Challenges in Managing the Ebola Outbreak Due to Reduced U.S. Involvement

The Ebola crisis in East Africa is intensifying, with confirmed cases in major cities of the Democratic Republic of Congo and Uganda. Public health officials globally, and those on the ground, report that the response has been weakened by the minimal presence of the United States, which typically leads in managing significant outbreaks.

The U.S. historically funded strong disease surveillance networks in the region and ran emergency teams for public health emergencies. These efforts largely ceased after the U.S. Agency for International Development (U.S.A.I.D.) was shut down early in the previous year. The Centers for Disease Control and Prevention (CDC) also lost many experts, including those stationed in the Democratic Republic of Congo, who could have contributed to controlling the epidemic.

Epidemiologists and previous Ebola outbreak responders indicate that the delayed international awareness of this outbreak, which had already spread across borders by then, directly results from weakened surveillance systems.

American officials were informed of the outbreak on Thursday, nine days after the World Health Organization (W.H.O.) knew of it, and almost a month after the first casualty. The confirmation delay was partly due to samples reaching the national lab in Kinshasa, Congo, at an incorrect temperature, an error that U.S.A.I.D. previously managed.

As of Wednesday, the W.H.O. reported the virus had affected approximately 600 individuals and resulted in 139 deaths. These numbers could rapidly rise as contact tracing and testing efforts expand, revealing the virus’s spread.

Confirmations of infections in Goma, a Congolese city with over a million residents, Bunia with a population of about 800,000, and Uganda’s capital, Kampala, home to 1.9 million people, indicate a significant spread. Notably, Goma is roughly 350 miles away from the region where the outbreak was initially identified.