When Global Neglect Becomes Domestic Crisis: Imagining Ebola in America

It is far from a hyperbolic thought exercise —USAID’s global health programs have been halted, and now a dangerous Ebola outbreak in Uganda is unfolding. Ebola, with an average fatality rate of 50% [CDC, 2024; WHO, 2024], is a pathogen that demands early detection and nuanced, rapid response. It is a pathogen for which we have no vaccine. Without the critical support provided by USAID, which has long helped contain such outbreaks abroad, our collective defenses are now compromised.

USAID has invested in systems that prevent outbreaks from spiraling out of control, protected our borders and enabled the US Government to have early visibility on emerging disease threats. These investments—ranging from advanced diagnostics to effective surveillance networks—have been a safety net for the United States. The decision to halt these programs has eliminated that net, leaving us vulnerable.

This situation is already unfolding. Reports from the Africa CDC and other health experts indicate that the containment measures in Uganda are under pressure. The halting of USAID-funded initiatives has reduced both the surveillance capacity and the rapid-response mechanisms that once played a crucial role in controlling such outbreaks. Without these safeguards, our domestic public health systems—which rely on early detection and prompt intervention—could find themselves implicated.

Imagine the dire consequences if Ebola were to reach American soil. In neighborhoods across America, ambulances crowd the streets while emergency rooms swell with patients displaying the unmistakable symptoms of Ebola—high fevers, severe internal bleeding, and shock. Families huddle inside their homes, desperate to shield themselves from a virus with a staggering 50% mortality rate. Hospitals are overwhelmed as healthcare workers—dressed in full protective gear—race through corridors to treat a tidal wave of critically ill patients. Makeshift quarantine zones spring up in community centers and schools as local clinics struggle to cope with the influx. Businesses shutter as communities go into lockdown, again. Children are kept home from school to keep them alive. Public transportation grinds to a halt and the peaceful life of our neighborhoods is replaced by uncertainty, despair and silence.

This unfolding crisis highlights a fundamental truth: cutting global health investments is not a cost-saving measure, but a risky gamble with far-reaching consequences. Robust global health security, underpinned by proactive investments like those provided by USAID, is essential for preventing local outbreaks from becoming national emergencies. The decision to discontinue such programs has already weakened our collective ability to detect, contain, and respond to deadly pathogens like Ebola.

Now is the time for urgent, coordinated action. Approve waivers for USAID’s infectious disease, global health security and early warning programs. Mobilize emergency response resources that are currently sitting idle, waiting for approval to go back to doing the work they are already experts in. Re-engage with the WHO to ensure America has complete visibility and influence over outbreak response.

Programs that could help if granted permission:

1. USAID Strengthening Infectious Disease Detection Systems
2. USAID Local Health Systems Sustainability Project
3. USAID Medicines, Technologies and Pharmaceutical Services project
4. USAID Meeting Targets and Maintaining Epidemic Control

Stand up for America. Do something.