When cases of Ebola began appearing in the Democratic Republic of the Congo, the surveillance networks that might have caught them early were already gone. Last year, Elon Musk's so-called Department of Government Efficiency — widely known as Doge — cut the US Agency for International Development's Ebola detection and response programmes. Musk himself later admitted those cuts had been made "accidentally". The consequences, researchers argue, are now visible in real time.

Jeremy Konyndyk, who directed USAID's Ebola response during the 2014–2015 West Africa epidemic and now leads Refugees International, is direct about the link. Had the DRC's global health infrastructure remained intact, the current outbreak would have been identified far sooner. "I'm very confident about that," he said. Davide Rasella, a research professor at the Catalan Institution for Research and Advanced Studies and head of the Global Health Impact Assessment and Evaluation Group at Barcelona's ISGlobal institute, reaches a similar conclusion: the absence of surveillance and preparedness funding is "one of the reasons" the outbreak was not caught earlier.

The wider stakes extend well beyond the Congo basin. A study published in The Lancet estimated that the full abolition of USAID could produce 14 million deaths, among them 4. 5 million children. When a Democratic congressman cited those figures, Musk threatened legal action and insisted Doge had caused no harm.

Rasella, one of the study's authors, stood by its methodology without hesitation. That Musk has spent the days since the outbreak intensified posting attacks on X — calling one journalist "utterly evil" for naming victims — rather than addressing the evidence, tells its own story. The question scientists are now asking is not whether the cuts had consequences, but how many more will accumulate before the calculus changes.