The USAID logo is seen on a machine that processes recycled plastic into construction blocks at the Pasig Eco Hub, a project impacted by the Trump administration’s freeze on foreign aid (Photo by Ezra Acayan/Getty Images)
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Recent global disease outbreaks might seem disconnected—a significant rise in measles cases in the United States, a persistent Cyclospora foodborne illness, and the spread of Ebola in parts of Africa. However, they all highlight the weaknesses in a global public health infrastructure that is increasingly fragile.
Public health often goes unnoticed when systems are functioning well. Effective vaccination campaigns prevent epidemics, and disease surveillance identifies outbreaks before they expand. When these systems fail, outbreaks become harder to manage, costlier, and more challenging to contain. Here’s how measles, Cyclosporiasis, and Ebola are exposing vulnerabilities in our public health systems.
Measles
The United States has recorded the highest number of measles cases in a single year in over 30 years, with five months still remaining in the year. According to John’s Hopkins University’s U.S. measles tracker, 2,295 cases have been reported, with 93% involving individuals who are either unvaccinated or have unknown vaccination status.
Measles was declared eliminated in the U.S. in 2000, largely due to the effective measles, mumps, and rubella vaccine, which provides 97% protection against measles when two doses are administered. However, declining vaccination rates driven by vaccine hesitancy have created vulnerable groups where the virus can easily spread. To ensure herd immunity and protect the general population, vaccination rates need to be at 95%. Currently, at least 39 states have school vaccination rates below this threshold for measles. Vaccine hesitancy, fueled by misinformation and lack of trust in vaccines, has facilitated the resurgence of measles in the U.S.
Cyclosporiasis
The ongoing struggle with Cyclosporiasis in the U.S. highlights a different, yet significant, weakness. Cyclospora is a tiny parasite causing foodborne illness, often linked to contaminated produce. Identifying the contaminated food source requires advanced laboratory techniques, thorough epidemiologic investigations, and coordination among state and federal health agencies.
Numerous factors have contributed to the high number of cases in the U.S.—including a long incubation period that complicates food testing, as symptoms can appear up to two weeks after consuming contaminated food. However, a lack of investment in public health infrastructure has also played a part. For instance, last year, the Department of Health and Human Services laid off hundreds of CDC employees, some of whom were involved in detecting outbreaks like Cyclosporiasis. The CDC also reduced the size of a lab specifically monitoring certain infectious diseases such as Cyclosporiasis. When resources are limited, investigations become more challenging, delaying interventions that protect public health.
Ebola
The Ebola outbreak in Africa underscores another crucial lesson: the importance of global funding. International aid has historically been vital in supporting outbreak surveillance, boosting laboratory capacity, training healthcare workers, and responding to emergencies in countries with limited resources.
The current outbreak in the Democratic Republic of Congo is the fastest-growing Ebola outbreak on record, with over 1,000 deaths and more than 2,500 confirmed cases. In mid-July, the World Health Organization reported that its joint $518 million plan to combat Ebola with the Africa CDC faced a funding gap of over $400 million. Additionally, global funding cuts through the U.S. Agency for International Development have raised concerns about the ability to quickly detect and respond to Ebola due to reduced personnel, equipment, and laboratory tests.
The specific impact of any single funding cut is hard to measure because the Ebola outbreak and its spread have been influenced by numerous factors, including political instability, armed conflict, and mistrust in healthcare workers. Nevertheless, funding for surveillance and response capabilities is widely acknowledged as a fundamental component for effective outbreak control.
Public Health Lessons
Measles, Cyclosporiasis, and Ebola are all spreading at unprecedented levels. The lesson from these outbreaks is evident. Public health cannot function as a reactive system that only garners attention during crises. It requires ongoing public trust, clear and transparent communication, investment in surveillance systems, and robust global funding and partnerships to tackle infectious disease threats. The outcome of future disease threats will be shaped long before the threat emerges.
