Landing at Nairobi’s Jomo Kenyatta International Airport in early June felt like arriving into a scene from a different time, specifically the COVID-19 pandemic era. Officials in full personal protective equipment—blue gowns, white masks, clear goggles—funneled the travel-weary hordes past a thermal temperature sensor to identify anyone with a fever, and we had to scan a QR code so we could be tracked for contact tracing. Two days earlier, Kenya’s high court had ordered the suspension of a plan to transport Ebola-exposed Americans from nearby countries into Kenya for quarantine at a military base; the government went ahead with the plan anyway, which fueled furious protests in which two Kenyans were killed by police. So far, Kenya has seen no reported Ebola cases, and the population would certainly like to keep it that way. As of Friday, neighboring Uganda has had 16 confirmed cases and one death. The Democratic Republic of Congo, which borders Uganda and is where the outbreak originated, has seen 363 confirmed cases and 63 deaths. Nearly everyone agrees that these numbers are probably an undercount. Things are poised to get worse.

In fact, this Ebola outbreak threatens to be the worst in history. Case numbers have shot up at an unprecedented rate. This species of Ebola, the Bundibugyo virus, is harder to detect, and there is no vaccine for it. It is hitting one of the most volatile regions of one of the world’s most fragile states. And it comes during a time of unprecedented retreat of the world’s most prosperous nations from the world’s most vulnerable—a move led by the United States and exemplified by the dismantling of the U.S. Agency for International Development last year.

The demise of USAID did not cause this Ebola outbreak. But it is a gift to Ebola. It likely delayed its detection and hampered efforts to deliver tests and treatment to the affected areas. It has broken down meticulously constructed networks of trust and generally slowed the response to the virus.

“There are things that normally we would have in place that are no longer there,” a former USAID health official based in Nairobi told me. (She requested anonymity for fear of blowback.) Agency cuts have dampened “surveillance systems, early warning systems, and just the number of healthcare workers.”

A strong, united front could have made this epidemic a manageable outbreak. Instead, it is an active and unpredictable emergency with the potential to kill thousands and destabilize a region that is both already fragile and core to many of America’s interests, from national security to economic prosperity.

The current Ebola outbreak originated in Mongbwalu, a mining town in Congo’s Ituri province. This is a region long strained by war, with armed groups battling for control over both the territory and the mines on it, where workers spend long days in the sweltering heat digging for gold. Entire economies spring up around these mines: The workers, some of whom are children, need things to eat and places to sleep; the gold needs panning and processing; women are often employed cooking, cleaning, or selling sex. Congolese mining towns tend to be porous and migrant-heavy, rough, difficult places to live in some of the country’s roughest, most difficult areas, where there is plenty of reason to distrust outsiders. Sexual violence is endemic. Some 7 million people are displaced within Congo, mostly in the eastern provinces, of which Ituri is one. Hundreds of thousands more Congolese have fled to neighboring Uganda and Burundi. Since the first Ebola case of this outbreak was confirmed less than a month ago, cases have been detected in Goma, a rebel-held Congolese city that borders Rwanda, and in Kampala, the Ugandan capital—each more than 350 miles away from Mongbwalu.

Mongbwalu is remote. But until last year, you would have found USAID workers in Goma and Kampala.

It’s hard to........

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