Dangerous Pathogens, Unsecured Labs, and the Global Health Crisis
The Trump administration’s pause on foreign aid has set off alarm bells across the global health community, as critical programs aimed at preventing and controlling infectious disease outbreaks have ground to a halt. Scientists warn that this decision has left the world more vulnerable to dangerous pathogens, with potentially catastrophic consequences—not just for Africa, where many of these programs were in operation, but for every country, including the United States. The coronavirus pandemic served as a stark reminder of how quickly outbreaks can spread globally, and experts fear that without continued investment in global health security, the next major pandemic could be just around the corner. Dr. Githinji Gitahi, head of Amref Health Africa, emphasizes that “it’s actually in the interest of the American people to keep diseases down,” as infections do not respect borders. Yet, the U.S. has now pulled back from its role in funding and supporting these efforts, leaving a gaping hole in global health infrastructure.
The situation on the ground is dire. In Africa, labs are being left unsecured, and dangerous pathogens—some of which could be weaponized—are being stored without adequate oversight. Inspections for diseases like mpox (formerly known as monkeypox), Ebola, and other infections at airports and border checkpoints have been halted, and millions of unscreened animals are being shipped across borders, increasing the risk of disease transmission. The Democratic Republic of Congo is currently experiencing the deadliest mpox outbreak in history, with cases now spreading to a dozen other African countries. Meanwhile, the U.S. is grappling with its own crises, such as a worsening bird flu outbreak, and other countries like Uganda, Tanzania, and Nigeria are battling deadly hemorrhagic fevers such as Ebola, Marburg, and Lassa. The timing of the aid pause couldn’t be worse.
The Fallout of the Foreign Aid Pause
The Trump administration’s decision to freeze foreign aid has had immediate and far-reaching consequences. In 2023, U.S.A.I.D. invested nearly $900 million in labs and emergency-response preparedness across more than 30 countries. These programs were designed to help countries detect, respond to, and prevent outbreaks before they spiraled out of control. But with the aid freeze, these initiatives have been brought to a standstill. Even payments to grantees for work already completed are mired in legal disputes. While waivers were issued to allow some work to continue on containing Ebola, Marburg, mpox, and bird flu, Trump administration appointees reportedly interfered with payment systems and implemented obstacles to implementing these waivers. The result? About 5,800 contracts were canceled, effectively shuttering most U.S.A.I.D.-funded programs, including those that had been granted permission to continue.
The impact of these cuts is not just financial; it’s human. U.S.A.I.D. had more than 50 dedicated staff members working on outbreak responses, a number that has now been reduced to just six. Among those let go were leading experts in lab diagnostics and the manager of the Ebola response. “I have no idea how six people are going to run four outbreak responses,” lamented one official who was terminated. Additionally, hundreds of thousands of community health workers in Africa—many of whom were the first line of defense in detecting outbreaks—have been sent home. These workers were critical in identifying cases of diseases like Marburg in Tanzania, where a community health worker trained through a U.S.-funded program was the first to report an outbreak that eventually grew to 10 cases. Without these workers, the ability to detect and respond to outbreaks has been severely diminished.
A Global Health Security Crisis
The consequences of this aid freeze extend far beyond Africa. Experts estimate that the cuts could result in more than 28,000 new cases of infectious diseases like Ebola and Marburg annually, as well as 200,000 cases of paralytic polio each year. These numbers are a stark reminder of how quickly progress in global health can be undone. Diseases like polio, dengue, and mpox often enter the U.S. through international travel, and without robust systems in place to detect and contain outbreaks overseas, the risk of these diseases reaching American shores increases significantly. “Diseases make their way to the U.S. even when we have our best people on it, and now we are not putting our best people on it,” Dr. Gitahi warns.
The situation is made even more precarious by the U.S.’s withdrawal from the World Health Organization (W.H.O.), which has been forced to implement its own cost-cutting measures. The loss of American leadership and expertise in global health security is not only harming other countries but also undermining U.S. interests. As Dr. Keiji Fukuda, a veteran of both the W.H.O. and the C.D.C., put it, “For the life of me, I cannot see the justification or the reason for this very calculated, systematic approach to pull down public health.” The U.S. is not only depriving the world of its expertise but also isolating itself from global discussions on health security, a move that could have long-term consequences.
Trying to Adapt in a Post-Aid Landscape
Despite the challenges, some countries are attempting to adapt to the sudden loss of American funding. Nigeria’s health minister, Dr. Muhammad Ali Pate, acknowledges that “the U.S. government is not responsible, ultimately, for the health and the security of Nigerian people,” adding that “the responsibility is ours.” But many countries lack the resources and infrastructure to fill the gap left by the aid freeze. In Kenya, for example, labs in high-risk counties have run out of test kits and reagents for diseases like Rift Valley fever, yellow fever, and polio, and nearly half their staff have been lost. The country, which borders Uganda, Tanzania, and Ethiopia—all of which are battling dangerous outbreaks—has lost more than 35,000 workers due to the aid cuts. Without these workers, the risk of an outbreak slipping through undetected increases dramatically.
In other parts of the world, the impact is equally devastating. In West Africa, a U.S.-funded program that introduced rodent-proof food containers to prevent the spread of Lassa fever has shut down, leaving communities vulnerable to this deadly disease. In Thailand, a modest U.S.A.I.D.-funded project on malaria elimination has been abruptly ended, risking the loss of goodwill and surveillance capabilities. As Jui Shah, who helped run the program, explains, “In Asia, relationships are crucial for any type of work, but especially for roles that work with surveillance and patient data. Americans will suffer if other countries hesitate to engage with us about outbreaks.”
The Future of Global Health Security
The long-term implications of the aid freeze are deeply unsettling. Without continued investment in global health security, the world becomes a more dangerous place. Pathogens that were once under surveillance are now at risk of being stolen or mishandled, raising the specter of bioterrorism. Some experts worry that bad actors could release weaponized pathogens like anthrax or brucellosis, while others fear that even unskilled handling of these threats could spark a disaster. The U.S. had been at the forefront of efforts to train lab workers in Africa to safely handle and dispose of dangerous pathogens, but these programs have now been shuttered. As Kaitlin Sandhaus, founder of Global Implementation Solutions, notes, “We have lost our ability to understand where pathogens are being held,” a situation she describes as “very dangerous.”
The vacuum left by the U.S. is already being filled by other countries, such as China and Russia, which are investing in labs and health infrastructure in Africa. While these investments may seem benevolent on the surface, they often come with their own agendas and risks. China, for example, is building labs in Africa where it can “work on whatever you would like without anyone else paying attention,” according to one U.S.A.I.D. official. Russia, meanwhile, is providing mobile labs to Uganda, further complicating the already fraught landscape of global health security.
A Dangerous New Era for Global Health
The abrupt end to U.S. foreign aid for global health security has ushered in a dangerous new era. The consequences of this decision are already being felt, from the unsecured labs in Africa to the overwhelmed clinics in Congo, and from the halted inspections at airports to the silenced community health workers who once served as the world’s first line of defense. The U.S. is not only abandoning its leadership role in global health but also putting its own citizens at risk. As the world becomes more interconnected, the need for robust global health security systems has never been greater. Yet, at this critical moment, the U.S. is stepping back, leaving the world more vulnerable to the next pandemic. The question now is not if the next outbreak will occur, but when—and whether the world will be prepared to respond.