The Dictatorship
Ebola outbreaks are always challenging. The Trump administration made the job harder.
News recently broke that the United States is building a quarantine and treatment center in Kenya to send U.S. healthcare workers to, rather than bring them back to the U.S. treatment centers that have been used successfully in prior outbreaks. The U.S. government also issued travel bans to deny entry to individuals who were recently in the Democratic Republic of Congo, Uganda or South Sudan despite objections from the African Centers for Disease Control and Prevention and the World Health Organization that travel bans are an ineffective response.
“We cannot and will not allow any cases of Ebola to enter the United States,” affirmed Secretary of State Marco Rubio.
This makes no sense.
The current Ebola outbreak — more specifically, the Bundibugyo species of the virus — is a callback to the 2013-2016 epidemic in West Africa. Both outbreaks were unexpected, though in different ways. Prior to 2013, the affected West African countries (Guinea, Sierra Leone, and Liberia) had never seen an Ebola outbreak. By the time the epidemic came to global attention, the virus had been circulating for months.
Ebola is a deadly infection, but not a highly contagious one.
Like the West African outbreak, recognition of the current epidemic in the Congo was delayed at least 3 weeks (we are still unsure when the first case occurred). It also spread unrecognized into a neighboring country — in this case, Uganda. While the Congo is a veteran of 16 prior Ebola outbreaks and is generally very quick to recognize them, the uncommon Bundibugyo virus has only surfaced twice before — in the Congo in 2012 and in Uganda in 2007. The location of the outbreak was expected, but the virus species was not.
Several American medical charities were already established in this area, and at least two physicians have been exposed to the virus. But even before the outbreak began, the Trump administration’s response was hamstrung.
In February 2025, Elon Musk admitted the Department of Government Efficiency had accidentally canceled Ebola prevention. He said it was restored “immediately,” but government documents show otherwise. STAT News reported that foreign aid from the Department of Health and Human Services to the Congo in fiscal 2025 dropped to a third of what was provided in 2024. In the same period, funding from the U.S. Agency for Intentional Development was cut from $1.2 billion to $715 million. In the first three months of fiscal 2026, USAID sent just $67 million. And the Trump administration’s withdrawal from WHO in 2025 reduced the organization’s funding, further hobbling efforts in the area and leaving the U.S. on the sidelines.
Because of this, testing capacity was limited from the start. Most tests on hand were for other Ebola virus species, not Bundibugyo. Initial negative tests slowed recognition of the outbreak and have continued to make accurate diagnoses — necessary for isolation, quarantine and contact tracing — challenging.
These cuts “have left the region dangerously exposed”, International Rescue Committee DRC Director Heather Reoch Kerr said in a statement last week. According to Kerr, many areas lack adequate frontline support and basic personal protective equipment (like gloves, gowns, masks, eye goggles and shoe covers) meant to shield healthcare workers from viral exposure. She warned that inadequate surveillance means “the true scale of transmission may be significantly higher than current figures suggest” in an outbreak that already has the fastest growth on record.
The refusal to repatriate exposed patients may understandably deter recruitment of medical personnel willing to travel to the affected countries.
Earlier this month, two American physicians, Peter Stafford and Patrick LaRochelle, were exposed to the virus. For LaRochelle, it was his second medical evacuation due to working Ebola outbreaks. The first time, in 2018, he was evacuated to the U.S. This time, LaRochelle and Stafford were instead sent to the Czech Republic and Germany, respectively. LaRochelle is again being monitored, while Stafford is receiving treatment for a confirmed infection.
Donald Trump was president the first time LaRochelle was evacuated. Prior to entering the Oval Office, Trump posted 95 times about the West African Ebola crisis. In a post on Aug. 1, 2014, he wrote“The U.S. cannot allow EBOLA infected people back. People that go to far away places to help out are great-but must suffer the consequences!” The next day, he added“The fact that we are taking the Ebola patients, while others from the area are fleeing to the United States, is absolutely CRAZY—Stupid pols.” Hours earlier, he had posted“The U.S. must immediately stop all flights from EBOLA infected countries or the plague will start and spread inside our ‘borders.’ Act fast!”
These entreaties were absurd in 2014, but in 2026, in Trump’s second term, they are national policy. And they are just as wrong now as they were 12 years ago.
Ebola is a deadly infection, but not a highly contagious one. Viral transmission requires close contact with blood and other body fluids when the patient is showing symptoms of disease and feeling ill. In 2014, the U.S. had no viral transmission within specialized facilities that treated Ebola patients. The single transmission event occurred at a Dallas hospital, where two nurses unknowingly treated an Ebola patient. This sparked national outrage when an exposed nurse flew across the country during her incubation period — and ended up visiting my universityfrom which she had graduated.
Frantic news reporters interviewed employees at every stop the nurse made during her weekend travels in Ohio. Her parents voluntarily quarantined in their home under police guardand health authorities kept tabs on other close contacts. Not a single person developed Ebola. The nurse did not begin to feel ill until she arrived back home in Texas, at which point she was transferred to Emory University for treatment in their Special Communicable Diseases Unit. There was no significant “spread inside our borders,” as Trump prophesied.
Current healthcare workers treating patients in central Africa will have no guarantees of the specialized treatment Americans previously received at Emory and other U.S. locations. The refusal to repatriate exposed patients may understandably deter recruitment of medical personnel willing to travel to the affected countries, as many will be reluctant to “suffer the consequences” of their humanitarian efforts.
This may be the administration’s biggest own goal to date. As Rubio, then a senator, accurately argued in 2014the key to Ebola response is containing the outbreak at the source. This requires a surge of personnel who are willing to put their lives at risk to help others. Our government previously viewed such volunteerism as part of a social contract that included top-notch care back home if the worst happened and those medical personnel contracted the virus. That pact has been broken in lieu of a medical center that is not yet built or staffed in Kenya. Many locals oppose it (and a Kenyan judge has even temporarily suspended the facility’s operations). Recruiting adequate staff will be significantly more challenging.
Responses to Ebola outbreaks are never easy. They require coordination among many countries, nongovernmental organizations and community leaders. They often face challenging local conditions, including conflicts, distrust of Western medical personnel and general skepticism and inaccurate information about Ebola among affected populations. We need more funding and personnel available to assist the agencies already on the ground, and to follow protocols that have worked to end prior epidemics rather than change the game as it’s in progress. In 2014, Rubio called Ebola workers “heroes.” He was right then, and the Trump administration should treat them that way now. Otherwise, they are taking a grave risk with an already dangerous outbreak.
Tara C. Smith is a professor of epidemiology at Kent State University’s School of Public Health. Before that, she spent nine years in the Department of Epidemiology at the University of Iowa College of Public Health, where she directed the college’s Center for Emerging Infectious Diseases.