Since 2000 there has been an Ebola outbreak almost every year, but the current epidemic in eastern Democratic Republic of Congo (DRC) and Uganda is different and more worrying.
Most recent major Ebola epidemics were driven by the Zaire strain, for which vaccines and some treatments now exist. This outbreak is caused by the rarer Bundibugyo strain, first identified in Uganda in 2007. There is no vaccine or specific drug for Bundibugyo, and it kills roughly one in three people it infects. According to the World Health Organization (WHO), this is the third and deadliest Bundibugyo-linked epidemic to date: as of Wednesday at least 139 people had died and some 600 suspected cases had been reported.
WHO Director-General Tedros Adhanom expressed deep concern about the scale and speed of the epidemic, and said that case numbers could change as field operations scale up, including surveillance, contact tracing and laboratory testing. He declared an international health emergency unexpectedly and without the usual prior consultation with advisers, saying the virus had likely been spreading unnoticed for several weeks. Health teams are racing to contain the outbreak while facing security risks and difficult working conditions.
Some experts and observers are asking whether cuts to US global health support contributed to delayed detection and a weaker response. US epidemiologist Eric Feigl-Ding warned that current figures may be only the tip of the iceberg: with little testing and the virus already killing health workers, the outbreak could be far wider than official counts suggest. He also said the epidemic appears to be spreading faster than the 2014 West Africa outbreak in Guinea, Sierra Leone and Liberia.
Ebola transmits through direct contact with infected people or bodily fluids, not through the air, so in principle Bundibugyo can be contained by isolating cases, testing and tracing contacts. The critical factor, experts say, is how quickly those measures can be deployed.
Feigl-Ding and others argue that the US used to provide rapid on-the-ground support through the US Agency for International Development (USAID), funding local health workers and clinics and delivering medicines and logistics. But since January 2025, when a new administration froze aid payments for 90 days and ordered a review of programs, USAID operations were heavily disrupted: many staff were laid off and the agency’s budget was cut sharply. Although Congress later restored some funding, the temporary interruption and staff losses had global effects. Several European governments also cut development aid during the same period.
Political choices and unusual reorganizations at the US government level amplified the impact. After his 2025 inauguration, the president initiated a US withdrawal from the WHO that became official a year later; the US had been one of WHO’s largest donors, having provided more than $1.2 billion in 2023–24. The US Centers for Disease Control and Prevention (CDC) also faced major reductions under Health Secretary Robert F. Kennedy Jr., with announced layoffs and cuts to external contracts. US media later reported that some staff who had been responsible for epidemic response were mistakenly terminated and then rehired. The CDC has said it currently has over 30 staff in the DRC assisting response efforts.
Tech entrepreneur Elon Musk, who briefly led a reorganization called the Department of Government Efficiency, later said he had “accidentally” terminated some Ebola containment programs for a short time; reporting in US newspapers suggested not all canceled programs were fully restored. The New York Times reported that US embassy staff in Kampala believed the cuts had made an Ebola outbreak in Uganda worse.
Humanitarian and health organizations on the ground warn that reduced resources have consequences. Julie Drouet, country director for Action Against Hunger in the DRC, said cuts to humanitarian and health funding are inevitably harmful to the Congolese population and to epidemic prevention and detection. She also pointed to other reasons for delayed detection: the Bundibugyo strain is unusual for the DRC, and initial tests focused on the Zaire strain returned negative results. The first death occurred in the community rather than in a health facility, allowing undetected spread.
Eastern DRC provinces such as North Kivu, South Kivu and Ituri are resource-rich but plagued by violence and instability, which complicates epidemic control. When armed groups advanced in early 2025, displaced populations and disrupted health services created conditions that can accelerate spread and make aid delivery harder. Cases have now been confirmed in the eastern city of Goma and in Uganda’s capital; both are more connected and densely populated than the outbreak’s original locations, increasing the risk of rapid spread.
Aid agencies say they are doing everything possible under difficult circumstances, organizing humanitarian air bridges and adapting logistics to reach affected areas. The WHO has released an initial $3.9 million to support national health systems and is calling on governments and donors to increase funding significantly. Health experts urge rapid scaling of testing, contact tracing and protective equipment for frontline workers to reduce transmission and protect responders.
In short, multiple factors have likely combined to make this outbreak more dangerous and harder to detect: an uncommon virus strain, early community deaths and limited testing, armed conflict and population movements, and reduced international health resources after major aid and institutional cuts. Whether and to what extent specific US policy moves directly worsened this outbreak will require further investigation, but health workers and organizations on the ground say the erosion of funding and capacity has made epidemic prevention and response more difficult.
With additional reporting from Anthony Howard.
This article was originally written in German.