Suspicion was flying on Wednesday as health officials around the world tried to defend their response to the Ebola outbreak in East Africa.
First, the Africa Centers for Disease Control and Prevention faced criticism when the World Health Organization suggested that it was doing too little in reporting the outbreak. On Wednesday, reports quoted Secretary of State Marco Rubio as accusing the WHO of being late in its efforts.
In response to those reports, Tedros Adhanom Ghebreyesus, WHO director-general, said, “We are not changing the country’s work, we are only supporting it,” subtly redirecting the backlash of African health officials.
For some Africans, the suggestion that African health officials have already coordinated their response to the Ebola crisis scratched an old wound: The idea that only outsiders know best when it comes to outbreaks of deadly diseases on the continent.
Health officials in Africa say they have been fighting diseases on the continent for decades, and in some cases there has been great success. However, they say that those successes are not getting much attention around the world as African health workers face serious consequences and make life or death sacrifices, and are criticized internationally.
African health workers provided the bulk of front-line care during a series of Ebola outbreaks on the continent. More than 500 of them died in the 2014 epidemic in three West African countries alone.
Dr. Christian Happi, a professor of molecular biology and genetics at Nigeria’s Redeemer University who was born in Cameroon, recalled the outbreak of Ebola in West Africa. A Liberian-American man with symptoms arrived in Lagos and was immediately isolated at the clinic, he said.
When the man tried to free himself, the doctor who was treating him, Ameyo Stella Adadevoh, forcibly locked him up, claiming the good of the community. In the ensuing argument, the man infected him. Later he died, and he died too. But the outbreak in Lagos – the continent’s most populous city – ended within months, and Dr Adadevoh is credited with giving his life to help prevent its spread.
Thinking at that time, Dr. Happi said he feared for his life the night he isolated the virus. His laboratory in Lagos lacked proper safety equipment, he said, but if necessary, he was willing to sacrifice his life.
“It is a wrong theory when they believe that the health system in Africa is complicated,” he said in an interview, referring to other world health officials. He noted Rwanda’s success in containing the Marburg Virus outbreak in 2024 as another, recent example of effective health communication in Africa.
The WHO declared on Sunday that the Ebola outbreak was a global health emergency, but at the time the virus may have been weeks old. Early laboratory results kept coming back negative because local health officials in the Democratic Republic of Congo did not have equipment to test for Ebola Bundibugyo, the rare strain causing the current outbreak. There is no vaccine available to treat Ebola Bundibugyo.
The Trump administration disbanded the United States Agency for International Development last year, crippling the distribution of foreign aid. It also formally withdrew from the WHO in January. Many African nations rely on US foreign aid to help manage disease outbreaks, and cuts in US aid have already had a devastating impact.
On Monday, the Trump administration called for an emergency public health law to close US borders to those who have recently traveled to Congo, Uganda or South Sudan. (This restriction does not apply to US citizens or US service members.)
The African CDC said it recognizes each country’s sovereignty and the right to control travel during outbreaks of violence, but warned that normal travel restrictions and border closures are not disruptive.
“This current Ebola outbreak highlights a deep injustice in the global health establishment,” read a statement issued by the organization on Tuesday. “Many African leaders believe that if this disease were to threaten the rich regions of the world, the cures would probably already be available.”
Dr. Tedros said the number of suspected cases had risen to nearly 600, including 139 deaths, on Wednesday. Monitoring capacity in Congo’s northeastern Ituri province, the heart of the current outbreak, is still growing.
Health workers in Ituri must overcome years of mistrust due to the authorities’ failure to prevent violence and killings by local militias against civilians. In 2021, the government declared a state of siege in the area, which became martial law.
However, the Africa CDC defended its record. “Since the beginning of the current Ebola outbreak, Africa CDC has acted quickly, transparently and responsibly,” the agency said in a statement.
It also suggested that Africa is forced to face a dual situation when it comes to health emergencies. The center revealed that thousands of Africans died during the Ebola outbreak in 2014, but an effective global response was only found after an American doctor fell ill.
A doctor, Kent Brantly, a missionary, contracted Ebola in Liberia and was rushed to Emory University Hospital in Atlanta for treatment. On Monday it was announced that American doctor Peter Stafford had tested positive for Ebola in the Congo. He was flown to Germany for medical treatment.
In discussions this week, American public health experts emphasized the importance of cooperating with health authorities in countries affected by Ebola and acknowledged that foreign officials have stepped up.
Ebola care “is often seen as a global force flying in and saving Africans. But most of the people saving lives and risking their lives are Africans,” said Lina Moses, an associate professor at Tulane University School of Public Health and Tropical Medicine, who worked in Sierra Leone during the 2014 epidemic.
At the same time, pro-democracy activists in Africa have for decades lamented the failure of governments to invest in health infrastructure, which has often led them to rely on donor aid to fill the gaps.
Corruption has stolen funds intended for public health and put them in the pockets of government officials, critics say.
Africa’s dependence on foreign aid to combat disease outbreaks also speaks to broader concerns about the troubled relationship between the continent and the West, dating back to colonial times, said Yvonne Adhiambo Owuor, a Kenyan novelist.
“It’s a cultural disease,” he said. “It is always Africa that needs to be saved.”
