“We all lost so many staff and so much money"

The outbreak started in a small village near the border of South Sudan. The village, like many in the Democratic Republic of Congo, was a mining town — transient workers coming in and out, traveling around the Ituri province in search of work, while others fled violence between the Congolese military and rebel groups from nearby Rwanda. Some of the stricken miners traveled to other villages, the Ebola virus incubating slowly in their systems. Congo’s eastern provinces touch four countries by land — South Sudan, Rwanda, Uganda, and Burundi — and the borders between them are porous, meaning people flow in and out relatively unchecked. By the time the virus — a variant of Ebola for which there is no cure or vaccine — was detected, it was too late.

Over 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 wider than reported, and that the outbreak has a chance to be one of the largest in recent history, potentially on par with the deadly West African epidemic that killed over 11,000 in 2014. While it’s unlikely that the disease spreads to the U.S., our government’s policy is directly linked to the fate of thousands across the region. 

Aid workers say there’s a simple, devastating reason why things got this bad: Donald Trump’s dismantling of the U.S. Agency for International Development (USAID), the lynchpin of the international humanitarian system, meant that when the virus struck, nobody was prepared to fight it. 

“The health care centers in the eastern DRC are on their knees,” Heather Reoch Kerr, the DRC country director for the International Rescue Committee says in a WhatsApp call from Kinshasa. “They just don’t have the equipment that they need.”

The DRC’s health care system is heavily subsidized by organizations like the IRC, Doctors Without Borders, the World Health Organization, and dozens of other NGOs. Many of those groups depend heavily on funding from Western countries — particularly the United States. That funding, under Trump, has almost completely dried up. In 2024, for instance, the final year of Joe Biden’s presidency, the U.S.’s foreign aid obligations to Congo were somewhere around $1.4 billion. In 2026, after Trump’s dismantling of USAID, that number was down to around $146 million, an almost 90-percent decrease. (The number could be even lower, depending on how you tally funding sources. The Washington Post estimates that as little as $26 million could have been allocated to Congo.)

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These cuts on government spreadsheets from Washington’s boardrooms had an immediate, brutal impact on the communities they were propping up. When the current outbreak started, they were already behind. Kerr says that part of the problem was that when people started getting sick, the regional health networks were largely testing ailing patients for Ebola Zaire, the most prevalent strain of the disease that has caused outbreaks in Congo in the past and was responsible for the 2014 pandemic in West Africa. Those tests came back negative, and the local health care workers didn’t have the resources to investigate further. But finally, a health worker managed to get a sample from Goa — a city in eastern Congo that is under the control of a Rwandan-backed rebel group called M-23 — to the capital of Kinshasa. There, better-equipped clinics ran more tests and discovered that it wasn’t Ebola Zaire, but a more rare form of the virus called Bundibugyo. The journey from Goa to Kinshasa alone, Kerr said, takes more than a day and a half, as M-23 has closed the airport there. By the time the disease was properly identified, Kerr said, it could have been spreading through the region for a full month.

By this time, people were starting to get seriously ill. Because of the USAID cuts, many health care workers in the isolated communities in the region didn’t have proper protective equipment. Because the disease wasn’t identified properly, dead patients were being buried using normal practices, not the highly regimented procedures necessary for heavily contagious Ebola cases. The virus spread, and spread, and spread. Cases popped up in Kampala. Dr. Mesfin Teklu Tessema, a global senior health expert for the IRC, says he is very concerned that the virus has spread deep into South Sudan, an impoverished and conflict-stricken nation that borders the region where the outbreak began — but he has no way to know, as surveillance and reporting networks in that country are even worse than in rural Congo.

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The way to beat Ebola, Dr. Tessema explains, is to isolate communities with outbreaks and establish diligent contact tracing of infected patients. Ebola’s incubation period inside an outwardly healthy person can be up to three weeks, meaning that early detection of the disease is extremely important in limiting its spread. None of this happened. 

“We just don’t know how many people have been exposed,” Dr. Tessema said. “We don’t know where they are. They have three weeks — they could travel and we’d never be able to find them.”

Unlike Ebola Zaire, the Bundibugyo variant has no working vaccine and few treatment measures. Tessema said that tests are underway with versions of existing vaccines and the anti-viral drug Remdesivir, but that those will take both time and funding to be applied in the field. And all the while, the virus continues to spread.  

There are reported cases now in several urban areas, including the rebel-controlled city of Goa and Uganda’s capital Kamapala. When Ebola hits major cities, it can quickly spread out of control, like it did in the West African outbreak a decade ago.

“We really feel the scale of this one is going to be really big,” Kerr said. 

The WHO immediately declared the current outbreak a public health emergency of international concern, a step that Tessema says usually takes several days of deliberation among a committee. But instead, WHO Director General Dr. Tedros Adhanom Ghebreyesus declared the emergency unilaterally, assembling an emergency committee not to classify the problem but to immediately coordinate a response, something Tessema says emphasizes the severity of the outbreak. 

The U.S., for its part, has slowly mobilized a response. The State Department announced earlier this week that it would send $23 million in aid to the DRC, through the United Nations, and fund up to 50 clinics, though the latter may take weeks to get up and running.

This help will be welcome, but is almost certainly too little too late. The fragile health networks that service most of Congo’s isolated, rural areas — where Ebola outbreaks often begin — need constant funding in order to retain and train staff, Kerr says. Standard Ebola containment procedure relies on a high level of community participation — people encouraging each other to seek treatment, following proper protocols, helping each other when needed. Those systems require trained and funded health officials to work, and when Trump made his cuts, they started to vanish. They were eroded further by armed conflict and poverty, which force communities to fracture and make it difficult to retain any institutional structure to fast-moving outbreaks. 

“All that knowledge seems to have disappeared from these communities, which is deeply depressing I must say,” Kerr says. “If there’s no investment then it’s just not going to work.”

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For decades, U.S. funding was what propped up these systems. It was what gave the people in the most vulnerable parts of the world even half of a fighting chance at life when epidemics like Ebola spread. “We spent the weekend feeding USAID into a wood chipper,” Elon Musk, who was then head of the so-called Department of Government Efficiency, tweeted cheerfully in February of last year. 

“We all lost so many staff and so much money,” Kerr says, referring to her organization and the dozens of international and local groups that work in the region. Those groups, ultimately, are what went into Elon Musk’s wood chipper, one that was rolled out and fired up on the orders of the man we elected to lead.