US delayed assistance to Uganda’s Ebola response

Ugandan officials appear to have largely contained an outbreak of the Ebola virus but they did so without the same level of support they have previously received from the U.S. government. Officials declared an outbreak of the rare Sudan strain of the virus on Jan. 30 following the death of a nurse at Mulago National Referral Hospital, the country’s largest health care facility, in the capital, Kampala. The declaration came just days after a freeze on all foreign aid by U.S. President Donald Trump’s administration and amid ongoing efforts to suspend or fire substantial portions of the staff at the U.S. Agency for International Development, which has been a key partner in Uganda’s previous Ebola outbreaks. For more than a week after the outbreak was declared, some U.S. funding that would normally have been available to help the government and its partners respond to the virus was suspended, according to Dr. Suudhi Bamutya, who guides epidemic responses for the Uganda Red Cross Society, and was involved in meetings to determine the official plan to address the outbreak. “We tried to improvise with the resources we had,” he said. “Even government itself had to improvise on how things could be run with a cut in funding,” by repurposing money from other programs. “The other programs may be affected, other essential services.” The freeze on U.S. funding persisted despite a waiver issued by the U.S. State Department allowing spending on “life-saving assistance” to continue. Bamutya said some U.S. funding specifically for Ebola resumed on Feb. 10. The next day, Elon Musk, speaking in the White House, said pausing funding for Ebola had been a “mistake.” Musk, the tech mogul, is in charge of the U.S. Department of Government Efficiency Service, or DOGE, which has led the efforts to dismantle USAID. Nevertheless, Uganda has only nine confirmed cases of the deadly virus and one death. Following treatment, the eight surviving patients were released last week. Ministry officials are still quarantining dozens of contacts of those patients, but there have been no additional confirmed cases, and the country is now counting down to declaring an end to the outbreak. Health experts said there were several reasons Uganda has succeeded in containing the response, including earlier investments from both the Ugandan and the U.S. governments. Uganda maintains a particularly strong disease detection system and a committed team of experts, as well. This outbreak required officials to track the index patient, a health worker, who sought treatment in Mbale, in eastern Uganda, as well as Wakiso and Kampala, in the center of the country, before his death. The other eight confirmed cases were family members and health workers who had direct contact with the patient. While the response appears to have been effective, Bamutya said the lack of U.S. funding curbed what would normally have been a more robust track-and-trace effort “considering how the index case moved.” “This time we had to make it more targeted,” he said. “That means there is a risk of leaving some areas unattended to. But the strategy was to put the little available resources only to those areas we believe are needed the most. That can leave some gaps without knowing.” Neither U.S. officials nor the Ugandan health ministry responded to requests for comment. The Red Cross Society is called in regularly to help respond to crises. During this outbreak, it was involved in assisting with community-based surveillance and to evacuate suspected cases. It also plays a significant public awareness role, often in concert with USAID. During an Ebola outbreak in 2022 that left 55 people dead, USAID worked with the Red Cross and other agencies to raise public awareness about the disease, to help dispose of hazardous waste, and to make sure health facilities had enough supplies. Much of that earlier support was missing during the latest outbreak. Bamutya said that earlier U.S. funding had been crucial to prepositioning items like personal protective equipment. But those have been used up and not replaced, which might hinder future efforts. “The next epidemic that comes may not find us in better shape, like it found us in the other outbreaks,” he said.