Short Wave - Did Trump's foreign aid cuts fuel the Ebola outbreak?

Episode Date: June 24, 2026

The Ebola outbreak in the Democratic Republic of Congo is growing – and is likely larger than official numbers show. The deadly disease spreads through bodily fluids, on average killing half the people it infects. And while officially declared in May, the case numbers point to the virus circulating for months without being detected. To make matters worse, there’s not a vaccine for this specific species of ebolavirus – at least, not yet. NPR global health correspondent Jonathan Lambert has been covering everything Ebola-related for the past month or so, and shares what he’s learned today.Interested in more health and science news? Email us your question at [e-mail] public media with NPR+ and enjoy perks for over 25 podcasts like this one. It includes perks like bonus episodes, early access, archive access, curated playlists and sponsor-free listening. Learn more at plus.npr.org. See pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

You're listening to Shortwave from NPR. Hey, shortwavers, Regina Barber here. And today I'm joined by NPR Global Health Reporter, Jonathan Lambert. Hey, John. Hey, Gina. So you're here today to talk about the ongoing Ebola outbreak. Yeah, it's been just about the only thing I've covered over the past month and a half or so. The outbreak has gotten really big, really fast.

It's already the third largest Ebola outbreak on record. That's terrible. So where did the number stand right now? As of now, there are over 1,000 confirmed cases and over 250 confirmed deaths, but the toll is likely much higher. Why is that? Well, many cases and deaths are probably going uncounted. The outbreak is centered in a region of the Democratic Republic of Congo that's really remote and battered by a lot of ongoing conflict. I see how that could make responding to the outbreak a lot harder.

Yeah. And the virus got a head start. it was likely circulating for months before officials realized that it was. That's made it harder to rein in, which is really worrisome for a disease that, on average, kills about half the people it infects. So do scientists have a sense of how bad it could get? Well, the CDC projects that in the absence of robust control measures, as many as 20,000 people could be sick by August.

If it continues at that pace, it could rival the 2014-216-Ibollah outbreak in West Africa, which killed over 11,000 people. And there are concerns that it could spread more widely in the region. So today on the show, how this became one of the largest Ebola outbreaks in history. And what has to happen to treat patients and get it under control? You're listening to Sherwave, the science podcast from NPR. Okay, so John, remind us of some of the basics of Ebola. Yeah, it's a disease caused by a virus, specifically the ortho- Ebola virus.

The first known outbreak was in 1976 in the Democratic. Republic of Congo. Since then, at least a couple dozen outbreaks have occurred, mostly from East to West Africa. So what causes an outbreak to occur? Usually it's a spillover event. That's when a virus that typically circulates in non-human animals jumps from an animal to a human. Scientists aren't sure how many animals harbor Ebola, but they do know that it circulates in some bats. So how does this virus get from the bat to the human? It's not exactly clear. In many parts of East and West Africa, some people eat bat meat for food and could get exposed that way. Exposure to guano or bat poop could be another route.

Yeah, this reminds me of COVID, but this infection is much more serious, right? Right. Ebola is a very deadly disease. And its deadliness stems in part from a kind of sneakiness. Like, how is it sneaky? So when the virus first infects a person, it goes straight for key immune cells. Typically, these cells help spur the production of antibodies, which allow them immune system to target a pathogen. But by attacking these cells first, Ebola viruses delay this

response. And that gives the virus a huge head start. This is terrifying. Yeah. So the virus first goes to the lymph nodes, then to the spleen, the liver and kidneys, replicating and damaging these tissues as it goes. I spoke to virologist John Connor at Boston University about this. Here's how he put it. The cleaning and garbage disposal units of the body are backing up. And that backs up into the blood system that has a lot of negative consequences. And these cascading problems can be very damaging. And that's often, that's why you get to death. One major cause of death is just loss of all these fluids through vomiting and diarrhea.

Patients can lose up to 10 liters a day. That is so much. That's like over two and a half gallons. Yeah. And it's through contact with those bodily fluids or handling infected dead bodies that the virus spreads. So, you know, we compared it to COVID earlier. It's not spread through droplets in the air like that. So Ebola isn't as contagious.

Yeah, but it still sounds like an awful disease. It is. And that's why health officials are really usually on the lookout for it. And over the last decade or so, countries like DRC that experience a lot of Ebola outbreaks have really beefed up their surveillance systems. For instance, they've built up lab infrastructure so they can test samples that might be from Ebola patients. U.S. foreign aid really helped build up those systems, and in recent years, it's helped outbreaks get declared relatively early on. Okay. So usually they're caught pretty early, but you're saying that didn't happen for this current situation? No. So when the outbreak was declared on May 15th, that initial death toll had already reached 65. I track outbreaks like these pretty closely.

And when I saw that announcement, I had this like moment of panic that I'd somehow missed early reports because the numbers just seemed too big for a lot. new outbreak. Oh, wow. Now health officials suspect the outbreak wasn't new then, and it likely started months ago, perhaps as early as February. So why was there a delay in declaring it? A few reasons. Like I said, it's a tough region to work in because it's remote and there's conflict. And the species of a bolla that's spreading is a rarer one. It's called boondabuzio, and there have been only two other outbreaks of it in 2007 and 2012. Genetically, it's like 30% different than the more common species. Unfortunately, Unfortunately, that means that the tests that DRC typically uses can't detect it.

So cases that seemed like Ebola kept turning up negative. Oh, so how did they eventually tell it was Ebola? Health officials shipped samples to a bigger lab in Kanshasa, DRC's capital, where they did more sophisticated tests. But even that process was delayed. Early samples weren't shipped properly, and there were delays in those shipments. Wow. Yeah, and these outbreak surveillance activities are the kind of thing that used to be heavily supported by U.S. foreign aid, including by USAID.

And after the Trump administration's massive aid cuts last year, I'm sure it was affected. Yeah, a lot of it is gone. The State Department has said that it's false to claim that those cuts impacted the Ebola response, but I've spoken with a lot of global health experts who think it contributed. One of them was Anna Bodipo-Mayamba. She worked on the Ebola response in DRC for USAID. When you dismantle those programs, you no longer have your frontline eyes and ears on the ground that can alert you. And so it's very easy for an outbreak to spread very quickly.

And the outbreak is clearly spreading quickly now. So how are health officials responding? On a few fronts, they've significantly ramped up testing. So now there are more labs that can test samples in the Northeast where this outbreak is. And they added testing machines that can detect Bundabuzzo, this rarer species of Ebola. So that's good. But W. HO officials told me that they need to do a lot more testing to keep up. And as they do that testing, once somebody's results comes up positive, what happens? Well, from a public health perspective, the hope is that they isolate to limit further spread. Now, you can't make an infected person do that, but you can hope that they do. Meanwhile, health officials work to figure out their contacts and hopefully

get them to quarantine in case they're infected too. There isn't an approved vaccine for this species of Ebola, so this kind of basic bread and butter response is. the main tool that officials have to curve the spread. What about treating the disease? Like, are there any approved treatments for Ebola? Unfortunately, not for this kind of Ebola. Now, that doesn't mean patients can't be treated at all. Providing what's called basic supportive care, like replacing lost fluids,

treating pain, treating other co-infections, can help people recover. And at least 100 people already have. That's good. Yeah. But this kind of care isn't available everywhere. And health officials are scrambling to set up treatment centers in more remote areas. but those are still out of reach for many. And the conditions in some of those centers are really rough for both providers and patients.

I'm here in Rampara Ebola Treatment Center. This is journalist Emmett Livingstone, who is reporting on Ebola for NPR in the DRC. He visited a clinic earlier this month. All of us are in full protective gear, which includes a bib, two layers of clothing, several layers of gloves, a mask. it's difficult to describe the level of discomfort wearing one of these suits. It's very hot in Aturi, the sun is bright. It's very difficult to breathe inside the suit.

And on top of that, the goggles fog up, so it's also difficult to see. Working under these conditions makes it hard for doctors to treat patients, and it's obviously a difficult situation for those patients. The Ebola patients themselves, some of them appear to be in a great deal of pain. We heard some people crying out. the doctor said that at a certain stage of the Ebola virus disease, the whole body aches and it's extremely painful. This all sounds so heartbreaking. Yeah, it is not good.

I've spoken to a number of clinicians who've worked in Ebola wards in the past, and they've described some really harrowing experiences. But they also maintained that Ebola isn't a death sentence, and with access to high-quality care, people can get better. It's just really hard to access that kind of care in the places where Ebola typically seems. spreads. So we're now a month into the official outbreak. What are you watching for now? A few things. One is just how big the outbreak continues to get and where it goes. Right now, it's still mostly in DRC with a handful of cases in Uganda, but that could change. I'm also closely watching if contact tracing becomes more robust. Right now, only a little over half of contacts are being identified by officials. experts are telling me that that's way too low, and that percentage ticking up will be a sign that the outbreak is starting to get under control.

So what about new treatments? Like, could those come anytime soon? There are efforts underway to quickly stand up clinical trials to test possible treatments and vaccines. Those take time, probably at the earliest a month or two. But the sooner they start, the sooner clinicians and health officials could have more powerful tools to treat patients and rein this outbreak in. John, thank you so much for bringing us this reporting. Of course, Gina. This episode was produced by Hannah Chin and edited by Rebecca Ramirez. Tyler Jones checked the facts.

Jimmy Keely was the audio engineer. I'm Jonathan Lambert. And I'm Regina Barber. Thank you for listening to Shortwave, the science podcast from NPR.