USAID Cuts Could Hinder Management of Ebola Outbreak in Congo and Uganda

The World Health Organization declared a global health emergency on Saturday due to the rapid spread of Ebola virus in the Democratic Republic of Congo and Uganda. Ebola causes severe hemorrhagic fever and is often fatal. There’s no approved vaccine for the strain of Ebola responsible for the current outbreak, known as the Bundibugyo variant. The WHO said in a statement that the outbreak is potentially much larger “than what is currently being detected and reported.”

Public health professor and emergency room physician Dr. Craig Spencer, who is an Ebola survivor, says this Ebola outbreak could be the fourth largest in history. “This is going to be a really difficult outbreak to manage and respond to,” says Spencer. The ability of healthcare workers to address the outbreak in eastern Congo, “given the violence and conflict, is anything but ideal.”

Spencer adds that cuts to USAID and the U.S. withdrawal from the World Health Organization have increased the likelihood for viruses to spread nationally and internationally, citing outbreaks of measles in the U.S. and Ebola and hantavirus abroad. “This is not all just a coincidence,” says Spencer. “This is a consequence of us cutting back our support.”

TRANSCRIPT

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AMY GOODMAN: The World Health Organization declared a global health emergency Saturday due to the rapid spread of Ebola virus in the Democratic Republic of Congo and Uganda. The announcement came a day after the African Union’s public health agency said it confirmed Ebola infections in the DRC’s northeastern province of Ituri, where 87 deaths and hundreds of cases of illness have been reported. Cases have also been confirmed in Kampala, Uganda’s capital. At least four healthcare workers are among the dead.

In a statement, the WHO said the outbreak is potentially much larger “than what is currently being detected and reported.” This is WHO Director of Health Emergency Alert and Response Operations Abdirahman Mahamud.

ABDIRAHMAN MAHAMUD: Well, we know very well that the country has experience, but the region where it is happening is highly volatile with the humanitarian situation going on and the population moving around from South Sudan to Uganda and other parts. So, our response is to stand with the regional government, with the regional government and the country neighbor, in terms of solidarity, to show again that they can control this outbreak.

AMY GOODMAN: Ebola causes severe hemorrhagic fever and is often fatal. There’s no approved vaccine for the species of Ebola responsible for the current outbreak.

This all comes as the World Health Organization is coordinating the international response to the outbreak of the Andes strain of the hantavirus, which began on a Dutch cruise ship. The MV Hondius has docked in Rotterdam, where the ship’s crew will self-isolate. There are three confirmed deaths and at least 11 confirmed cases, where dozens more are being monitored. As of Sunday morning, there were no known cases of hantavirus in the United States.

For more, we go to Providence, Rhode Island, where we’re joined by public health professor and emergency medicine physician Dr. Craig Spencer, also himself an Ebola survivor. In 2014, Dr. Spencer tested positive after returning to the U.S. from Guinea, where he was helping Ebola patients with Doctors Without Borders. He was treated at Bellevue Hospital here in New York City for 19 days and made a full recovery. Dr. Spencer’s recent piece for STAT is headlined ’The hantavirus is a wake-up call. Will the Trump administration answer it?”

Thanks so much for joining us from Brown University, Dr. Spencer. If you can start off by talking about Ebola and the significance of the announcement by the World Health Organization?

DR. CRAIG SPENCER: For sure. Well, I’ve been saying that we learned too much too quickly to be anything but remarkably concerned. As you noted in the intro, this was first declared on Friday, and already by Saturday the World Health Organization had declared this a public health emergency of international concern. Never has something been done so quickly. And that’s because the number of cases that were reported when this was first declared would make it already the fourth-largest Ebola outbreak in history. This has likely been circulating for much longer than is being reported, maybe one, two, three months. And I wouldn’t be surprised if the actual case numbers are dramatically higher than what we’ve seen so far. I think in the coming days and weeks we’re going to learn a lot more what cases actually look like, where they’re at.

But as has been pointed out, this is an incredibly difficult region to work in. I’ve worked in eastern Congo a bunch of times. I’ve responded to Ebola. This is going to be a really difficult outbreak to manage and respond to even under ideal circumstances. And eastern Congo, particularly given the violence and conflict, is anything but ideal.

AMY GOODMAN: Can you describe what happened to you and your particular concern about public health professionals dealing with this, and what you think needs to be done?

DR. CRAIG SPENCER: Ebola is a disease of compassion, in that the folks that are most likely to be infected are people that take care, provide close care for people who are sick, for patients who have diarrhea, and for vomiting. Think about family members. Think about mothers taking care of their children, as well as healthcare workers taking care of patients.

If you have the right protections, gloves and masks and everything that you need to stay safe, the likelihood of transmission is actually quite low. But most folks taking care of family members, as well as most healthcare professionals in this part of Congo, don’t have access to the same things we may have access to here, including gloves, good personal protective equipment, and sometimes even running water. That makes the risk really, really high, particularly for healthcare professionals in a place where there’s already not enough of those healthcare workers, and where over the last year we’ve seen dramatic cuts in the supplies and support going to many of these clinics and health facilities in eastern Congo,

AMY GOODMAN: I wanted to turn to Nicholas Enrich, a former civil servant who worked at USAID, the Agency for International Development, through four administrations, serving as director of policy, programs and planning in the Bureau of Global Health until January of last year. On March 2nd, 2025, he was placed on administrative leave for exposing the Trump administration’s illegitimate and dangerous dismantling of the agency. He’s written a book called Into the Wood Chipper: A Whistleblower’s Account of How the Trump Administration Shredded USAID. This is Nicholas Enrich speaking to Democracy Now! in April.

NICHOLAS ENRICH: There was an outbreak of Ebola happening in Uganda at the time that USAID was being dismantled. And while I knew we couldn’t start a robust outbreak response, that we usually have, because of everything that was being dismantled, there were a few key activities that I really felt that we needed to do. And they would not even let us screen passengers at airports, that were traveling on international flights onwards to the United States, to make sure that they had Ebola — that they did not have symptoms of Ebola. So, that was a real risk to U.S. national security, and it was just sort of laughed off and ignored by the political appointees and DOGE.

AMY GOODMAN: So, Dr. Craig Spencer, if you can talk about this — do you think these cuts have exacerbated this crisis — and about the significance of it being in cities and conflict areas?

DR. CRAIG SPENCER: Absolutely. Look, Nicholas is fully correct. If you recall, it was just over a year ago that Elon Musk gleefully declared that they were throwing USAID into the wood chipper. And you may recall that Elon Musk also sheepishly said at his first Cabinet meeting that he mistakenly canceled Ebola prevention but turned it back on. For many folks, the story ended there, but what actually happened was there was an Ebola outbreak, and DOGE and Elon Musk cut all the support that we normally would have been giving to respond to that Ebola outbreak. The result was that exactly USAID, who in the past would have been supporting things like airport screening in Uganda, was not providing that logistical or financial support. USAID and other partners would have been providing support to make sure testing was adequate, to make sure a vaccine rollout could have taken place, but we didn’t have USAID on the ground.

Similarly, CDC has long had relationships in this part of the continent, in Congo and in Uganda, and a lot of those relationships have broken down and withered over the past year, because we just haven’t been paying. Similarly, the U.S. has pulled out of the World Health Organization over the last year, which means that in normal circumstances our CDC folks are not able to even talk to World Health Organization people, something that is absolutely unbelievable and an incredible mistake for something that we should be able to do and be prepared for at all points.

And the result is what we’ve seen over the past couple of weeks with hantavirus, we’ve seen with the dramatic increase in number of measles cases in the U.S., and now Ebola in DR Congo and across the border in Kampala. This is not all just a coincidence. This is a consequence of us cutting back our support, not only here at home, but also abroad.

AMY GOODMAN: If you could talk about your piece in STAT, “The hantavirus is a wake-up call. Will the Trump administration answer it?”

DR. CRAIG SPENCER: Yeah, so, a year ago, I wrote a piece for The Atlantic saying that we were going to regret this, we were going to regret the cuts to CDC, we were going to regret the abdication of leadership on the global stage, pulling out of the WHO and dismantling USAID. And I think that right now we’re seeing the end result of all of that, and we’re starting to see the worst-case scenario.

You know, in normal times, we would have had people on the ground, organizations on the ground that the U.S. helped support. There are a lot of NGOs that have worked in eastern Congo for a long time that do things like provide infection prevention and control training, that make sure clinics have personal protective equipment. We’re seeing what happens when those things, unfortunately, aren’t in place.

Similarly, we saw over the past couple of weeks with the hantavirus response, the U.S. was not at the forefront. It was not helping lead response, but was — found itself pretty flat-footed. I was saying that, you know, normally we would be two steps ahead, but we found ourselves two weeks behind.

Similar here with the Ebola outbreak, the CDC reported yesterday on a press call that it learned about the outbreak the same time the rest of the world did, which is horrible, given the fact that we used to have very close, collaborative and trusted relationships in the DR Congo and in Uganda. But again, over the past year, a lot of that work, a lot of that trust and a lot of that collaboration has broken down.

AMY GOODMAN: Dr. Craig Spencer, I want to thank you for being with us, public health professor and emergency medicine physician at Brown University, Ebola survivor himself. In 2014, Dr. Spencer tested positive after returning from Guinea, where he was helping Ebola patients with Doctors Without Borders. He was treated at Bellevue Hospital for 19 days and made a full recovery. We’ll link to your piece, “The hantavirus is a wake-up call. Will the Trump administration answer it?”

Coming up, a government-sponsored prayer rally is held on the National Mall in the latest move by the Trump administration to push Christian nationalism. We’ll speak to Bishop William Barber and journalist Sarah Posner.

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AMY GOODMAN: “I Think of You” by Amadou & Mariam, performing in our Democracy Now! studio.