US aid cuts may have delayed detection of this Ebola outbreakExBulletin

When did the Ebola epidemic raging in the DRC begin?

The official statement was released on May 15. But the scale and scope of the virus – more than 600 suspected cases and 139 deaths – has disease experts speculating that the virus could have been spreading in the Democratic Republic of Congo for weeks, if not months.

They put forward several reasons, some reflecting human decisions, others beyond the control of health authorities.

The rarity of this species of Ebola, called Bundibugyo, likely contributed to the delay, health officials say. Standard tests for detecting Ebola in the field are not designed for Bundibugyo, and it took time for samples taken in Ituri province – the epicenter of the outbreak – to be sent to Kinshasa, more than 1,000 kilometers away, for further testing. Ituri province is also in the grip of armed conflict which has intensified in recent months, making these logistics even more difficult.

But for decades, the U.S. government has invested hundreds of millions of dollars to prepare for this type of epidemic, particularly in the DRC, which is a hotbed of Ebola and other infectious diseases. This aid has been significantly reduced following the dismantling of the United States Agency for International Development and other reductions in foreign aid by the Trump administration.

“Outbreaks will always happen,” says Grace Tran, who worked on Ebola preparedness with USAID. “It’s more the fact that this has been around for so long, and this thing is much bigger than we thought. I think that part of it has to do with the budget cuts.”

Failures in preparation

Historically, USAID and the U.S. Centers for Disease Control and Prevention have been the primary players in supporting disease surveillance and response.

A fundamental but crucial element was logistics. This includes helping to transfer viral samples from remote locations to more centralized laboratories for testing. As part of the current outbreak, testing began in late April, but delays in shipping samples to Kinshasa, as well as inappropriate shipments that degraded the samples, hampered the process.

Typically, USAID has helped support this type of transportation, says Ana Bodipo-Mbuyamba, who served as director of USAID’s health office in the DRC from 2018 to 2023, where she worked on Ebola preparedness and response. U.S. funds also helped train health workers on the proper storage and shipping of these samples and also contributed to shipments from homes to laboratories.

“There was a time, especially in the remote areas of Ituri, where we were trying to get samples to the laboratory in Goma, supported by USAID,” explains Bodipo-Mbuyamba. “We were able to use some of our funding for humanitarian relief work to get a plane to transport some of these samples.”

During that outbreak, WHO officials told a news conference Wednesday that flight cancellations made it difficult to transport supplies between Kinshasa and Bunia, the largest city in Ituri province.

The CDC has always played a role in analyzing samples and providing technical expertise. But in a press call Sunday, Satish Pillai, head of the CDC’s Ebola response, said the United States was not informed of the outbreak until last Thursday, a day before it was declared.

Typically, the United States would be informed sooner, and it is unclear why there was a delay. But some experts have pointed to the United States’ withdrawal from the WHO, and its foreign aid more generally, as a potential factor.

“The reality is that the U.S. government is absent,” says Salim Abdool Karim, director of the South Africa AIDS Research Center and a member of the Africa CDC emergency committee tracking the epidemic. “We’re not sitting around wondering, oh, where is the American government? We’ve moved on.”

Strengthen surveillance systems

Testing is only a small part of monitoring. Someone on the ground – for example a health worker or a community member – should be wary. Maybe they hear about a cluster of mysterious deaths and report it to local health authorities. And that would lead to swabbing a sick person’s nose and possibly finding out the cause.

USAID has invested heavily in building local health systems, training health workers and communities to recognize and respond to potential outbreaks, says Bodipo-Mbuyamba. This work took years to build trust with communities, she said, many of whom are often wary of outsiders.

Due to the Trump administration’s aid cuts, many of these programs have ended or lost significant funds, she says.

“When you dismantle these programs, you no longer have your front-line eyes and ears on the ground to alert you,” she says. “Without it, you’re wasting valuable time and then precious lives are lost because of it.”

In active conflict zones like Ituri province, aid workers often serve as eyes and ears. But their funding has also been significantly reduced, from more than $900 million in 2024 to $179 million in the first year of the Trump administration.

A humanitarian organization, the International Rescue Committee, had covered 5 health zones in Ituri before the cuts. They had to be reduced to two, says Heather Kerr, IRC country director in the DRC, leaving the area even less monitored.

In a statement to NPR, the State Department said: “It is false to assert that USAID reform has negatively impacted our ability to respond to Ebola. In fact, by consolidating USAID’s global health functions under the State Department’s new GHSD office, our efforts are more aligned and effective. » On Tuesday, the State Department announced it would fund up to 50 clinics to help with the response, although it could take weeks. They also mobilized approximately $23 million in funds for the DRC, through the United Nations Office for the Coordination of Humanitarian Affairs.

For Bodipo-Mbuyamba, this decision comes too late.

“It’s so unfortunate and so sad to see all the work that we did disappear,” she said. “There was no reason for the dismantling [of USAID] in such a vicious way, now we are suffering the consequences.”

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