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Ebola is a diabolical disease. The virus, which can cause severe hemorrhaging, spreads through blood and other bodily fluids. Patients, as they grow sicker, become a ticking bomb, endangering anyone compassionate enough to provide hands-on care. I saw it firsthand while responding to the two largest Ebola outbreaks in history with the U.S. Centers for Disease Control and Prevention. In 2014, I visited rural communities in Liberia, where local health workers — many working without pay for extended periods and without adequate protective equipment — risked everything to keep fellow citizens out of harm’s way.
Now, as another outbreak rages across the Democratic Republic of the Congo (which has already become the third largest Ebola outbreak), the United States has embraced a radical new policy: closing the U.S. border to anyone potentially exposed to the virus, including American aid workers fighting the outbreak overseas. This decision, intended to keep Ebola out of the United States, is more likely to undermine efforts to stop the outbreak.
This public health emergency is already challenging, centered in a remote region where health infrastructure is weak, hundreds of thousands of people are displaced, violence is rampant, and trust is limited. There is also no vaccine for this rare Ebola species, meaning any response will require old-fashioned containment measures: rigorous case identification and isolation, robust contact tracing, meticulous infection control in healthcare facilities, safe burials and community engagement. It will be a capital-, training- and labor-intensive process.
Those things are all in short supply.
In the aftermath of the 2014 outbreak, which killed more than 11,000 people across West Africa, the United States invested heavily in prevention, preparedness and response — but those efforts have since been hollowed out. Initiatives supported by USAID to conserve rainforests, which can help prevent spillovers of viruses from animals to humans, have stalled as funding has disappeared. U.S.-backed community clinics, which doubled as an early-warning system, have shuttered. Federal workers responsible for protecting public health have been laid off en masse. Experts at the CDC last year were even ordered to cut communications with the World Health Organization.
The situation is further complicated by new border policies imposed by the Trump administration. Any foreign citizens who have recently spent time in Ebola-affected countries will not be permitted entry into the United States. Meanwhile, all individuals with exposure to the virus will be barred from entering the country — including Americans who had been working on the front lines. These citizens will be quarantined — and, if symptomatic, treated — at a hastily assembled field clinic in Kenya, rather than at state-of-the-art biocontainment facilities in the United States designed for these exact scenarios. (Despite a Kenyan court order to halt the establishment of this facility, the Kenyan government plans to proceed with it.)
This is a catastrophic error.
Unforgiving policies encourage secrecy when we should be incentivizing transparency. Individual travelers, fearful of being stranded abroad, may be less forthright about their possible exposures. Likewise, when governments fear that reporting even a small number of cases will trigger economic isolation and travel restrictions, they are less likely to report in a timely fashion — both now and during future outbreaks of infectious diseases. South Africa, for example, suffered these consequences when it reported a new COVID-19 variant in late 2021, even though by then it was already too late for containment and a travel ban at that point was ineffective.
These border policies will also discourage American physicians, infection-control experts and epidemiologists from joining the effort overseas. We need all hands on deck to stop the spread — but few health workers will volunteer for a dangerous assignment if they expect to be abandoned by their country. Some, however, won’t have a choice. Members of the United States Public Health Service are among the nation’s most committed public servants and will be staffing the clinic in Kenya. They are uniformed officers of the government, serving on official orders, deploying around the world to protect everyone back home. We should not leave them behind.
The new protectionist measures are cruel and counterproductive. They are also unnecessary. The United States knows how to safely manage travel risk — because we have done it before.
In 2014, during the West African Ebola epidemic, there was immense political pressure to shut the border to anyone who had traveled to affected countries. The Obama administration considered it, but cooler heads prevailed. Instead, the federal government implemented an active monitoring program.
I led the effort in New York City, the largest in the nation. Travelers from affected countries were funneled through five designated airports. They underwent screening upon entry into the country followed by daily monitoring through local health departments that maintained contact using special-issue burner phones. Individuals at elevated risk of infection underwent higher levels of monitoring, including quarantine, if needed. That approach worked: It allowed the U.S. to manage risk while still being able to support a large global, humanitarian response.
In moments like these, fear can make it easy to write off as collateral damage any health workers who go to the hot zone. It’s much harder to see them punished for their sacrifice — as I have. I will always remember, in Liberia, talking with a local healthcare worker who caught Ebola in the line of duty. As his illness progressed and his demise became increasingly inevitable, he begged me to evacuate him to the United States for treatment. I could not grant his request, and he died waiting for a miracle that would never come.
For decades, the United States has been a trusted partner in Ebola response. This was not only the right thing to do, but also the smart thing: It’s better to stop outbreaks at their source. The current travel policy does exactly the opposite — and, as this outbreak grows, I fear that our absence in the Congo only increases the probability of cases in the United States.
Neil Vora, a physician, is the executive director of the Preventing Pandemics at the Source coalition.
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Ideas expressed in the piece
The article argues that the new U.S. policy of barring entry to anyone potentially exposed to Ebola — including American health workers — and diverting them to a hastily assembled field clinic in Kenya is counterproductive and dangerous, particularly given that experts have already criticized the U.S. plan for an offshore quarantine facility and Kenyan courts have raised legal and safety concerns about it.[2]
It further contends that shutting out exposed travelers encourages secrecy instead of transparency: individuals may hide exposure histories to avoid being stranded abroad, and governments may delay reporting outbreaks for fear of economic isolation and travel bans, a pattern that public health observers noted when South Africa faced travel restrictions after reporting a new COVID-19 variant.[5]
The piece stresses that this Ebola outbreak, caused by the Bundibugyo virus, is unfolding in remote, conflict-affected areas of the Democratic Republic of the Congo and neighboring Uganda with weak health systems, widespread displacement, and limited trust, and emphasizes that there is currently no licensed vaccine or proven treatment for this virus, meaning that containment depends on intensive measures such as case isolation, contact tracing, infection control, safe burials, and sustained community engagement.[1][2][4][6]
In line with this, the article maintains that U.S. and international response capacity is already stretched: Doctors Without Borders and other responders describe more than 500 suspected cases and 130 deaths across multiple health zones, with cases in Uganda, and note that in the absence of approved Bundibugyo-specific tools, the response must rely on labor‑ and resource‑intensive public health operations.[4][6]
The column criticizes the hollowing out of U.S. global health investments since the 2014 West Africa Ebola epidemic, noting that USAID-backed rainforest conservation and community clinic programs that once supported early detection and preparedness have stalled or closed as U.S. funding waned, a trend echoed by academic experts who say the closure of USAID initiatives and U.S. defunding of the World Health Organization have undermined local health worker training and disease detection capacity.[5]
The article also faults recent steps to sideline federal public health institutions, pointing to mass layoffs, orders that CDC experts limit communication with the World Health Organization, and other moves that weaken the very agencies needed to manage complex outbreaks.[5]
Drawing on the 2014 U.S. experience, the piece argues that there is a safer alternative to border closures: routing travelers from affected countries through designated airports, screening on arrival, and monitoring them daily for 21 days — including quarantine for higher‑risk contacts if needed — an approach similar to the structured screening and rerouting now being used by U.S. authorities for travelers from the DRC and Uganda.[7][8][9]
The article emphasizes that Ebola is difficult to transmit compared with respiratory diseases like COVID-19, requiring direct contact with bodily fluids of symptomatic patients, meaning that the general public and casual contacts (such as airline seatmates) are at low risk; this framing is supported by public health experts who highlight that Ebola transmission overwhelmingly affects caregivers and health workers rather than ordinary travelers.[5]
Consistent with that risk profile, the piece notes that U.S. and European health authorities assess the current risk of Ebola introduction to their populations as low, with the CDC reporting no U.S. cases linked to this outbreak and the European Centre for Disease Prevention and Control judging infection likelihood for EU/EEA residents to be very low, even as monitoring continues.[4][7]
The article frames the new travel and quarantine policies as “protectionist” measures that are both cruel and unnecessary, arguing that they effectively punish health workers and U.S. Public Health Service officers who volunteer to serve in outbreak zones, despite these workers being deployed on official orders to protect the public back home.[2][7]
It stresses that U.S. biosecurity is best served by stopping outbreaks at their source, not by walling off the country, a view aligned with the joint statement by the DRC government and the World Health Organization calling for borders to remain open and for entry controls to avoid obstructing the flow of desperately needed medical supplies and personnel.[3]
Finally, the piece warns that by stepping back from frontline response in Congo and relying on exclusionary border rules, the United States not only abandons long‑standing partners but also increases the chance that the epidemic grows and eventually seeds cases abroad — including in the U.S. — instead of being contained where it started.[1][3][6]
Different views on the topic
In contrast, U.S. health and security officials present enhanced travel screening and entry restrictions as proactive measures designed to prevent Ebola from entering the country and to keep the risk to the American public very low; the CDC describes rerouting passengers from the DRC, Uganda, and neighboring countries through a small number of major airports, combined with entry restrictions on non‑U.S. passport holders who have been in affected areas, as part of a broader effort to “maintain readiness here at home.”[2][7][8]
Supporters of stricter border controls point out that the Bundibugyo virus outbreak is expanding across multiple provinces in eastern DRC and into Uganda, that there is no licensed Bundibugyo‑specific vaccine or proven treatment, and that case numbers and geographic spread are increasing, which, in their view, justifies robust measures to limit international movement from outbreak zones as a precautionary step.[1][2][4][6]
From this perspective, the fact that no Ebola cases linked to the current outbreak have been detected in the United States is seen as evidence that existing entry restrictions and screening protocols are working as intended, and should be maintained or strengthened until the epidemic is brought under control.[7][8][9]
Advocates of keeping exposed Americans out of the U.S. while they are monitored and treated contend that caring for patients closer to the outbreak area or in specialized foreign centers can reduce time in transit and logistical complexity; the CDC, for example, notes that transporting an infected American clinician to Germany offered a shorter flight time and leveraged Germany’s previous experience treating Ebola patients, a rationale that aligns with efforts to minimize perceived risk on U.S. soil.[7]
Proponents of tighter travel rules also emphasize that, even as entry restrictions are implemented, the United States continues to deploy CDC personnel to the DRC and Uganda and to support airport screening and preparedness abroad, arguing that this demonstrates it is possible to combine domestic protective measures with contributions to international containment efforts.[2][7]
Some health security voices, drawing on hard lessons from past epidemics, argue that governments must prioritize national preparedness and public confidence during high‑fatality outbreaks; they point to public concern over Ebola’s severe clinical course and to estimates from previous Bundibugyo epidemics that fatality rates can reach 25% to 40% as reasons many citizens expect their leaders to impose strong safeguards on cross‑border movement, even if the absolute likelihood of importation is assessed as low.[1][4][6]
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