“Failures of ‘America First Global Health’”: U.S. Global Health Cuts and DRC Conflict Fuel Ebola Crisis

Sweeping U.S. cuts to critical global health programs, including funding and staffing reductions at the Centers for Disease Control and Prevention (CDC), the dismantling of the U.S. Agency for International Development (USAID), and the U.S. withdrawal from the World Health Organization (WHO), have dangerously weakened the world’s ability to respond to rapidly evolving infectious disease threats, including the escalating Ebola outbreak unfolding in the Democratic Republic of the Congo (DRC) and the region, Physicians for Human Rights (PHR) said today.

“This outbreak is unfolding amid devastating cuts to global health and humanitarian assistance in the DRC that have weakened disease surveillance, strained already fragile health systems, and reduced the capacity to detect and respond to infectious disease outbreaks,” said Thomas McHale, SM, public health director at PHR. “Physicians for Human Rights has documented how abrupt U.S. foreign aid cuts disrupted frontline health services and infectious disease programs in conflict-affected eastern DRC, leaving communities more vulnerable at precisely the moment sustained international public health engagement when it is needed most. ”

The current Ebola outbreak, which the WHO declared a “public health emergency of international concern,” involves the rare Bundibugyo strain of Ebola, for which there is no approved vaccine or targeted treatment. Cases have already been identified in and around Bunia, Goma, and Bukavu in eastern DRC as well as in Kampala, Uganda, which are densely populated urban areas, and health workers themselves have become infected. The crisis is unfolding with the rapid and unchecked spread of infections and the sharply rising death toll, with 139 confirmed deaths reported to date.-A devastating set of emergencies are converging in eastern DRC, where ongoing armed conflict, attacks on civilians and health facilities, and mass population displacement have already pushed fragile health systems to the brink. Violence in and around Ituri and Goma, where several cases of Ebola have been detected, has severely disrupted humanitarian access and public health operations precisely as Ebola is spreading rapidly through affected communities.

PHR’s network of medical and humanitarian partners in DRC are reporting mounting tolls from the outbreak and scarce resources to confront the emergency. A doctor in an Ebola-affected area of DRC tells PHR that “…this outbreak is occurring at a time when we are no longer truly able to carry out proper epidemiological surveillance because of the disruption in USAID funding. To continue this surveillance, we are forced to rely on our own personal resources, including purchasing phone credit, fuel, and paying transportation costs. This is extremely difficult given the current level of need.”

Health workers in DRC told PHR that they need support for disease surveillance, materials to support safe disposal of bodies, including body bags, access to laboratories to process samples quickly, and infection prevention and control supplies, including masks, protective suits, face shield and other personal protective equipment to allow health workers care for Ebola patients safely. The same doctor told PHR that “…without rapid support, surveillance, case confirmation, the safe management of bodies, and the protection of health care workers all risk being seriously compromised.”

U.S. global health funding cuts have contributed to the global health emergency posed by the Ebola outbreak. Decades of U.S. investment helped build the disease surveillance systems, laboratory infrastructure, trained workforce, community outreach networks, and emergency coordination mechanisms necessary to detect and contain outbreaks early before they spiraled into regional and global crises. But those systems are now being hollowed out. The Trump administration’s abrupt cuts to U.S. global health funding in January 2025 have undermined public health efforts around the globe, resulting in impacts such as disruptions to HIV and TB prevention and treatment programs, the elimination of services for survivors of conflict-related sexual violence and undermining critical disease monitoring. U.S. funding cuts are degrading public health response capacities in eastern DRC, across Africa, and globally at a moment when rapid response care and robust international coordination is urgently needed.

Public health experts have expressed alarm that the latest outbreak of this rare strain of Ebola likely went undetected for two months, allowing the virus to spread further and losing critical opportunities to trace, isolate, and treat individuals who were exposed or infected.

“The outbreak of Ebola in DRC is another example of the failures of the America First Global Health strategy,” said McHale. “At its best, U.S. global health leadership can help identify, address, and prevent infectious disease outbreaks before they spiral out of control. But this outbreak comes at a time when the United States has shuttered USAID, slashed CDC funding and work force, cut resources for humanitarian response in DRC, including disease surveillance capacity, and hampered the ability of health care workers on the ground to respond to the emerging Ebola crisis.”

PHR’s recent report, “Wasted Investments, Looming Crisis,” documents how reductions in US support for global health have dismantled research platforms, surveillance infrastructure, and frontline health systems that are essential not only for HIV and TB programs, but also for responding to future outbreaks of deadly infectious diseases. A research brief by PHR (“Abandoned in Crisis”) documented the early impacts of U.S. aid cuts on health services in DRC.

“Due to the Trump administration’s cuts, we no longer have the full measure of global coordination and operational capacity needed to rapidly track transmission, monitor cross-border spread, support frontline clinicians, and swiftly identify and treat people who may have been exposed,” said McHale. “In the conflict-affected regions of eastern DRC, where insecurity and displacement are accelerating disease transmission and limiting access to care, these losses are especially dangerous and further deepening the polycrisis. Global health security depends on sustained international cooperation — not retreat.”

As world leaders gather at the World Health Assembly in Geneva this week, governments must urgently promote a rights-based Ebola response that is grounded in science, transparency, and respect for human dignity, while ensuring affected communities have access to timely, evidence-based care and information. Immediate support is needed to protect frontline health workers through the provision of adequate personal protective equipment and infection prevention and control supplies, as health workers remain at heightened risk of exposure. World governments should urgently scale support for epidemiological surveillance, laboratory testing, contact tracing, safe clinical care, community engagement, and dignified and safe burials, including the provision of body bags and other essential supplies for the safe management of the deceased, and essential personal protective equipment for health care workers. Sustained investment in supply chains, local response capacity, and research into Bundibugyo-specific diagnostics, treatments, and vaccines are essential to preventing further spread and protecting the right to health.

The United States should also strengthen coordination with the WHO and fully disburse congressionally-appropriated global health funds to support an effective response to the Ebola crisis, including urgent measures to track and protect exposed individuals and communities, and strengthen frontline response capacities to prevent further spread of the virus. All parties to the conflict in the DRC, including occupying forces, should uphold existing ceasefire agreements and guarantee safe and unhindered access for health care workers and humanitarian personnel to support populations in areas affected by violence. This should include enabling the immediate reopening of Goma International Airport so that life-saving medicines, medical supplies, and humanitarian aid can reach at-risk communities.