How foreign aid cuts are setting the stage for future outbreaks

Comes at a time of worsening crises globally

By Apoorva Mandavilli | March 10th, 2025, 2:41 AM

Dangerous pathogens left unsecured at labs across Africa. Halted inspections for mpox, Ebola, and other infections at airports and other checkpoints. Millions of unscreened animals shipped across borders.

The Trump administration’s pause on foreign aid has hobbled programs that prevent and snuff out outbreaks around the world, scientists say, leaving people everywhere more vulnerable to threatening viruses and bacteria.

That includes Americans. Outbreaks that begin overseas can travel quickly: The coronavirus may have first appeared in China, for example, but it soon appeared everywhere, including the United States. When polio or dengue appears in this country, cases are usually linked to international travel.

“It’s actually in the interest of American people to keep diseases down,’’ said Dr. Githinji Gitahi, who heads Amref Health Africa, a large nonprofit that relies on the United States for about 25 percent of its funding.

“Diseases make their way to the United States even when we have our best people on it, and now we are not putting our best people on it,’’ he added.

In interviews, more than 30 current and former officials of the US Agency for International Development, members of health organizations, and experts in infectious diseases described a world made more perilous than it was just a few weeks ago.

Many spoke on the condition of anonymity for fear of retaliation by the federal government.

The timing is dire: Congo is experiencing the deadliest mpox outbreak in history, with cases exploding in a dozen other African countries.

The United States is home to a worsening bird flu crisis. Multiple hemorrhagic fever viruses are smoldering: Ebola in Uganda, Marburg in Tanzania, and Lassa in Nigeria and Sierra Leone.

In 2023, USAID invested about $900 million to fund labs and emergency-response preparedness in more than 30 countries. The pause on foreign aid froze those programs. Even payments to grantees for work already completed are being sorted out in the courts.

Waivers issued by the State Department were intended to allow some work to continue on containing Ebola, Marburg, and mpox, as well as preparedness for bird flu.

But Trump administration appointees choked payment systems and created obstacles to implementing the waivers, according to a USAID memo by Nicholas Enrich, who was the agency’s acting assistant administrator for global health until Sunday.

Then last month, the Trump administration canceled about 5,800 contracts, effectively shuttering most USAID-funded initiatives, including many that had received permission to continue.

“It was finally clear that we were not going to be implementing’’ even programs that had waivers, Enrich recalled.

The decision is likely to result in more than 28,000 new cases of infectious diseases such as Ebola and Marburg, and 200,000 cases of paralytic polio each year, according to one estimate.