On April 24, a nurse in the Democratic Republic of the Congo’s Ituri province fell ill. The illness was confirmed as Ebola — a rare strain called Bundibugyo with no licensed vaccine or therapeutic and a 20-40% case fatality rate — three weeks later. By then, the virus had reached Kinshasa, and Goma, a city under rebel control; more than 90 people were dead. On May 17, WHO declared it a public health emergency of international concern. The lag traces to a banal cause. The regional laboratory at the provincial capital was calibrated only for the Zaire strain that has caused every previous Congolese outbreak; so, samples had to travel 1,500 km to Kinshasa for confirmation. To be sure, this outbreak — by most expert assessments — is not the makings of a pandemic. Ebola transmits when patients are symptomatic, unlike the silently spreading coronavirus of 2020. But since that year, political, social and institutional changes have eroded the redundancies on which any real response would depend.
The US, hitherto key to multilateral health spending, completed its withdrawal from WHO in January, terminating funding that underwrote a fifth of the agency’s emergency-response work. WHO is shedding roughly a quarter of its workforce by mid-year. Pandemic preparedness, until recently a bipartisan baseline, has become a partisan project — the US health secretary has spent his career questioning vaccines. The erosion of trust in public health expertise is such that measles — once eradicated by vaccines in the developed world — has made a comeback.
Six years after Covid, the framework of pandemic preparedness has been weakened. While Ebola is unlikely to stress-test our defences just yet, the next formidable pathogen may arrive to find them already hollowed out, with no time to rebuild.
