The Ebola outbreak in East Africa is intensifying, with confirmed cases now reported in major cities within the Democratic Republic of Congo (DRC) and Uganda, raising concerns over the region’s ability to contain the virus. Experts and frontline health workers say the response has been hampered by a notably limited role so far from the United States, which historically played a leading part in managing such outbreaks.

The current crisis centers in Ituri Province, DRC, a conflict-ridden area with high population mobility and a fragile healthcare infrastructure. The World Health Organization (WHO) reports that as of Wednesday, approximately 600 people have fallen ill, with 139 confirmed deaths, numbers that are expected to rise as contact tracing and testing expand. Infections have been identified in cities including Goma, near the Rwandan border, Bunia, and Uganda’s capital, Kampala, indicating broad geographic spread far beyond the initial cases detected in early April.

Public health specialists note that weakened U.S. engagement has contributed to delayed detection and response. The United States was informed of the outbreak nearly two weeks after the WHO, and almost a month after the first death, with initial diagnostic samples mishandled and delayed en route to the national laboratory in Kinshasa—a task previously coordinated by the U.S. Agency for International Development (USAID). Several capacities lost through the closure of USAID’s disease surveillance systems and cuts to the U.S. Centers for Disease Control and Prevention (CDC) staffing have diminished rapid response capabilities.

Heather Kerr, country director for the International Rescue Committee in Congo, described the health system as “on its knees,” citing the absence of anticipated U.S. logistical support and funding in the outbreak’s early phase. In previous Ebola outbreaks, USAID managed critical tasks such as stockpiling and rapidly deploying personal protective equipment (PPE), training health workers, and coordinating resources for safe burials, functions that have largely not been filled in this response. Doctors treating patients have reportedly worked with minimal protective gear, a situation health officials say endangers frontline workers.

Some experts emphasized that Congo’s epidemiological expertise remains strong, but assistance with logistics and supply chain management during outbreaks has been vital. WHO has delivered nearly 25 tons of medical equipment from locations across Africa; however, shipments arrived only in late May, weeks after the outbreak’s recognition. Dr. Salim Abdool Karim, chair of the Africa CDC emergency committee, highlighted that only large-scale contributors like the United States can mobilize the necessary transport and operational support swiftly at a regional scale.

The U.S. State Department disputed assertions that reduced engagement impaired the outbreak response. Spokesman Tommy Pigott described claims linking the USAID restructuring to response delays as “false,” noting the recent allocation of $23 million to Congo and Uganda for Ebola-related support, including PPE. Additional multiyear funding aimed at expanding health infrastructure was also announced, though erection of clinics may take weeks to months. Secretary of State Marco Rubio criticized the WHO for a delayed outbreak identification and pointed to the earlier U.S. withdrawal from the WHO and cuts to global health collaboration frameworks as complicating factors.

Several critical U.S. public health positions remain vacant, including the global health security coordinator role and staffing shortages at the CDC’s regional offices in Congo and Uganda. The CDC’s reduction by hundreds of employees over recent years and a pause in high-security Ebola research capacity also raise concerns about preparedness. CDC officials stated they have deployed personnel on the ground but declined to provide detailed staffing figures.

The current outbreak involves the Bundibugyo Ebola virus strain, for which there are no approved vaccines or treatments, further complicating containment efforts. Standard Ebola tests do not detect this strain, contributing to its undetected circulation before official recognition.

With the virus’s high mortality rate—up to 50 percent—and incubation period reaching three weeks, delayed detection challenges response efforts. Former USAID officials and health workers fear that without restored robust surveillance and rapid logistical support, controlling the outbreak will be a prolonged and difficult process. They also stress the necessity of rebuilding infrastructure and international cooperation to strengthen the response as cases surge across the region.