The outbreak began in a small village near the border with South Sudan. The village, like many in the Democratic Republic of Congo, was a mining town – migrant workers came and went, moving through Ituri province in search of work, while others fled fighting between the Congolese army and rebel groups in neighboring Rwanda. Some of the sick miners traveled on to other villages while the Ebola virus slowly matured in their bodies. Congo’s eastern provinces border four countries – South Sudan, Rwanda, Uganda and Burundi – and the borders between them are porous: people move back and forth largely uncontrolled. When the virus – an Ebola variant for which there is no cure or vaccine – was finally discovered, it was too late.
More than 600 cases and at least 139 deaths have been reported so far. Experts on the ground in the DRC tell ROLLING STONE that the disease has likely spread far beyond reported numbers – and that this outbreak could become one of the largest in recent history, possibly comparable to the devastating West African epidemic that killed over 11,000 people in 2014. Even if spread to the USA is unlikely, our government’s policies are directly linked to the fate of thousands of people in the region.
Aid groups cite a simple, damning reason why the situation could escalate as it did: Donald Trump’s dismantling of the US Agency for International Development (USAID) – the linchpin of the international humanitarian system – ensured that no one was prepared for the outbreak when the virus struck.
Health system on the ground
“The health centers in eastern Congo are exhausted,” says Heather Reoch Kerr, country director of the International Rescue Committee for the DRC, in a WhatsApp conversation from Kinshasa. “There is simply a lack of the necessary equipment.”
The DRC’s health system is largely supported by organizations such as the IRC, Doctors Without Borders, the World Health Organization and dozens of other NGOs. Many of these groups rely heavily on resources from Western countries – especially the United States. Under Trump, this funding has almost completely dried up. In 2024, the final year of Joe Biden’s presidency, US foreign aid commitments to Congo amounted to around $1.4 billion. By 2026, after Trump’s dismantling of USAID, that number had fallen to about $146 million – a decline of nearly 90 percent. (The actual amount could be even lower, depending on how you calculate funding sources. The Washington Post estimates that only $26 million may have been allocated to Congo.)
These cuts to government tables from Washington conference rooms had immediate, brutal consequences for the communities that depended on them. When the current outbreak began, the structures were already weakened. Kerr explains that part of the problem was that regional health networks initially tested sick patients primarily for Ebola Zaire – the most common virus variant that has been responsible for past outbreaks in Congo and the 2014 West Africa pandemic. These tests came back negative and local health workers lacked the resources to carry out further investigations. Finally, an employee managed to bring a sample from Goa – a city in eastern Congo under the control of the Rwandan-backed rebel group M-23 – to the capital Kinshasa. There, better-equipped laboratories had the ability to carry out more extensive tests and determined that it was not Ebola Zaire, but a rarer variant called Bundibugyo. The journey from Goa to Kinshasa alone takes more than a day and a half because M-23 has closed the airport there. By the time the disease was correctly identified, it may have been spreading through the region for an entire month, according to Kerr.
Protective equipment was missing everywhere
Meanwhile, more and more people became seriously ill. Because of USAID cuts, many health workers in the region’s remote communities lacked appropriate protective equipment. Because the disease was not recognized in time, deceased patients were buried according to normal practices – not according to the strictly regulated procedures that are mandatory for highly contagious Ebola cases. The virus spread further and further. Cases emerged in Kampala. Dr. Mesfin Teklu Tessema, global senior health expert at IRC, is deeply concerned that the virus has penetrated deep into South Sudan, an impoverished, conflict-torn country that borders the region where the outbreak began. But he has no way of checking this because surveillance and reporting networks there function even worse than in rural Congo.
The key to containing Ebola, explains Dr. Tessema, lies in isolating affected communities and conducting rigorous contact tracing of infected patients. The incubation period of the virus in an externally healthy person can be up to three weeks – early detection is therefore crucial to limit the spread. None of that happened.
“We simply don’t know how many people were exposed,” says Dr. Tessema. “We don’t know where they are. They have three weeks – they could travel and we would never be able to find them.”
No vaccines, no resources
Unlike Ebola Zaire, the Bundibugyo variant has no effective vaccine and few treatment options. Tessema reported that tests are underway with versions of existing vaccines and the antiviral drug remdesivir – but it will take both time and money before these can be used in the field. And meanwhile the virus continues to spread.
There are now reported cases in several urban areas, including the rebel-held city of Goa and Uganda’s capital Kampala. If Ebola reaches large cities, it can spread rapidly and uncontrollably – as was the case in the West African outbreak a decade ago.
“We really feel like this is going to be really big,” Kerr said.
The WHO immediately declared the current outbreak an international public health emergency – a step that typically requires several days of deliberation in a committee, according to Tessema. Instead, WHO Director General Dr. Tedros Adhanom Ghebreyesus single-handedly declared a state of emergency and convened an emergency committee – not to classify the problem, but to coordinate an immediate response. For Tessema, this underlines the gravity of the situation.
Washington’s delayed reaction
For its part, the USA has slowly initiated a reaction. The State Department announced earlier this week that it would provide $23 million in aid to the DRC – through the United Nations – as well as funding for up to 50 clinics, the latter of which is expected to take weeks.
This help is welcome, but it will almost certainly come too little, too late. The fragile health networks that serve most of Congo’s remote rural areas – where Ebola outbreaks often originate – need continued funding to retain and train staff, Kerr says. Standard Ebola containment measures require high levels of community participation: people encouraging each other to receive treatment, following protocols and standing up for each other. These structures need trained and paid health care workers — and when Trump made his cuts, they began to erode. Armed conflict and poverty compounded this disintegration, forcing communities apart and making it nearly impossible to maintain any institutional structure in the face of rapidly spreading outbreaks.
“All of this knowledge seems to have disappeared from these communities, which I find deeply depressing,” Kerr says. “Without investment it simply won’t work.”
What Musk’s chipper did
For decades, US funding was what kept these structures alive. It was what gave people in the most vulnerable parts of the world a chance of survival when epidemics like Ebola broke out. “We spent the weekend putting USAID through a wood chipper,” tweeted Elon Musk, who was then head of the so-called Department of Government Efficiency, in February last year – sounding extremely happy.
“We all lost so many employees and so much money,” Kerr said, referring to her organization and the dozens of international and local groups operating in the region. It was these groups that ultimately ended up in Elon Musk’s chipper – a device set in motion at the behest of the man we elected to lead this country.
