At a Trump administration cabinet meeting on Wednesday, unelected South African centibillionaire Elon Musk joked about how his so-called Department of Government Efficiency (DOGE) “accidentally canceled” Ebola prevention. He assured the room that DOGE had “fixed” the issue. In reality, as an Ebola outbreak continues in Uganda, the aid response from the United States has been severely curtailed by the destruction of the country’s largest foreign aid arm—and other lifesaving humanitarian programs are also still broken, including AIDS and famine work.
Over the past month, DOGE has overseen the dismantling of USAID, first placing on administrative leave and then laying off the vast majority of its workers, and freezing funding for contractors implementing its programs. The State Department developed emergency humanitarian waivers intended to keep lifesaving work going—but current and former USAID workers and other public health experts have told WIRED that the waivers are useless.
“The waiver is a myth” says Asia Russell, the executive director of the international HIV advocacy group Health GAP.
Current and former USAID workers and other Ebola experts do not believe these issues are corrected, with Ebola-response teams having been dismantled and payments to partner organizations delayed, as first reported by the Washington Post. “The entire Global Health team has been gutted,” one current worker (who spoke under condition of anonymity for fear of retribution) tells WIRED. “So the response would be minimal.”
The Centers for Disease Control and Prevention head up Ebola prevention within the US, with USAID supporting efforts abroad. On January 27, the CDC was ordered to cease communications with the World Health Organization, the United Nations agency devoted to responding to public health crises.
Craig Spencer, a public health professor at Brown University and epidemiologist who survived Ebola after contracting it treating patients in Guinea in 2014, says Musk’s claims about fixing the issue are wrong. He points to the stark difference between the US response to a Marburg virus outbreak in Rwanda last year and the current outbreak in Uganda as evidence that things have stopped working properly. The US responded promptly to the Marburg eruption, he says, and helped contain the disease’s spread; this time around, Spencer says Ugandan health workers struggled to get in touch with the CDC in a timely manner. While the WHO was able to step in, Spencer worries about future incidents without robust US global public health funding and infrastructure: “Outbreaks will be worse on the ground, and get bigger quicker.”
“The US funding freeze has affected key outbreak response capacities,” says World Health Organization spokesperson Alexander Nyka. The absence of USAID’s Outbreak Response Team is especially keenly felt; WHO describes its services as a “game changer.” According to WHO, the US previously provided around 20 to 40 percent of funding for sudden infectious disease outbreaks.
“Uganda’s Ebola outbreak occurred on the same day as the foreign aid freeze. Despite that, the waiver for assistance in addressing the outbreak was quickly reinstated,” the State Department told WIRED in a statement. “This is a process. If errors are made, they will be flagged and corrected as needed, while striving to do what’s best for the American people.”
The CDC did not respond to requests for comment.
Other lifesaving USAID programs ostensibly granted humanitarian waivers have encountered similar issues. Earlier this month, WIRED reported that the food aid and famine prevention program FEWS NET remains inactive, despite having received a waiver, with many of the workers who had implemented the program furloughed or laid off. This is still true today. “We have not yet been able to resume any activities,” says Payal Chandiramani, a spokesperson for Chemonics, the international firm implementing a large portion of the program.
Meanwhile, lifesaving AIDS and HIV programs are also not resumed. The President’s Emergency Plan for AIDS Relief is one of USAID’s most high-profile success stories, credited with saving over 26 million lives since former President George W. Bush founded the program in 2003. Around the same time Musk was joking about his USAID blunders with Trump officials, PEPFAR’s supporters gathered for a protest in Washington, DC, to draw attention to the impact of losing these programs. Despite receiving a waiver, PEPFAR has not been able to resume its work, along with other stymied AIDS-related programs, with funding and staffing cuts hampering the program. “The waivers have not been working,” says Emory Babcock, a former USAID contractor working on PEPFAR laid off at the beginning of DOGE’s cuts.
On the same day as Musk’s comments, the Trump administration terminated over 10,000 global health grants from USAID and the State Department, killing a variety of services that had been granted a lifesaving waiver.
The Elizabeth Glaser Pediatric AIDS Foundation, a non-profit that often receives funding from USAID and works with PEPFAR, got notice on Wednesday that three of its project agreements with USAID had been terminated, despite previously receiving approval to resume activities under the PEPFAR waiver. The programs support over 350,000 patients in Lesotho, Eswatini, and Tanzania, including 10,000 children. “There’s nothing left,” says Russell. “The collateral damage is piles of bodies.”
Even though a federal judge ordered the Trump administration to unfreeze foreign aid funds to temporarily fulfill outstanding bills and payments owed to contractors around the world, the Supreme Court stayed the order on Wednesday night, which means aid groups—including those working on infectious disease prevention in Africa—continue to go unpaid for services rendered, in some cases preventing any further lifesaving work.
Meanwhile, a new, deadly hemorrhagic fever has emerged in the Democratic Republic of the Congo over the past five weeks, with over 60 people already dead, and numbers of people falling sick still rising. Although it causes a violent, rapid cascade of symptoms including vomiting blood, it is not Ebola, nor Marburg, but instead appears to be an unknown disease. A USAID worker who spoke on the condition of anonymity tells WIRED: “We have nobody on the ground to monitor this.”
