Experts say cuts to U.S. and Western foreign aid have exacerbated an Ebola outbreak in central Africa after Washington slashed international aid operations and closed USAID.
In May, authorities in the Democratic Republic of the Congo and Uganda declared outbreaks after lab tests detected the Bundibugyo virus, which causes a type of Ebola disease that is transmitted through contact with infected bodily fluids, wild animals and contaminated objects or meat and has a fatality rate of around 50%.
The U.S. Centers for Disease Control and Prevention said the current outbreak is the 17th that the DRC has suffered, and one case has been confirmed in France.
The outbreak has killed over 500 people and sickened more than 1,560.
The World Health Organization said the first patients have been enrolled in a clinical trial in the DRC that will test two drugs against the Bundibugyo strain, and researchers plan a separate study to see whether another drug can protect people exposed to the virus.
Amanda Rojek, a physician scientist at the University of Oxford, said, "We urgently need treatments that can help people affected by Bundibugyo virus disease," and experts involved in the response said three trials are being launched to test existing medicines against the strain.
Researchers will test the antiviral remdesivir, manufactured by Gilead Sciences, and the monoclonal antibody MBP-134, developed by Mapp Biopharmaceutical, both delivered intravenously, and each will be tested alone and in combination against standard supportive care. Vasee Moorthy, the WHO research and development lead for the outbreak, said the Biomedical Advanced Research and Development Authority funded research behind MBP-134, technically owns the doses and that the government donated the doses necessary for the trial. So far only one clinic in the DRC is involved, with plans to expand.
Moorthy said it will take months, potentially into next year, to learn whether the treatments work and that researchers may need more than 1,000 patients to reach a definitive answer. Yazdan Yazdanpanah, an infectious disease physician and epidemiologist, said a vaccine is not available today and that it will be months before vaccine candidates begin testing. He said a third trial, slated to start sometime this week, will test whether oral obeldesivir pills can prevent disease in close contacts as post-exposure prophylaxis; study teams will visit enrolled contacts twice a day to deliver the drug and monitor symptoms.
Organizers warned that running clinical trials will be difficult because of ongoing armed conflict and attacks on health centers, growing mistrust and rumors in communities, and other operational challenges; WHO officials declined to disclose the exact location of the clinic enrolling patients to protect clinicians. Moorthy said community advisory meetings and open lines of communication are central to ensuring trials proceed ethically.
Bob Kitchen, vice president of emergencies for the International Rescue Committee, warned that the outbreak could become the deadliest on record without urgent intervention and said the DRC is confronting the current outbreak "more fragile and less prepared" than it had been during the 2018-2020 outbreak that killed more than 2,000 people.
The U.S. Agency for International Development officially closed last July, with the majority of its programs abolished and a small remainder absorbed into the U.S. State Department, a move that attracted criticism from former presidents Barack Obama and George W. Bush and from Bill Gates. The closure came as part of cuts enacted by the Department of Government Efficiency, a temporary organization set up by President Donald Trump; Elon Musk initially oversaw DOGE's operations and recently defended decisions on cutting USAID following claims that it had contributed to the deaths of children.
Observers say the cuts are not limited to the U.S.: Oxfam noted that G7 countries were set to slash their aid spending by 28% in 2026 compared with 2024 levels. Analysis by researchers at the Barcelona Institute for Global Health projects French foreign aid will fall by around a third since 2023, Germany's will drop by more than 36%, and the U.K.'s is down 45% compared with recent peak levels.
Virologist Angela Rasmussen, science chair for the Save America Movement, said foreign aid cuts have "demonstrably worsened" the Ebola crisis, arguing that cuts to USAID-funded infrastructure have led to increased violence and decreased capacity in the region. She said shipments cannot get through and existing medical supplies funded by USAID — basic supplies like gloves, PPE and body bags — are not getting to the hardest hit areas of Ituri province, and that the loss of USAID-funded cold chain infrastructure meant swab samples had been degraded during transport to biomedical testing facilities, contributing to delays in detection of the virus.
The Council on Foreign Relations said fighting in early 2025 between Congolese authorities and groups led by the rebel paramilitary group M23 culminated in the capture of Goma and worsened nationwide political violence, and that Islamic State-affiliated groups have carried out attacks in eastern DRC. The council described the situation as one of the largest and deadliest humanitarian crises in the world, saying 1 million Congolese have sought refuge abroad and 21 million remain in the country urgently in need of aid, including medical assistance and supplies.
Jade Le, chief of infectious diseases at Access TeleCare, said cuts to foreign aid had "absolutely" made the outbreak harder to contain and described USAID's previous role in building health infrastructure, training workers, providing testing kits and PPE, and transporting samples to labs. She said the dismantling of USAID, the funding cuts and pull-out from WHO, the reductions in workforce at the CDC, and reduced health aid to the DRC have contributed to delays in detection and reduced effectiveness of U.S. assistance this time.