Respiratory disease - Asthma, COPD, Pneumonia
USAID Was Promised Emergency Waivers For Ebola And AIDS. They're Not Working
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.
"CDC was given an exemption to coordinate with WHO and other external partners to conduct public health outbreak and emergency response," CDC spokesperson Melissa Dibble told WIRED in response to questions about how the Ebola outbreak was impacted by the Trump administration changes. It is unclear when the exemption was granted.
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."
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 nonprofit 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 the number 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."
Update 2/27/25 6:21 ET: This story has been updated with comment from the CDC.
Child Dies Of Ebola In Uganda; Concern Rise Over Disease Surveillance In Outbreak
In a setback for health officials, a 4-year-old child became the second person to die of Ebola in Uganda, the World Health Organisation said in a statement. The officials who had hoped for a quick end to the outbreak that began at the end of January, Associated Press reported.
The child was hospitalised at the main referral facility in Kampala, the capital of the East African country, and died Tuesday. The statement said WHO and others are working to strengthen surveillance and contact tracing.
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The death undermines Ugandan officials' assertions of an outbreak under control after eight Ebola patients were discharged earlier.
Tracing contacts is key to stemming the spread of Ebola, and there are no approved vaccines for the Sudan strain of Ebola that's infecting people in Uganda.
Over 20,000 travellers are screened daily for Ebola at Uganda's different border crossing points, according to WHO, which supports the work.
The WHO has given Uganda at least $3 million to support its Ebola response, but there have been concerns about adequate funding in the wake of the US administration's decision to terminate 60% of USAID's foreign aid contracts.
Dithan Kiragga, executive director of the Baylor College of Medicine Children's Foundation, a non-governmental group that supports Ebola surveillance in Uganda, told The Associated Press on Friday that his group had stopped its work supporting local health authorities in screening travelling passengers after the termination of its contract with USAID. The five-year contract, signed in 2022 and worth USD 27 million, employed 85 full-time staff who were employed in a range of public health activities, Dr Kiragga said.
Charles Olaro, the director of health services at Uganda's Ministry of Health, said that US aid cuts hurt the work of some non-governmental groups supporting the response to infectious diseases.
Story continues below Advertisement
"There are challenges, but we need to adjust to the new reality," Dr Olaro said, speaking of the loss of US funding.
Ebola, which is spread by contact with the bodily fluids of an infected person or contaminated materials, manifests as a deadly hemorrhagic fever. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding.
Scientists suspect the first person infected with Ebola in an outbreak acquired the virus through contact with an infected animal or eating its raw meat.
Uganda's last outbreak, discovered in September 2022, killed at least 55 people before it was declared over in January 2023.
Ebola in Uganda is the latest in a trend of outbreaks of viral hemorrhagic fevers in the east African region. Tanzania declared an outbreak of the Ebola-like Marburg disease in January, and in December, Rwanda announced its own outbreak of Marburg was over.
Uganda in January 2023 declared the end of a nearly four-month Ebola outbreak that it briefly struggled to contain but was then able to swiftly bring under control despite the absence of a proven vaccine against the viral strain in question.
The outbreak killed 55 of the 143 people infected since September, according to health ministry figures. Six of the fatalities were health workers.
Uganda has had multiple Ebola outbreaks, including one in 2000 that killed hundreds. The 2014-16 Ebola outbreak in West Africa killed more than 11,000 people, the disease's largest death toll.
Ebola was discovered in 1976 in simultaneous outbreaks in South Sudan and Congo, where it occurred in a village near the Ebola River, after which the disease is named.
With agency inputs
Second Ebola Death In Uganda, Raising Concern Over Disease Surveillance In Outbreak
Uganda's last outbreak, discovered in September 2022, killed at least 55 people before it was declared over in January 2023. Representative file image.Photo Credit: AP
A 4-year-old child became the second person to die of Ebola in Uganda, the World Health Organization said Saturday (March 1, 2025), in a setback for health officials who had hoped for a quick end to the outbreak that began at the end of January 2025.
The child had been hospitalized at the main referral facility in Kampala, the capital of the East African country, and died Tuesday (February 25, 2025), the WHO office in Uganda said in a brief statement. That statement said WHO and others are working to strengthen surveillance and contact tracing.
There were no other details about the death and local health officials were not commenting on the case.
The death undermines Ugandan officials' assertions of an outbreak under control after eight Ebola patients were discharged earlier in February. The first victim was a male nurse who died the day before the outbreak was declared on January 30. He had sought treatment at multiple facilities in Kampala and in eastern Uganda, where he also visited a traditional healer in trying to diagnose his illness, before later dying in Kampala.
The successful treatment of eight patients who had been contacts of that man, including some of his relatives, had left local health officials anticipating the end of the outbreak. But they are still investigating its source.
Tracing contacts is key to stemming the spread of Ebola, and there are no approved vaccines for the Sudan strain of Ebola that's infecting people in Uganda.
Over 20,000 travelers are screened daily for Ebola at Uganda's different border crossing points, according to WHO, which supports the work.
The WHO has given Uganda at least $3 million to support its Ebola response, but there have been concerns about adequate funding in the wake of the U.S. Administration's decision to terminate 60% of USAID's foreign aid contracts.
Dithan Kiragga, executive director of the Baylor College of Medicine Children's Foundation, a non-governmental group that supports Ebola surveillance in Uganda, told The Associated Press on Friday (February 28, 2025) that his group had stopped its work supporting local health authorities in screening traveling passengers after the termination of its contract with USAID. The five-year contract, signed in 2022 and worth $27 million, employed 85 full-time staff who were employed in a range of public health activities, Dr. Kiragga said.
Charles Olaro, the director of health services at Uganda's Ministry of Health, said that U.S. Aid cuts hurt the work of some non-governmental groups supporting the response to infectious diseases.
"There are challenges, but we need to adjust to the new reality," Dr. Olaro said, speaking of the loss of U.S. Funding.
Ebola, which is spread by contact with the bodily fluids of an infected person or contaminated materials, manifests as a deadly hemorrhagic fever. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding.
Scientists suspect the first person infected with Ebola in an outbreak acquired the virus through contact with an infected animal or eating its raw meat.
Uganda's last outbreak, discovered in September 2022, killed at least 55 people before it was declared over in January 2023.
Ebola in Uganda is the latest in a trend of outbreaks of viral hemorrhagic fevers in the east African region. Tanzania declared an outbreak of the Ebola-like Marburg disease in January, and in December, Rwanda announced its own outbreak of Marburg was over.
Uganda has had multiple Ebola outbreaks, including one in 2000 that killed hundreds. The 2014-16 Ebola outbreak in West Africa killed more than 11,000 people, the disease's largest death toll.
Ebola was discovered in 1976 in simultaneous outbreaks in South Sudan and Congo, where it occurred in a village near the Ebola River, after which the disease is named.
Published - March 02, 2025 09:15 am IST
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