When Rwanda announced an outbreak of the highly infectious Marburg disease in September, partners from around the world, including the U.S. Agency for International Development (USAID), provided emergency funding to help curb it. Marburg kills 88% of the people who catch it, but this funding, in conjunction with efforts from the Rwandan ministry of health, rapidly contained and treated 51 of 66 cases in what was thought to have largely been a public health victory.
On the day of President Donald Trump’s inauguration, another Marburg outbreak was announced in Tanzania, where the virus has thus far killed at least eight people. Meanwhile, Ebola (a virus similar to Marburg, also with a high fatality rate) was recently detected in Uganda; public health officials are struggling to contain mpox in Africa; and H5N1, the virus commonly referred to as bird flu continues to infect an unprecedented number of people and species around the globe.
Many are concerned that the Trump Administration’s actions in the first two weeks of operation, including signaling that he would withdraw from the World Health Organization (WHO) and issuing a freeze on public health communications, are hampering the nation’s potential to respond to these various infectious disease threats at a time when protective measures need to be ramped up most.
“It’s just a sucker punch in your gut,” said Dr. Syra Madad, an infectious disease epidemiologist at NYC Health and Hospitals. “These threats are not going away — in fact, it’s the opposite. They are increasing.”
Since the U.S. helped found the WHO in 1948, its partnership with the global health agency and its member countries has helped curb countless outbreaks, including ending smallpox and bringing polio to the brink of eradication. The U.S. is the largest donor to the agency in the world.
"They’re not looking at the damage this is going to cause the United States’ credibility."
The partnership with the WHO facilitates U.S. participation in various global surveillance systems for infectious disease threats that could touch down in the country. It allows the U.S. and participating countries to share vaccine stockpiles, pool international data about infectious disease risks, and even send public health workers to countries with outbreaks to help with contract tracing and other surveillance efforts.
Withdrawing from the WHO would mean forgoing these existing networks and destroy trust that has been built up over decades of international collaborations.
“They’re not looking at the damage this is going to cause the United States’ credibility," Madad told Salon in a phone interview. "When the next administration comes around, it’s going to undermine the United States’ leadership in public health."
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In the Democratic Republic of the Congo, where another suspected Ebola outbreak was recently reported, unrelated violence erupted in the capital city of Kinshasa, motivating the U.S. to close its embassy there and remove staff, said Dr. Jennifer Nuzzo, an epidemiologist and director of the Pandemic Center at Brown University School of Public Health.
“You have a possible Ebola outbreak happening in the country at the same time you are trying to repatriate Americans,” Nuzzo told Salon in a phone interview. “To not be able to talk to the partners that may know what is going on to help assess risks and what it means for people returning … you start to see what we lose by not being able to engage.”
If the United States leaves the WHO, it could have widespread geopolitical implications. At the signing of Trump’s executive order, he said the WHO demanded “unfairly onerous payments” from the U.S. that were disproportionate compared to other participating countries like China. While Trump could be trying to leverage U.S. power to make changes at the WHO, the executive order could actually reduce the U.S.’ influence if it is fulfilled.
“You’re going to see other nations like China and maybe the E.U. kind of fill in some of these gaps,” Madad said. “The U.S. is not going to be at the table for many of these global health decisions, so it’s going to really reduce global influence around the world.”
In a Jan. 21 statement, the WHO said it hopes “the United States will reconsider,” and looks forward “to engaging in constructive dialogue to maintain the partnership between the USA and WHO, for the benefit of the health and well-being of millions of people around the globe.”
In parallel with the promise to withdraw from the WHO, the Trump Administration also froze all public health communication from agencies like the Centers for Disease Control and Prevention (CDC). In less than two weeks, important public health data has been withheld, scientific meetings have been cancelled without advanced notice, and there was a temporary blockage of research funding through the National Institutes of Health (NIH).
“The information freeze has been incredibly debilitating,” Nuzzo said. “But even if we were allowed to pick up the phone and call people, not being able to work collaboratively means that outbreaks don’t get controlled — and when outbreaks don’t get controlled, they can spill across borders and become epidemics and pandemics.”
Yesterday, Elon Musk posted on X, formerly known as Twitter, that Trump had agreed to shut down USAID after putting two top officials there on leave. Employees showed up to work and were locked out of the building.
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“All these people have gotten fired, there's confusion about what funding can be, the websites are down,” said Dr. Stephanie Psaki, the former U.S. coordinator for global health security of the National Security Council. “We're like sitting ducks.”
It is unclear whether the Trump Administration will follow through on its promise to withdraw from the WHO. No WHO member state has ever previously withdrawn from the organization, although there have been prior instances when countries signaled their intent to withdraw but ultimately resolved the situation before doing so.
If the U.S. makes history by being the first to withdraw, the country would be losing access to critical information used to monitor the spread of infectious diseases globally.
“You cannot protect yourself against pandemics as a country without understanding what's happening around the rest of the globe,” Nuzzo said. “We can't just go it alone and protect our own citizens because when new viruses are circulating elsewhere on the planet. We remain vulnerable.”
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