The Trump administration’s decision to dismantle the US Agency for International Development (USAID) and stop funding for global public health efforts may increase the risk of mpox becoming a global emergency, according to experts and aid workers.

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Experts have warned that freezing the funds could exacerbate the spread of mpox. The World Health Organization (WHO) declared mpox a public health emergency of international concern last year in August as cases surged in the Democratic Republic of Congo (DRC) and spread to other African countries. USAID has been working to contain the outbreak through vaccination, testing, and surveillance.

Until weeks ago, the United States has been leading response efforts, with USAID and the Centers for Disease Control and Prevention (CDC) contributing $55 million in emergency assistance last year.

“It’s a real mistake not to be doing everything we can to control this while we’re still able to,” The Guardian quoted Stephen Morse as saying, who is a professor of epidemiology at Columbia University focusing on risk assessment of infectious diseases. “Taking huge steps backwards is only going to make everything worse.”

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According to an aid worker, the funding freeze has resulted in some provinces in the country, which depend solely on USAID funds, being stripped of any resources to contain the virus.

“We were working on creating a sustainable system that can respond not just to the current mpox outbreak but can be used in the future for any other outbreak, and now we’re not sure if that will succeed,” said a USAID worker with knowledge of the mpox response, according to The Guardian report.

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“Just like all these increased cases of Ebola and Marburg in neighbouring countries, it’s not if, but when the next one in the DRC will be and how the country is going to be ready.”

Risk of global spread of disease

Experts have stressed that reducing the aid will not only increase the risk of mpox spreading to other countries but could also increase the chances of mpox of other pandemics reaching the US.

“Disaster and catastrophe are the appropriate words for shutting down USAID,” a US-based researcher told the Guardian. “It’s not just about people overseas who will be affected, but there’s a likelihood of mpox or the next pandemic spreading to the United States.”

Also read | Judge blocks Trump’s foreign aid freeze as USAID faces mass layoffs

In 2022, a global outbreak of mpox led to over 100,000 being infected in 122 countries, marking the first time the virus spread outside Africa.

While US Secretary of State Marco Rubio issued guidance allowing life-saving assistance through a waiver, USAID workers said no waiver has been approved to continue mpox programmes in the DRC, the report added. Experts argue that this unpredictability makes it challenging to run a disease control programme.

Legal challenges

Trump’s order has also faced legal troubles, with one federal judge recently ruling to halt the move, giving the government five days to comply. However, aid workers expressed that the ruling has created confusion on how to restart programmes, which may face further cuts in future.

Also read | US President Donald Trump fires USAID inspector general: Report

USAID workers have also shared how the current situation has been affecting them as their careers remain in limbo after being brought to the US from DRC.

“I have been experiencing health consequences related to extreme stress, anguish, and sleep deprivation due to worrying about staff, partners, and the situation in general in DRC and not being able to respond in the way that I normally would,” a USAID employee said, as quoted by The Guardian.

(With inputs from agencies)