By Craig Spencer

Dr. Spencer is an emergency doctor and a professor at Brown. He contracted Ebola in 2014 after treating patients in Guinea.

As soon as I heard about the Ebola outbreak in the Democratic Republic of Congo, I knew it was going to be catastrophic.

On Friday, the D.R.C. reported 246 suspected cases. Most Ebola outbreaks end before they get that big. The same day, reports emerged that someone had died of Ebola hundreds of miles away in Kampala, Uganda’s most populous city. Less than a week after it was first declared, this is already the third-largest Ebola outbreak in history.

I’ve seen Ebola up close. I got it while treating patients in West Africa in 2014. I know how destructive the disease can be — and how unprepared we are for its return.

After the 2014 outbreak, which killed over 11,000 people, the world strengthened systems to catch and contain Ebola outbreaks early. Much of that infrastructure — surveillance networks, rapid response teams and diplomatic partnerships — has been dismantled over the past year, as the United States abdicated its longstanding role as a leader in global health and humanitarian response.

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If the outbreak were caused by the more common Zaire strain of Ebola, we’d now be able to provide a recently developed vaccine to family members of infected patients and to health care workers. But we have no effective treatments or vaccines for the rare Bundibugyo strain of Ebola driving the current outbreak.

We’ll need to rely on bread-and-butter outbreak response measures, like contact tracing, isolation and community support. These are hard to carry out under ideal conditions. And the eastern part of Congo, where this outbreak is concentrated, is anything but ideal. Armed conflict has forced millions from their homes and left many health facilities damaged or destroyed. An Ebola outbreak in the region in 2018 took nearly two years to contain.

This time around, we have far less capacity to respond. In the first weeks of the second Trump administration, Elon Musk gleefully boasted about feeding the United States Agency for International Development into a “wood chipper.” The dismantling of U.S. foreign aid left clinics, community health workers and humanitarian organizations that formed the backbone of health care across eastern Congo without crucial funding.