Ebola Breaks Out in Uganda as US Halts Foreign Aid

By Nakisanze Segawa, GPJ Uganda

KAMPALA, UGANDA — One nurse died from the Sudan Ebola virus in Uganda on Jan. 29. Two more cases were confirmed days later — and hundreds of people were direct contacts. The virus spreads fast, and it’s deadly: The Sudan strain’s fatality rate ranged from 40% to 100% in past outbreaks, and there are no approved vaccines.

Now, the United States Agency for International Development, a key partner in treating Ebola and slowing its spread, has stopped all funding for global health and all of its other projects.

Last time there was an outbreak, in 2022 and 2023, Uganda ended it in record time – just 69 days, according to the World Health Organization.

“That had never happened before,” says Edith, a public health specialist in Uganda who worked on the previous outbreak. She asked that only her first name be used because she’s not authorized to speak with the press. “But now I wonder if the rapid response teams are being offered all the necessary finances they need to restrain the spread at such a vital moment.”

The Ugandan government says citizens shouldn’t panic.

“I just want to assure you that with or without the current freeze we are going to work within our means,” says Diana Atwine, the permanent secretary for Uganda’s Ministry of Health. “We have … everything at our disposal to handle the situation.”

The apparent closure of USAID came after a Jan. 20 executive order from newly-inaugurated US President Donald Trump. The order mandated a 90-day pause on all foreign development assistance programs, but it’s not clear whether those programs will resume afterward. Within the directive was an immediate stop-work order for all US-funded international development activities, including all health programs. This week, the USAID headquarters in Washington, DC, were abruptly closed. The USAID website, and all the data it once shared, is down.

The most recent of multiple Ebola outbreaks in Uganda was declared in September 2022, and the US provided more than 22.3 million United States dollars to support the Ugandan government’s response. USAID paid for contact tracing, the distribution of protective equipment, safe burials, rapid response and more. It also provided resources to the World Health Organization, UNICEF and other organizations that managed the emergency response. By the time it ended, in January 2023, 77 people had died, according to World Health Organization data.

All told, USAID’s 2024 budget for infectious-disease detection and response was 745 million dollars, and the US has helped respond to 11 outbreaks of Ebola and other hemorrhagic fevers since 2020.

With those funds withdrawn, it’s unlikely that Uganda will be able to contain the outbreak, says Lawrence Gostin, a law professor at Georgetown University and director of the WHO Collaborating Center for National and Global Health Law.

An end to US efforts to do contact tracing and surveillance could be catastrophic on a global scale.

“Ebola could be spreading silently in an African country and we would be too late in recognizing it,” Gostin says. “By the time we identified the outbreak it could have spread widely, including Europe and the US.”

And the US, Gostin says, would be “utterly unprepared” for an outbreak.

Following Trump’s order, the monitoring of bird flu has stopped in 49 countries; all mpox and HIV testing has stopped in Sierra Leone; and USAID is no longer tracking the Marburg virus outbreak in Tanzania.

In Uganda, Atwine says, the health ministry has dispatched rapid response teams to areas with known infections. The country has also launched the world’s first Ebola vaccine, together with the World Health Organization, she adds. There are 2,100 doses ready for trial.

To accelerate early action in response to the outbreak, the World Health Organization has allocated 1 million dollars — far less than the 27 million dollars the WHO channeled toward the crisis in 2022.

Some Ugandan residents aren’t convinced that the country can manage the outbreak.

For years, the government has failed to distribute even the amounts allocated by the government to the country’s budget to health care services, says Byansi John, a resident in Wakiso district, one of the areas on alert.

Byansi also says that USAID’s closure should be a wake-up call for a country that he says suffers from white-savior syndrome.

“The Trump era should teach us to learn that we can’t always rely on foreign aid to tackle our health challenges and even all other sectors,” he says. “Americans don’t owe us anything. It’s high time to strengthen our systems and make our leaders accountable when they don’t deliver, so we get the good services we need.”

Story by Nakisanze Segawa is a Global Press Journal reporter based in Kampala, Uganda.

This story was originally published by Global Press Journal an award-winning international news publication with more than 40 independent newsrooms in Africa, Asia and Latin America.