GoKawiilThe latest outbreak of Ebola in the Democratic Republic of the Congo (DRC) and Uganda is one of the largest on record, with more than 1,700 cases confirmed since April. Dozens of governments and health organizations are supporting the public-health response, caused by the Bundibugyo species of Ebola virus. Their approaches reveal how global health is evolving after US cuts to international aid.
What it will take to stop the spiraling Ebola outbreak
After closing the US Agency for International Development and cutting budgets for medical projects overseas in 2025, the US federal government is now focused on preventing Ebola from crossing its own borders. In May, it imposed travel bans for foreign nationals entering from the DRC, Uganda and South Sudan. A field hospital in Kenya was funded to hold exposed and infected Americans locally, rather than repatriating them. Canada and the Bahamas have also imposed travel bans.
The Africa Centres for Disease Control and Prevention (Africa CDC) and the World Health Organization (WHO) have criticized these travel bans as lacking a scientific basis. Evidence shows that such restrictions do little to contain the spread of Ebola (C. Poletto et al. Euro Surveill. 19, 20936; 2014). They often create economic harm by disrupting supply chains, cross-border trade and tourism (Y. L. Bazak et al. BMJ Glob. Health 9, e013900; 2024).
By contrast, the approach coordinated by Africa CDC centres on evidence-based measures such as community reporting, case isolation and infection-control protocols in health-care facilities — all coupled with community engagement. In my view as an expert in pandemic-preparedness governance who worked on vaccine access during the COVID-19 pandemic, this cooperative model is the most effective and ethical way to deal with future epidemics and pandemics. Other nations must support it.
Better diagnostics could have limited this Ebola outbreak
Within days of confirming that Ebola was circulating in humans in the DRC and Uganda, Africa CDC declared a ‘public health emergency of continental security’. Past declarations have been issued by the WHO and designed to alert the international community to the risk of cross-border spread. They have often been slow to come — for example, the 2014 Ebola declaration in West Africa followed months of transmission and more than 900 deaths. But this time, Africa CDC treated the declaration as means to mobilize assistance, rapidly coordinating with the WHO to contain the outbreak and direct resources to where they are most needed, under a single plan, budget and team.
The DRC has increased bed capacity in health facilities, established a decentralized testing network across the affected region and created screening and referral units to identify and triage cases. How and where to focus resources and efforts is being determined by the DRC and for its population, rather than to limit transmission across borders.
At a high-level meeting of African ministers of health that I attended in May, several countries pledged support in cash or kind for the DRC response, asking for nothing in return. I repeatedly heard ministers emphasize the need for solidarity with the DRC. This stands in contrast to the bilateral agreements that the United States is signing with other nations. These require receiving countries to meet a range of stipulations, including providing access to their disease data with no reciprocal access to US data, and commitments to co-fund substantial portions of pandemic-preparedness and surveillance efforts.