I Blew the Whistle on DOGE’s Dismantling of USAID. Now the Dire Consequences I Predicted Are Becoming Reality.

The Ebola Outbreak is just the most visible problem

By Nicholas Enrich

Boston Globe

June 12, 2026, 3:00 a.m.

Nicholas Enrich is the former top global health official at USAID and the author of “Into the Wood Chipper: A Whistleblower’s Account of How the Trump Administration Shredded USAID.”

Just a few weeks since it was first detected, the Ebola outbreak in the Democratic Republic of the Congo (DRC) is already on pace to become the deadliest Ebola outbreak ever.

It is no coincidence that we’re seeing such a calamity just a year after the United States relinquished its leadership position in global health. This is exactly the kind of public health emergency I predicted in a whistleblower memo I released last year as the Trump administration recklessly dismantled the US Agency for International Development (USAID). My warning was not heeded; instead, I was removed from my position as USAID’s top global health official.

This outbreak was always going to be a tough one to contain. Centered in an urban conflict zone with a large migrant community within range of the borders of three countries, the rare Bundibugyo strain is both difficult to detect and has no proven vaccine or treatment. But the retreat of the United States from the global health stage has exacerbated the challenges at every turn.

This Ebola outbreak took far longer to identify than other recent ones. The virus had circulated undetected for several weeks, maybe even months, and the shockingly high initially reported numbers — over 200 suspected cases, over 60 suspected deaths — were the first indication the outbreak was already out of control. When the Trump administration and Elon Musk’s Department of Government Efficiency dismantled USAID in 2025, the programs that were aimed at rapid detection of outbreaks like this one were abruptly shuttered. All the investments USAID had made in training community health workers, bolstering surveillance, and strengthening diagnostic networks to help countries identify and respond to infectious disease threats before they became international crises were undone.

Workers from the Uganda Red Cross Society evacuated the body of a suspected Ebola victim in Kampala last month. The outbreak is affecting Uganda as well as the Democratic Republic of the Congo.

Once the outbreak was detected, as local and regional authorities mobilized to contain the spread, international response efforts were upended by the chainsaw the Trump administration has taken to the once-unparalleled American infrastructure for global health. The US withdrawal from the World Health Organization not only fractured international coordination to respond to Ebola but resulted in the United States not even learning of the outbreak until nine days after it was reported to the WHO on May 5. By then it was already too late to interrupt transmission at its source: The outbreak had spread to multiple urban centers in the DRC, and the virus had already slipped across the border into Uganda.

Under these circumstances, an immediate influx of resources in support of local response efforts was urgently needed to make up for lost time. But again the United States failed to deliver. USAID had a playbook for such a response. But in the wake of the destruction of USAID — 170 global outbreak experts disbanded, contracts with local partners shredded, thousands of community health workers forsaken — the US government struggled to reinvent the playbook within the State Department, an agency with no experience in responding to an Ebola outbreak, resulting in confusion and delays. Decisions that need to be made in hours now take days or even weeks at a moment when losing time means losing lives and facilitating the uncontrolled spread of the virus.

A local activist, dressed in protective equipment, tried to raise awareness about Ebola in Goma last month.

Blowing the whistle

As the top global health official at USAID when the agency was shredded, I have not been surprised by the disjointed and inadequate American response to this deadly outbreak. The seeds of this catastrophe were sown in a federal office building in Washington, D.C., more than a year ago. In the first chaotic weeks of the Trump administration, I witnessed firsthand the ignorance, indifference, and cruelty of DOGE and Trump’s political appointees as they tore apart USAID’s health programs in the midst of the previous Ebola outbreak.

I watched in shock as Trump’s team scoffed at and ignored the warnings of infectious disease experts, choking off our desperate attempts to respond to that outbreak in Uganda. They prevented us from conducting screening at airports to ensure passengers did not have symptoms of Ebola before boarding international flights. They refused to deliver thousands of sets of personal protective equipment (which American taxpayers had already paid for) intended for health care workers on the front lines of the outbreak. They put Ebola experts on administrative leave, locking them out of USAID’s email server and systems. How did the administration justify its failure to respond? Tim Meisburger, Trump’s appointee in charge of humanitarian assistance, put it bluntly: “Ebola is a scam.”

A child returning from school stopped to look at Ebola awareness illustrations in Munigi this month.

At a White House Cabinet meeting in late February 2025, Elon Musk blatantly lied to the American public, stating that he had “restored Ebola prevention immediately, and there was no interruption.” As he spoke, his DOGE team was terminating the very contracts needed to respond to the outbreak. That was the last straw for me. I decided to expose, in a series of memos, what was actually happening at USAID and how the systematic destruction of our global health programs would inflict suffering around the world on a massive scale and threaten the health and safety of Americans.

The destruction at USAID was not limited to its response to Ebola. The entire agency — which is credited with saving 92 million lives over the past two decades on less than 1 percent of the federal budget — was, as Musk gloated, fed “into the wood chipper.” I watched DOGE shred all our lifesaving health programs — work that spanned HIV, tuberculosis, malaria, maternal and child health, nutrition, family planning, and pandemic preparedness. As my final official act as a civil servant, I compiled the risks of the cuts across all our programs, and the projected cumulative devastation was overwhelming.

Reflecting modeling and analysis compiled by technical experts across USAID’s health programs, my memos predicted dire consequences. The estimates indicated that up to 2.6 million additional people could die unnecessarily each year due to the cuts to USAID. That included as many as 28,000 cases of viral hemorrhagic fever, like Ebola. But Ebola would only cause a tiny fraction of the impact. The modeling projected, for example, an additional 166,000 deaths each year from malaria and a 30 percent annual increase in tuberculosis, the world’s leading infectious disease killer, which claimed the lives of over a million people each year before the cuts. Nor would the damage be limited to infectious diseases. The cuts would have an outsize impact on maternal and child health, with 16 million pregnant women not receiving services like essential medications and services for postpartum hemorrhaging and eclampsia; 11 million newborn babies not receiving critical postnatal care within two days of their birth; nearly 15 million sick children not receiving treatment for pneumonia and diarrhea, two of the top causes of preventable death in children under age 5; 3 million people with HIV losing access to their lifesaving treatment; and 1 million children not treated for severe acute malnutrition.

One of my memos concluded that the cuts to USAID “will lead to increased death and disability, accelerate global disease spread, contribute to destabilizing fragile regions, and heightened security risks — directly endangering American national security, economic stability, and public health.” Issuing the warning cost me my job — the same day I published the memo, I was pushed to administrative leave, ending my 15-year career in federal service.

Ebola is just the tip of the iceberg

Now, a year later, the devastation has unfolded largely as I predicted. Today the horrors of Ebola capture global health headlines. But the ongoing outbreak in the DRC is unfortunately only the tip of the iceberg. Beneath the surface lies far broader, though less reported, wreckage caused by the dismantling of USAID in combination with the US withdrawal from the WHO, the gutting of the Centers for Disease Control and Prevention and the National Institutes of Health — including the decimation of the Vaccine Research Center responsible for discovering Ebola vaccines — and deep cuts to health research at leading American scientific institutions.

The impacts of the cuts were immediate and tragic. Health clinics and emergency ambulance services shuttered overnight. Clinical trials were deserted. Thousands of health care workers lost their jobs. Lifesaving food and medicine was left to expire in warehouses. According to conservative estimates, in the year since USAID was dismantled, 750,000 people have died as a result of the cuts. For the first time in a generation, more children died in one year — 2025 — than in the previous year.

Catastrophic though the last year has been for global health, the longer term outlook is even worse. Destroying USAID ended its unprecedented global immunization campaign that protected millions of children from some of the world’s deadliest preventable diseases. Testing and diagnosis rates for HIV and tuberculosis are plummeting as decades of progress toward controlling the world’s top infectious disease killers is erased. Independent researchers estimate that up to an additional 14 million people may perish over the next five years, people who would have survived if USAID programs remained.

Americans should be particularly concerned by how much ground has been lost on pandemic preparedness in the past year. Over the past decade, and especially since the Covid pandemic, the United States invested hundreds of millions of dollars in developing a global early warning system to ensure that countries are prepared to detect and respond to emerging disease outbreaks before they can spread into more serious crises. And then the Trump administration abruptly abandoned these efforts — in an instant setting us back years in pandemic preparedness. Today, despite all our investments, we are now less prepared for the next pandemic threat than we were before Covid.

Not too late

Despite all the setbacks, it is not too late to act. The immediate need is to commit the personnel and resources to forcefully respond to the current Ebola outbreak. That means reengaging with the local, regional, and international partners we ghosted last year and reestablishing American leadership and coordination in the international outbreak response. The administration should immediately reverse course on the State Department’s ineffective policy of banning travel to the United States from affected countries (including even travel by American citizens exposed to Ebola) — a shortsighted attempt to keep the virus outside our borders. The moves are counterproductive — complicating delivery logistics for critical supplies, dissuading experts from joining the response, and discouraging the reporting of cases in new areas — and only serve to stoke division at a time when global coordination is critical.

Ultimately, this Ebola outbreak should serve as a wake-up call for the administration to begin reinvesting in the systems and expertise required to advance global health and effectively detect and respond to the next pandemic threat. That means filling key government positions that currently sit unoccupied — the US ambassador to the DRC and the directors of the CDC, the National Institute of Allergy and Infectious Diseases, and Global Health Security and Biodefense in the National Security Council, to name just a few. It means recognizing that global coordination is critical to preparedness and reengaging with the WHO. And it means collecting and analyzing data on the effects of the global health cuts to understand the full extent of the destruction — informing evidence-based assessments of what needs to be prioritized for reinvestment.

The Trump administration has backtracked on bad policy before, and faced with sharp enough opposition, it can be forced to reverse course again.

The Ebola outbreak may be the most vivid reminder of the consequences of America’s having walked away from its longstanding role as a leader in global health. But it is only the most easily recognizable symptom of the damage the administration’s cuts have wrought on global health. The broader deadly impacts — increases in maternal and child mortality, backsliding on decades of progress combating HIV, tuberculosis, and malaria, and renewed vulnerability to emerging pandemic threats — are already occurring, even as the public remains largely unaware.