As the World Health Organization declared the Ebola spread in the Democratic Republic of the Congo and Uganda a public health emergency of international concern, public health experts warn that U.S. policy has shifted in a way that could make containment harde
On May 27, U.S. Secretary of State Marco Rubio stood at a cabinet meeting and said the number one priority of U.S. foreign policy is to protect American people—adding, “We cannot and will not allow any cases of Ebola to enter the United States.”
For Tanya Lewis, that line landed with a warning she says public health experts are already feeling: the response to this Ebola outbreak is changing in ways that could raise the stakes for everyone trying to stop it.
Health officials in the Democratic Republic of the Congo declared the country was in the midst of an Ebola outbreak on May 15. Two days later. the director general of the World Health Organization designated the spread of Ebola in the DRC and Uganda as a public health emergency of international concern—the highest kind of official alert the WHO issues for an outbreak.
“We have only really known about it for the last two weeks or so. ” Lewis said. explaining that while the WHO’s declaration came recently. the outbreak was likely spreading before the world had clear visibility. “Given the high numbers of cases and deaths, it’s likely the outbreak was going on well before that.”.
Ebola, Lewis said, belongs to a family of viruses called orthoebolaviruses, which cause a type of hemorrhagic fever. In this illness, immune cells are infected, leading to internal bleeding, organ failure, and death. While Ebola is notorious for its high fatality rate, the specific outbreak strain matters.
This one is caused by Bundibugyo virus, a less common species of orthoebolavirus. Lewis said researchers have seen only “two outbreaks in the past that we know of.” And she stressed a gap in available medical countermeasures: unlike the more traditional Zaire ebolavirus. for which vaccines and treatments have been developed. there are no approved vaccines or treatments for Bundibugyo Ebola.
“Researchers are racing to test a couple of antibody drugs and a drug called remdesivir. ” Lewis said. describing an urgency that is hard to ignore when people are dying. She noted that the mortality rate for this Bundibugyo strain is “slightly lower” than for Zaire Ebola. but she also made clear that the difference does not mean it is survivable for many.
Part of the public fear around Ebola is about how it spreads, and Lewis tried to ground that worry in how the disease actually moves. It is not transmitted through casual contact. Instead, she said transmission requires close contact, bodily fluids, caregiving, and it can involve burial practices.
“That’s why you see those individuals wearing. you know. full-on PPE and protective gear. ” Lewis said. describing the reason health care workers are put in hazmat-style protection. Ebola patients are sick enough that bodily fluids are encountered constantly during care. But she also emphasized that it isn’t like diseases such as COVID that spread readily in everyday settings.
Still, containment has been especially difficult where Ebola is now spreading. Lewis pointed to the DRC’s conflict zones and said that treating patients is not only dangerous because of the virus—it can also become deadly because of violence. She said clinics have been caught in crossfire. and that health care workers and aid workers have been targeted because they can be “in the wrong place at the wrong time.”.
In those conditions, the WHO’s emphasis—Lewis said—has included making safe places for treatment and not targeting health care workers who are already risking their lives to care for very sick patients. If the environment is unstable, the epidemic is harder to contain.
Experts also say the outbreak’s trajectory is concerning. Lewis described the outlook as still unclear—“it’s still an open question exactly how bad this outbreak will get”—and said some experts and groups including the International Rescue Committee have warned it could be worse than any previous Ebola outbreak.
But she also anchored the danger with numbers. The 2014 to 2016 Ebola outbreak is currently the deadliest on record, with about 30,000 cases and 11,000 deaths. This outbreak, as of May 26, has had more than 1,000 suspected cases and more than 240 suspected deaths.
Lewis said what alarms experts most is that the public health world only became aware of the outbreak when it was already in the hundreds. “So that’s concerning because where there are deaths, there are likely many, many more cases,” she said. She added that scientists are still working to determine how far it will spread and how quickly it will grow. noting that early estimates suggest the rate of growth may be faster than in some prior outbreaks.
Even if the virus’s spread depends on local conditions, Lewis said this is not something that will disappear on its own. The course of the outbreak depends in part on response capacity—including what countries like the United States do to provide aid to the DRC and Uganda.
That brings the conversation back to the policy decisions that, in Lewis’s view, risk undermining containment.
She said the U.S. has made major cuts to international aid programs, including to USAID and the State Department. She added that some experts believe those cuts helped create the conditions for the outbreak to “get out of hand.”
Beyond funding, she argued there has been a shift in how the U.S. handles American health workers exposed to Ebola. In prior outbreaks, Lewis said, Americans who contracted Ebola while caring for sick people or who were exposed to the virus were brought back to the U.S. for quarantine and treatment.
In the current outbreak, she said, Marco Rubio recently stated that no one with Ebola will be entering the U.S., and that people with Ebola are now being shipped to other countries. She pointed to the fact that a doctor was recently treated in Germany.
For Lewis. the problem isn’t the intent to protect people—it’s the departure from a system she said the U.S. already has the capacity to use safely. “This is how the U.S. government is now treating our health care workers when we have safe ways to quarantine people and isolate them in biocontainment units in the U.S. ” she said. “Our tax dollars support these types of facilities.”.
She argued that it isn’t a matter of capability. “So it’s not as if the U.S. does not have the capability to safely care for people and treat them if they have Ebola,” she said. “We do, and we have done that in the past, and this is a big departure.”
The numbers and the medical gaps add urgency, but they also make the policy choices feel sharper. There are no approved vaccines or treatments for Bundibugyo Ebola. the outbreak’s spread is happening under conflict conditions that endanger clinics and aid workers. and the world only gained clarity a couple of weeks ago—when cases were already rising.
With the WHO calling this a public health emergency of international concern and the outbreak expanding beyond the point of early detection. the question raised by Lewis’s account is stark: whether cutting aid and changing how exposed health workers are managed will slow containment or make it harder at the moment the response needs to move fastest.
Ebola Democratic Republic of the Congo Uganda World Health Organization public health emergency of international concern Bundibugyo virus remdesivir antibody drugs conflict zones USAID Marco Rubio biocontainment units health care workers