WASHINGTON — For years, the United States has invested heavily, channeling hundreds of millions of dollars into initiatives aimed at preventing and managing infectious diseases in the Democratic Republic of the Congo (DRC).
However, in the months preceding a rapid Ebola outbreak, the Trump administration significantly reduced aid to the nation. This reduction is believed to have impaired the timely detection and response to the outbreak, according to six individuals involved in or familiar with the regional efforts.
The DRC is currently grappling with the third-largest Ebola outbreak on record. Experts estimate that 130 people have died, with at least 600 more infected, including an American. In response, the U.S. government has closed its borders to those from or who have recently traveled to the affected area, though U.S. passport holders are exempt from this restriction.
Insights into the effects of U.S. funding cuts are drawn from disclosures the Trump administration submitted to Congress last year, as well as a review of government funding databases and interviews with six individuals who currently or previously worked in public health in the region. Some individuals requested anonymity, fearing retaliation from the Trump administration.
The aid that the Trump administration halted was specifically intended to prevent epidemics, fortify health systems, establish supply chains for disease control, and enhance sanitation.
Officials from the Department of Health and Human Services and the State Department defended the government’s efforts, emphasizing U.S. involvement in the country. “We are doing everything we can to support Americans in the region,” said Heidi Overton, deputy director at the White House Domestic Policy Council, during a news conference on Monday.
Amid these funding cuts, Ebola response teams’ operations were halted, according to a source working on the ground in the region. Programs designed to detect Ebola cases, inform communities about infections, and distribute response kits faced reduced or eliminated funding.
Other efforts that could have supported the outbreak response, such as building medical stockpiles and reinforcing local health systems, have been weakened due to the cuts, according to four individuals working on infectious disease control in the DRC. Aid organizations that implemented these initiatives had to lay off staff and continue to operate with reduced personnel, they reported.
The International Rescue Committee, for example, reported cutting its programming from five to two areas at the center of the current outbreak following U.S. cuts.
“Preparedness in high-risk areas is crucial to halting transmission before the outbreak expands,” said Heather Reoch Kerr, IRC’s country director for the DRC. “Years of underinvestment and recent funding cuts have left many health facilities without the protective equipment, surveillance capacity, or support needed for a swift and safe response.”
Despite U.S. funding cuts, other entities like the World Health Organization have continued their efforts in the region, leading the response even as the U.S. withdrew from the WHO and ceased funding.
A challenging response to a deadly outbreak
The response to the outbreak, according to those directly involved, has been complicated by factors beyond U.S. cuts. Increasing violence in the region has hindered the response efforts and contributed to the deterioration of public health infrastructure.
One individual who lost their job due to the U.S. funding cuts mentioned experiencing “a silent but dangerous drift” in the region.
“The actors who once ensured epidemic preparedness are now absent or paralyzed,” the individual stated. “Politicians control budgets; budgets control lives. That is the painful reality.”
The Department of Health and Human Services sent nearly $33 million in foreign aid to the DRC in the 2024 fiscal year, but this figure dropped to less than $10 million in 2025. Data for the 2026 fiscal year remains incomplete.
The U.S. Agency for International Development allocated approximately $67 million in foreign aid to the country in the last three months of 2025, a decrease from $715 million in fiscal 2025 and nearly $1.2 billion in fiscal 2024.
These figures may change due to potential reporting delays in foreign aid spending.
Some public health funding has been transferred to the State Department under a new “America First” agreement with the DRC, where the U.S. pledged $900 million over five years. The changing programs, along with the interruptions and cuts through established USAID work, have introduced additional confusion to the system, according to three people working on regional efforts.
While State Department funding for public health efforts has started flowing, two individuals noted, the number of staff and resources in the region remains significantly lower than before the Trump administration. Despite attempts to address the outbreak, State Department employees lack the personnel and resources to assume the roles previously managed by USAID, according to one person working in the region.
“By bringing USAID global health functions under the new Bureau of Global Health Security and Diplomacy at the State Department, our efforts are more aligned and effective. Funding and support to combat Ebola continue, working with allies and partners,” a State Department spokesperson said in a statement.
A spokesperson for the Department of Health and Human Services stated that the Centers for Disease Control and Prevention are fully equipped to protect Americans and mitigate risks through their expertise in this disease area, highlighting their capacity for virus testing, tracking, and prevention. They declined to comment on the impact of foreign aid cuts on Ebola and other infectious disease response teams.
During previous Ebola outbreaks, foreign aid teams played a crucial role, according to Daniel Jernigan, who was instrumental in the CDC’s response to the 2014-2016 Ebola outbreak in West Africa. Jernigan, who spent approximately 30 years at the CDC, was among the leaders who left the agency last year amid political pressure and the dismissal of then-director Susan Monarez.
“We were sitting next to the USAID people the whole time,” he said. “Those cuts are going to have an effect no matter what the situation is.”
A collapsed system
The reduction in U.S. foreign aid has already significantly impacted the health systems in the area, according to forthcoming research indicating that mortality in the area has doubled since the funding cuts, which coincided with the takeover of the area by the M23 rebel group. Although it’s challenging to disentangle the factors that harmed the health system, the impacts are evident, according to those working alongside it.
“The central pharmacies collapsed, the rural clinics collapsed, and the mortality doubled,” observed Les Roberts, a professor emeritus at Columbia University who contributed to the research conducted by the Congolese nongovernmental organization RHA.
During his previous visits to the DRC, Roberts noted that the system functioned effectively: Rural clinics would report unusual increases in certain diseases or symptoms, prompting aid-supported central pharmacies to dispatch rapid responses. Responses to a range of diseases, including malaria, cholera, and Ebola, benefited from this system, according to global health workers who spoke to STAT.
“A response almost always was triggered because the clinics told us it was happening,” Roberts said, suggesting that a functional system could have expedited the response to the current outbreak.
Before the collapse, there had been some progress over the years in response speed and reducing corruption, aided by USAID and other governmental and nongovernmental organizations directing resources through the local health system, Roberts noted, reflecting on his numerous trips to the region.
One grant, intended to fund the region’s local health systems to enhance infection control, was among those cut by the Trump administration. The contract was initially scheduled to expire in 2028.
Tens of millions of dollars in other U.S. grants aimed at enhancing public health, sanitation, and infectious disease control in the DRC were paused or canceled, according to a list shared with congressional leaders last year and reviewed by STAT. President Trump previously described the broad foreign aid reductions as “waste, fraud, and abuse.”
A Zaire Ebolavirus outbreak that began in 2018 in the same region persisted for two years, with control efforts also hindered by conflict. That outbreak was the second largest on record.
“But we are now facing a perfect storm,” Megan Coffee, a senior infectious disease specialist at the International Rescue Committee, said in an email. “Last year, in an area where mines draw migrant workers, conflict minerals led rebel groups to displace government control, and at the same time aid cuts weakened the health system.”
The changes in U.S. policy have led global health workers to feel that they are entering a new era of American response: addressing problems as they arise instead of investing in prevention.
“There is this kind of paradigm shift of targeted responses to targeted problems,” noted one person working on public health in the region. “It’s not on a scale where it needs to be.”
U.S. Secretary of State Marco Rubio criticized the WHO for its outbreak response, stating Tuesday that it was “a little late” in identifying the outbreak.
Roberts noted that the broader threat to human life is not Ebola itself but the widespread cuts to foreign aid. He estimated that USAID’s cuts have resulted in approximately 300,000 additional deaths in the DRC. Other research supports this view, with one study suggesting that up to 14 million more people worldwide may die if the cuts persist through 2030.
The disruption of the foreign aid system has fueled anger toward Americans, Roberts said, at a time when trust in external medical authorities is vital.
Throughout his extensive time in the DRC, Roberts was often asked to sit in the front seat of a car while traveling, as having a white American was believed to aid their efforts.
In his most recent visit, following the cuts, this dynamic shifted significantly in some areas.
“The staff told me: ‘Les, you cannot come with us,’” he recounted. “‘You will put our lives in danger.’”
