams on the ground in the DRC, was direct about the connection. Weakened disease surveillance systems following severe health funding cuts in eastern DRC contributed to the delayed detection, the organization said. Years of underinvestment and recent funding cuts left many health facilities without adequate protective equipment, without the capacity to test for rare diseases, and without the frontline support needed to respond quickly. Heather Reoch Kerr, the IRC's country director for the DRC, explained that responders are now in the position of having to airlifted basic supplies—gloves, masks, hospital gowns—to healthcare facilities that would have had these items stocked in the past. Before March 2025, the US government funded much of the IRC's outbreak preparedness work in eastern DRC. That funding ended. Now, as the organization tries to mount an emergency response, it is doing so, as one IRC official put it, with a very small checkbook.
The State Department has disputed the characterization that its cuts hampered the response. A senior official told reporters that no specific USAID person or program in the region would have detected the outbreak, and that funding awards and Ebola management programs carried over after USAID was dismantled. The CDC's incident manager noted that the agency has maintained a presence in the region for decades, with roughly a hundred staff in Uganda and nearly thirty in the DRC. But the reality on the ground tells a different story. Two former USAID officials told CNN that many of the people with deep experience responding to Ebola outbreaks were fired when USAID was dissolved. More than that, they lost the relationships with local health officials, the coordination networks, and the ability to serve as what one former official called the glue that holds together health authorities, NGOs, and donors. You can have experts arrive from anywhere, that official explained, but if you cannot pay health workers, supply them with what they need, or coordinate the response, there is a real limitation. That is what was lost.
The CDC itself is struggling. One CDC expert working on the response told CNN that the agency is incredibly short-staffed across the board. Numerous experts have been fired, quit, or retired without being replaced over the past year and a half. Much of the CDC's global work is funded through the President's Emergency Plan for AIDS Relief, but the State Department has withheld roughly seven hundred million dollars from the CDC for that program this year, according to health policy sources. The same staff and systems that help stop HIV epidemics are the ones that halt other epidemics. With those teams and funding depleted in east and central Africa, the capacity to respond to any outbreak has been diminished.
Dr. Fiona Havers, an infectious disease physician who was deployed to Liberia during the 2014 Ebola outbreak, noted that previous responses relied heavily on USAID partners who handled the unglamorous but essential work: setting up clinics, importing ambulances, contacting suspected cases, staffing isolation facilities. All of those aid groups have had their programs shut down and their community health workers fired. They are no longer available, or available only in much more diminished capacity, to pivot to a new crisis. The loss runs deeper than money. Former USAID officials said there has been a loss of goodwill and credibility between the US government and local health authorities in the DRC, where the US was once the largest health donor and had what they called convening power. That respect and credibility are gone.
The State Department announced an initial twenty-three million dollars in bilateral foreign assistance to support surveillance, laboratory capacity, risk communication, safe burials, and clinical case management, with plans to fund up to fifty treatment clinics in affected regions. But health experts warn that this emergency response, while necessary, comes after the infrastructure that would have caught this outbreak earlier has already been dismantled. Greg Ramm of Save the Children, speaking from the DRC, summed up the situation plainly: none of them have enough funding. Experts have warned that many more people will die if the broader health system collapses, which is why it is critical that people with Ebola seek treatment and that health facilities remain open to treat other diseases. The question now is whether the emergency response, mounted hastily and with limited resources, can contain a virus that has already had weeks to spread through a region where the systems meant to stop it have been systematically weakened.
Citas Notables
Years of underinvestment and recent funding cuts have left many health facilities without adequate protective equipment, surveillance capacity, or frontline support needed to respond quickly and safely.— Heather Reoch Kerr, IRC country director for DRC
You can have a ton of experts come in, but if you can't actually get people out or pay health workers or supply them with the things that they need, there's a real limitation there, and that's what we lost with USAID.— Former USAID official who worked in the DRC
La Conversación del Hearth Otra perspectiva de la historia
Why did it take nearly a month to identify this outbreak?
The virus strain was unusual—one that local labs couldn't test for. Samples had to travel over a thousand miles to Kinshasa for confirmation. But that delay was made worse by weakened surveillance systems. The infrastructure that would have caught it faster had been hollowed out by funding cuts.
So the cuts didn't directly cause the outbreak, but they made the response slower?
Exactly. The virus was circulating regardless. But when you eliminate disease surveillance capacity, when you fire the people who coordinate responses, when you close clinics and cut community health workers—you lose the ability to detect and react quickly. A month is a long time for a virus to spread.
The State Department says the cuts didn't matter. What do the people actually working on this say?
The people on the ground tell a different story. The IRC says funding cuts directly contributed to delayed detection. Former USAID officials say they lost not just money but relationships, credibility, and the ability to coordinate. One called it the glue that held everything together.
What about the CDC? They still have staff there.
They do, but they're short-staffed. Seven hundred million dollars in AIDS funding has been withheld. The same teams and systems that stop HIV also stop other epidemics. With those depleted, the CDC is responding to this outbreak with fewer people and less infrastructure than they had before.
Is the emergency response enough?
It's necessary, but it's coming too late and with too little. One aid worker said plainly: none of us have enough funding. The systems that would have caught this outbreak early are already gone. You can't rebuild that infrastructure in the middle of a crisis.
What happens next?
Health experts expect more funding cuts are coming. Right now, the focus is on containing this outbreak. But the underlying question—whether the US can maintain the global health infrastructure needed to catch the next one—remains unanswered.