The Trump administration’s response to the Ebola outbreak in the Democratic Republic of Congo doesn’t appear to be following the playbook used in previous outbreaks, and it’s sounding alarm bells among biosecurity experts.
Current and former leaders of the U.S.’s infectious disease response apparatus are warning that they’re not seeing the level of coordination between federal agencies that’s needed to successfully respond to such outbreaks abroad.
“The conversations are happening,” said John Lowe, who co-leads the system of medical facilities in the U.S. equipped to respond to dangerous pathogens like Ebola. “It’s just the level of structure and organization to them don’t appear to be there.”
Paul Friedrichs, the former director of the White House Office of Pandemic Preparedness and Response Policy, said the Trump administration’s cuts to the OPPR and the National Security Council have left the White House without anyone who can lead an outbreak response.
“We need to be very clear-eyed that the ability to control this and contain it regionally is diminished,” said Friedrichs, who was also a member of the NSC’s biosecurity team before being tapped to serve as the inaugural leader of the OPPR from 2023 to 2025.
“That increases the risk of someone getting on a plane and bringing it to the United States, showing up in an unsuspecting emergency room and then having the same hell break loose that we saw during the last time when an Ebola-infected patient arrived in the United States,” Friedrichs added.
The Trump administration fired most of the OPPR’s employees and the NSC’s biosecurity staff earlier this year. Its appointee to take over for Friedrichs and head the OPPR, Gerald Parker, resigned in July. No new leader has been appointed to the office. Normally, the NSC and the OPPR would be leading the federal response to an outbreak like the current one in Congo.
The ongoing outbreak in Congo has caused 38 confirmed cases and 31 deaths since it was declared earlier this month, the World Health Organization said on Thursday. In response, the Centers for Disease Control and Prevention has issued a level one travel notice for Congo, which recommends travelers “practice usual precautions” like watching for symptoms and not traveling if they appear, as well as a bulletin on the CDC Health Alert Network.
In response to questions about the steps the federal government is taking to respond to the outbreak, a senior Trump administration official told NOTUS that “the U.S. government is working with the Government of the DRC to rapidly contain the virus to keep Americans safe, both at home and abroad. U.S. government staff are working side by side with public health officials from the DRC in their emergency operations center and are working directly with the Government of the DRC to assess and identify evolving needs.”
They declined to specify who in the White House or the federal government is currently working on the response and did not elaborate on what actions the U.S. is considering taking in Congo or the U.S.
The Department of Health and Human Services and the CDC did not respond to requests for comment on what other steps, if any, they have taken to respond to the Ebola outbreak in Congo.
Lowe said the organization he co-leads, the National Emerging Special Pathogens Training and Education Center, has been in regular communication with the CDC, particularly the Administration for Strategic Preparedness and Response — but that more is needed on a federal level for the U.S. to be fully prepared.
The outbreak in Congo “does appear to be an outbreak that is going to require an international response to help manage it,” Lowe said.
He said he and other NETEC leaders were in Washington, D.C., this week to meet with congressional staff about the importance of the National Special Pathogen System, which comprises over a dozen Special Pathogen Treatment Centers located in hospitals scattered across the country.
While these treatment centers are included in the president’s 2026 budget, that funding has yet to be made available. The funding for the network runs out at the end of September — and it’s unclear for how long the centers will be able to treat patients without it, Friedrichs said.
NOTUS reached out to all of the SPTCs to ask if they have received any indication of their funding status from the federal government. Several responded saying they have contingency funding should the government not pass a new budget by the end of the month.
“We have submitted a grant renewal application and are hoping to hear soon,” said a spokesperson for Denver Health, which serves as a regional resource hub for SPTCs.
Some of those grants were approved Thursday, Lowe said.
Friedrichs said other steps the federal government would normally take at this point would include deploying a team from the CDC to Congo to put “eyes on the ground”; the Department of State ensuring that its patient movement capability is ready to transport an infected American back to the U.S. for treatment (especially since American mining companies are currently present in Congo); and HHS reaching out to the pharmaceutical companies that manufacture the Ebola vaccine to ensure a supply is ready should it be necessary.
“This is the level of work that needs to be done before someone gets infected or exposed, and the ambassador’s calling back saying, ‘I’ve got an American who’s sick. What’s the plan?’” Friedrichs said.
A spokesperson for the State Department said via email, “The U.S. Department of State has no higher priority than the safety and security of U.S. citizens,” reiterated the CDC’s travel notice and added that the U.S. embassy in Congo has issued a health alert.
They also noted that the State Department has issued travel advisories for Congo due to “crime, civil unrest, armed conflict, and kidnapping.”
“We will continue to provide information to U.S. citizens in the area through [the Smart Traveler Enrollment Program], our embassy website, and travel.state.gov,” the spokesperson wrote.
Lowe said the federal agencies NETEC normally partners with are working with them to mount a response, but that it’s been noticeably slower than during previous outbreaks.
He said that some of the federal government’s delay could be due to the chaos that followed the Trump administration’s dismissal of former CDC Director Susan Monarez. Monarez testified this week she was fired because she refused to carry out orders from Health Secretary Robert F. Kennedy Jr. that were “inconsistent with my oath of office and ethics of a public health official.”
Several high-level CDC officials, including the director of the National Center for Immunization and Respiratory Diseases, Demetre Daskalakis, resigned after Monarez was fired.
“Demetre is usually right in the middle of all that,” Lowe said. “We would typically see a lead for the international piece, and then we would also see a lead for the domestic coordination.”
In the past, the U.S. has also partnered with the World Health Organization and the Africa Centers for Disease Control and Prevention during outbreaks of Ebola or other severe illnesses and high death rates. President Donald Trump withdrew the U.S. from the WHO in January, saying it “ripped us off.”
The U.S. would usually donate vaccines to help stop the spread of the virus, according to Lawrence Gostin, a professor of global health law at Georgetown University.
The WHO announced this week that distribution of Ebola vaccine doses — 400 of the 2000 in Congo’s national stockpile — had begun. It did not respond to a request for comment on whether the U.S. was coordinating at all or providing any vaccinations.
“Once the outbreak spreads to other parts of the DRC and the region, it will be much harder to curb,” Gostin said in an email to NOTUS. “I would expect to see the CDC take a leadership role on the ground as it has for all other Ebola outbreaks in the continent.”
The CDC’s website states that the agency has had an office in Congo since 2002, but doesn’t specify how many staff remain at the office or how they are responding to the outbreak.
The largest Ebola outbreak ever was in 2014. Over 11,000 people died in Guinea, Liberia and Sierra Leone. There were four cases in the U.S. that year and one death.
“Do I think this Ebola outbreak in a very remote area of DRC is going to be the one that imperils the United States? I think it’s a low likelihood,” said Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health. “Does the fact that the actions that we usually take are not happening a glaring warning sign for how we would be able to respond to future bio threats? Absolutely.”
Friedrichs said he knows the Trump administration has the playbook on how to deal with an infectious disease outbreak like the one occurring right now — he personally brought a copy of it to a tabletop exercise that took place the week before Trump’s inauguration in January that included the incoming members of Trump’s Cabinet.
The only problem?
“The only person on the Cabinet who didn’t show up for that exercise was RFK Jr.,” Friedrichs said. “Every other Cabinet member was there.”