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

Summary

Podcast Summary: Short Wave – "Did Trump's Foreign Aid Cuts Fuel the Ebola Outbreak?"

Episode Date: June 24, 2026
Host: Regina Barber
Guest: Jonathan Lambert, NPR Global Health Reporter
Additional Guest: Emmett Livingstone, NPR Reporter in DRC

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Main Theme

This episode of Short Wave delves into the current Ebola outbreak in the Democratic Republic of Congo (DRC)—now the third largest on record. The conversation centers on the factors contributing to the outbreak’s scale, with a key focus on whether recent U.S. foreign aid cuts, implemented under the Trump administration, impaired the detection and containment response. The episode breaks down how Ebola spreads, why this outbreak escalated so quickly, and what is being done to control it amidst logistical, political, and medical challenges.

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Key Discussion Points & Insights

1. The Current Outbreak: Size & Scope

• [00:32] Jonathan Lambert outlines the dire situation: over 1,000 confirmed cases and 250 deaths, with numbers likely undercounted due to the outbreak’s remote location and local conflict.
  • “The outbreak has gotten really big, really fast. It's already the third largest Ebola outbreak on record.” – Jonathan Lambert [00:41]
• The CDC projects that without intervention, up to 20,000 could be infected by August ([01:28]), potentially surpassing the 2014-2016 West Africa outbreak.

2. Ebola Basics: Transmission & Lethality

• [03:13] Ebola is caused by a virus (Ortho Ebola virus), with spillover from animals (especially bats) often triggering outbreaks ([03:32]).
• Transmission to humans is not fully understood, but likely routes include direct contact with bat meat or guano ([03:49]).
• Ebola’s deadliness is tied to its ability to “sneakily” attack the immune system, delaying antibody response and causing organ damage ([04:11]).
  • “When the virus first infects a person, it goes straight for key immune cells… by attacking these cells, Ebola viruses delay this response. And that gives the virus a huge head start.” – Jonathan Lambert [04:13]
• Memorable quote: “Patients can lose up to 10 liters a day.” – Jonathan Lambert [05:07], highlighting the severity of fluid loss.

3. Detection & Delay: Surveillance Shortfalls

• Surveillance systems in DRC have historically been strengthened in part by U.S. foreign aid, enabling early detection ([05:30]).
• In this outbreak, the declaration was notably late—cases may have started months prior, but weren’t confirmed until May 15 ([06:01]).

Why the Delay?

• The outbreak took place in a remote, conflict-ridden area.
• The rare Bundabugyo Ebola virus species was responsible; existing tests couldn't identify it ([06:28]).
  • “Genetically, it's like, 30% different than the more common species. Unfortunately, that means that the tests that DRC typically uses can't detect it.” – Jonathan Lambert [06:45]
• Lab sample shipment delays and technical issues further postponed confirmation ([06:59]).

The Role of Foreign Aid Cuts

• Surveillance and outbreak response were heavily supported by U.S. aid—much of which was cut under the Trump administration ([07:20]).
• Official denials from the State Department contrast with field experts’ accounts.
  • “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.” – Ana Bodipo Mbayamba, global health expert [07:44, paraphrased by Jonathan Lambert]

4. Current Control Efforts & Challenges

• [07:59] Testing has ramped up, with labs now detecting Bundabugyo Ebola ([08:00]).
• Contact tracing is happening, but only just over half of close contacts are being identified ([10:49]).
• No approved vaccine or targeted treatment exists for Bundabugyo. The response relies on “bread and butter” public health actions—isolation and contact tracing ([08:24]).
• Supportive care (fluids, pain treatment) is effective but hard to provide at scale in remote and resource-poor regions ([08:53]).
  • “Providing what's called basic supportive care...can help people recover, and at least 100 people already have.” – Jonathan Lambert [09:08]

On-the-ground Perspective

• [09:24] Emmett Livingstone reports from a treatment center in Rampura, DRC:
  • “All of us are in full protective gear…It's very hot…difficult to breathe…goggles fog up...” – Emmett Livingstone [09:34]
  • On patient suffering: “Some of them appear to be in a great deal of pain. We heard some people crying out. The doctors said that… the whole body aches and it's extremely painful.” – Emmett Livingstone [10:05]

5. Outlook & Next Steps

• The outbreak is still mostly in DRC, with some spread to Uganda. Jonathan is closely watching for signs of containment (better contact tracing) ([10:49]).
• New treatments and vaccines are under fast-track development, with clinical trials possibly starting in a month or two—but impact will not be immediate ([11:20]).
  • “The sooner they start, the sooner clinicians and health officials could have more powerful tools to treat patients and rein this outbreak in.” – Jonathan Lambert [11:31]

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Notable Quotes & Memorable Moments

• “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.” – John Connor, Boston University virologist, as relayed by Jonathan Lambert [04:34].
• “Ebola isn't a death sentence, and with access to high quality care, people can get better. And it's just really hard to access that kind of care in the places where Ebola typically spreads.” – Jonathan Lambert [10:21]
• On the humanitarian toll:
  • “This all sounds so heartbreaking.” – Regina Barber [10:18]

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Important Timestamps

• [00:41]: Outbreak scope and numbers
• [01:28]: CDC projections of outbreak’s potential scale
• [03:16]: Ebola basics – history, transmission, lethality
• [05:27]: Challenges of surveillance and detecting outbreaks early
• [06:45]: Bundabugyo species and testing challenges
• [07:20]: Discussion of U.S. foreign aid cuts and their impact
• [08:24]: Contact tracing and public health intervention limitations
• [09:24]: Live report from Ebola field clinic (Emmett Livingstone)
• [10:49]: What metrics signal outbreak is under control
• [11:20]: Clinical trials and hope for new treatments

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Episode Style & Tone Notes

• The tone is empathetic, science-driven, and direct, with clear efforts to avoid sensationalism while conveying urgency.
• Medical details are presented in accessible language, often contextualized with analogies and follow-up questions from Regina.
• Field reporting adds a visceral, human perspective that underscores the personal and logistical challenges on the ground.

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Conclusion

This episode offers a deeply reported, nuanced look at the largest Ebola outbreak in DRC’s recent history, breaking down the science and public health challenges while surfacing the role of foreign aid and global response infrastructure. It spotlights the complex interplay between politics, funding, scientific understanding, and local realities—with caution and optimism for future interventions.

Transcript

[Commercial Announcer]

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[Regina Barber]

You're listening to Short Wave from NPR. Hey, short waivers. Regina Barber here. And today I'm joined by NPR global health reporter Jonathan Lambert. Hey, Jonathan.

[Jonathan Lambert]

Hey, Gina.

[Regina Barber]

So you're here today to talk about the ongoing Ebola outbreak.

[Jonathan Lambert]

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.

[Regina Barber]

That's terrible. So where do the numbers stand right now?

[Jonathan Lambert]

As of now, there are over 1000 confirmed cases and over 250 confirmed deaths. But the toll is likely much higher.

[Regina Barber]

Why is that?

[Jonathan Lambert]

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.

[Regina Barber]

I see how that could make responding to the outbreak a lot harder.

[Jonathan Lambert]

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 on average kills about half the people it infects.

[Regina Barber]

So do scientists have a sense of how bad it could get?

[Jonathan Lambert]

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 2014-2016 Ebola outbreak in West Africa, which killed over 11,000 people. And there are concerns that it could spread more widely in the region.

[Regina Barber]

So today on the show, how this became one of the largest Ebola outbreaks

[Jonathan Lambert]

in history and what has to happen to treat patients and get it under control.

[Regina Barber]

You're listening to Shortwave, the science podcast from npr.

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[Regina Barber]

remind us of some of the basics of Ebola.

[Jonathan Lambert]

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.

[Regina Barber]

So what causes an outbreak to occur?

[Jonathan Lambert]

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.

[Regina Barber]

So how does this virus get from the bat to the human?

[Jonathan Lambert]

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.

[Regina Barber]

Yeah, this reminds me of COVID But this infection is much more serious, Right?

[Jonathan Lambert]

Right. Ebola is a very deadly disease. And its deadliness stems in part from a kind of sneakiness.

[Regina Barber]

Like how. How is it sneaky?

[Jonathan Lambert]

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 the 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.

[Regina Barber]

This is terrifying.

[Jonathan Lambert]

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.

[Regina Barber]

That is so much. That's like over two and a half gallons.

[Jonathan Lambert]

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.

[Regina Barber]

Yeah, but it still sounds like an awful disease.

[Jonathan Lambert]

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. US Foreign aid really helped build up those systems. And in recent years, it's helped outbreaks get declared relatively early on.

[Regina Barber]

Okay, so usually they're caught pretty early. But you're saying that didn't happen? For this current situation, no.

[Jonathan Lambert]

So when the outbreak was declared on May 15, 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 earlier reports. Cause the numbers just seemed too big for a new outbreak.

[Regina Barber]

Oh, wow.

[Jonathan Lambert]

Now, health officials suspect the outbreak wasn't new then, and it likely started months ago, perhaps as early as February.

[Regina Barber]

So why was there a delay in declaring it?

[Jonathan Lambert]

A few reasons. Like I said, it's a tough region to work in because it's remote and there's conflict and. And the species of Ebola that's spreading is a rarer one. It's called Bundabugio. 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, that means that the tests that DRC typically uses can't detect it. So cases that seemed like Ebola kept turning up negative.

[Regina Barber]

Ooh. So how did they eventually tell it was Ebola?

[Jonathan Lambert]

Health officials shipped samples to a bigger Lab in Kinshasa, 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.

[Regina Barber]

Wow.

[Jonathan Lambert]

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.

[Regina Barber]

And after the Trump administration's massive aid cuts last year, I'm sure it was affected.

[Jonathan Lambert]

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 Ana bodipo Mbayamba. 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.

[Regina Barber]

And the outbreak is clearly spreading quickly now. So how are health officials responding?

[Jonathan Lambert]

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 bundabujo, this rarer species of ebola. So that's good. But who officials told me that they need to do a lot more testing to keep up.

[Regina Barber]

And as they do that testing, once somebody's results comes up positive, what happens?

[Jonathan Lambert]

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 curb the spread.

[Regina Barber]

What about treating the disease? Like, are there any approved treatments for ebola?

[Jonathan Lambert]

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.

[Regina Barber]

That's good.

[Jonathan Lambert]

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.

[Emmett Livingstone]

I'm here in rampara Ebola treatment center.

[Jonathan Lambert]

This is journalist Emmett livingstone who is reporting on ebola for NPR in the drc. He visited a clinic earlier this month.

[Emmett Livingstone]

All of us are in full protective gear, which includes a bib, two layers of clothing, several layers of gloves, goggles, a mask. It's difficult to describe the level of discomfort wearing one of these suits. It's very hot in a touri. 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.

[Jonathan Lambert]

Working under these conditions makes it hard for doctors to treat patients, and it's obviously a difficult situation for those patients.

[Emmett Livingstone]

The Ebola patients themselves, some of them appear to be in a great deal of pain. We heard some people crying out. The doctors said that at a certain stage of the Ebola virus disease, the whole body aches and it's extremely painful.

[Regina Barber]

This all sounds so heartbreaking.

[Jonathan Lambert]

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. And it's just really hard to access that kind of care in the places where Ebola typically spreads.

[Regina Barber]

So we're now a month into the official outbreak. What are you watching for now?

[Jonathan Lambert]

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.

[Regina Barber]

So what about new treatments? Like, could those come anytime soon?

[Jonathan Lambert]

There are efforts underway to quickly stand up clinical trials to test possible treatments and vaccines. Those take time, probably at the earliest 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.

[Regina Barber]

John, thank you so much for bringing us this reporting.

[Jonathan Lambert]

Of course, Gina.

[Regina Barber]

This episode was produced by Hannah Chin and edited by Rebecca Ramirez.

[Jonathan Lambert]

Tyler Jones checked the facts. Jimmy Keeley was the audio engineer. I'm Jonathan Lambert.

[Regina Barber]

And I'm Regina Barber. Thank you for listening to Short Wave, the science podcast from N.

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