Michael T. Osterholm is a professor and director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
Twelve years ago, during the catastrophic Ebola outbreak in West Africa, I wrote in these pages that infectious diseases anywhere in the world can quickly become threats everywhere. That lesson has only grown clearer in the years since.
Today, African countries are far better prepared for dangerous outbreaks than they were in 2014. Investments made after the Ebola crisis — many supported by the United States across Republican and Democratic administrations — strengthened laboratory systems, surveillance networks, emergency operations centers and outbreak-response training across the continent.
We have seen the results. Recent Ebola outbreaks in Uganda were identified and confronted far more rapidly than similar events a decade ago. African public health leaders, laboratorians and frontline responders now possess capabilities that did not exist at sufficient scale during the 2014 epidemic.
Those partnerships and investments matter. They have saved lives.
But the newly emerging Ebola outbreak, caused by a lesser-known strain called Bundibugyo, in the Democratic Republic of Congo and Uganda, is a sobering reminder that preparedness is never finished and that dangerous gaps remain — gaps that recent federal budget and staffing cuts have likely widened.
Early reports suggest this outbreak may have circulated undetected for weeks or even months before recognition. The World Health Organization has indicated there are nearly 600 suspected cases and more than 130 suspected deaths. Those numbers will increase. And unlike other Ebola strains, there are no licensed vaccines or proven treatments for the Bundibugyo virus.
That changes the equation substantially. Without vaccines or therapeutics, the world must rely heavily on rapid detection, isolation, contact tracing, infection control, logistics and international coordination to stop spread. In other words, this outbreak is testing whether the global preparedness systems built since 2014 can function under difficult conditions.
It is also testing the U.S..
In 2018, the first Trump administration published a national biodefense strategy highlighting the need to rapidly develop tests, treatments and vaccines when an outbreak occurs. Following the covid-19 pandemic, Group of Seven nations endorsed the “100 Days Mission,” an ambitious commitment to develop such tools within 100 days of identifying a high-consequence pathogen threat.
The U.S. integrated that vision into its blueprint for preparing for future biological threats. The current Trump administration’s “America First Global Health Strategy” states that the U.S. should “contain outbreaks that originate outside of the United States rapidly at their source.”
Those are important commitments, but they only matter if they translate into results. Unfortunately, since covid, the U.S. has weakened many of the systems needed to respond to crises like this one.
This is a familiar cycle: The U.S. panics during a crisis, followed by neglect once the emergency fades. We are seeing that pattern again.
It’s not fair to lay the blame for the slow detection and response to this outbreak at the feet of the Trump administration. This outbreak is centered in an unstable area of Congo, and the Bundibugyo virus can avoid detection from tests for more common Ebola species. But this administration’s actions to date have not helped.
Shuttering the U.S. Agency for International Development ended programs helping countries like Congo and Uganda improve their local health systems. The administration terminated awards or withheld funding from the President’s Emergency Plan for AIDS Relief, even as the administration’s global health strategy acknowledged that “the same health infrastructure (including labs and healthcare workers) used for HIV/AIDS, [tuberculosis], and malaria can be mobilized to address new outbreaks.” That same strategy was successful in fighting the West Africa Ebola epidemic.
Meanwhile, many of the overseas staff positions at the Centers for Disease Control and Prevention are vacant, and large-scale staff reductions at federal health agencies have, over the past 16 months, shrunk capabilities in the U.S. and abroad. Many key federal health agency leadership positions also remain vacant, including permanent directors at the CDC and Food and Drug Administration. Expertise in infectious-disease preparedness at the National Security Council has been diminished. The Office of Pandemic Preparedness and Response Policy has been gutted.
These are not abstract bureaucratic concerns. They directly affect America’s ability to detect threats early, move personnel and supplies quickly, coordinate both across federal agencies and with international partners, and support partners on the front lines of outbreaks before they spread to the U.S.
Outbreaks do not wait for governments to organize themselves.
Still, the U.S. retains extraordinary advantages if it chooses to use them. Its biomedical research infrastructure, manufacturing capacity, logistics capability and emergency response reach are not simply strategic assets; they are instruments of stability and security that can help contain an outbreak quickly, if wisely employed.
The administration’s own strategy recognizes this. It pledges that “when necessary, the United States will also surge diagnostics, vaccines, therapeutics, personal protective equipment, and other commodities to aid in the response.” It further commits the U.S. to engage in multilateral partnerships for targeted purposes.
This outbreak is a test of those words. The U.S. should immediately and aggressively support African-led containment efforts through technical expertise, laboratory support, emergency logistics and accelerated research into tests, vaccines and treatments for this Ebola virus. It should work closely with Africa Centres for Disease Control and Prevention, the WHO and others to contain the outbreak as quickly as possible at its source.
This is not charity. It is protecting Americans at home and abroad from a highly lethal illness.
Pathogens exploit delays, complacency and political fatigue. They move through the cracks we allow to form in our public health systems and international partnerships. We claim to have learned from previous outbreaks that diseases emerge repeatedly and don’t respect borders. But they can be contained if the U.S. and its partners rapidly coordinate efforts and leverage our remarkable assets.
Twelve years after West Africa’s Ebola crisis, the question before us is not whether we can help build disease response capabilities in Africa or adequately surge resources to thwart a threat; it is whether we are willing to act decisively and effectively to save lives and quickly end this outbreak.
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