As I stepped onto a plane to attend the 79th Annual World Health Assembly last week, I learned with a sense of déjà vu that the World Health Organization (WHO) had declared the newest Ebola outbreak a public health emergency of international concern. In Geneva, my conversations with global health leaders gravitated to the most alarming elements of the outbreak: the failure of existing diagnostics to detect the rare ebolavirus strain Bundibugyo, which allowed the outbreak to grow undetected for some time; the lack of a vaccine or specific treatment for Bundibugyo viral disease; and the disarray across global health funding and response mechanisms that has hampered a coordinated response.
The bottom line is we were not ready for this outbreak, and we aren’t ready for the next one. I still remember the panic in the United States and around the world when Ebola emerged in West Africa 2014. National and global health leaders were universally resolved to be more prepared for outbreaks in the future.
At the time, I was a year into my tenure as president of the National Academy of Medicine (NAM). I found myself in the office of World Bank president Jim Kim, who encouraged me to lead an evaluation of the global response to Ebola, especially the role of the WHO, and recommend actions to prevent another such crisis in the future. The NAM launched the Commission on a Global Health Risk Framework for the Future, which proposed a collective global investment of $4.5 billion per year to prevent pandemics and the expected economic losses [1]. That investment should support three major priorities: strengthening public health systems, building capacity for global and regional coordination, and accelerating research and development. Chaired by Peter Sands, now Executive Director of the Global Fund to Fights AIDS, Tuberculosis, and Malaria, the Commission’s report was truly bold and forward looking for its time, highlighting pandemics as a major threat to the global economy and national security as well as health and humanity.
In the years that followed, the WHO established the Contingency Fund for Emergencies (CFE), creating a pooled-financing facility to provide rapid aid in the face of outbreaks, as well as the Health Emergencies Program to unify emergency resources and better provide rapid response. The U.S. Congress voted to fund the Global Health Security Agenda, which allowed for programs in the DRC and other countries to accelerate their capacity to prevent, detect, and respond to diseases that can threaten the world personally, economically, and politically. Several other critical organizations were chartered, including the Coalition for Epidemic Preparedness Innovations (CEPI), the Africa Centres for Disease Control and Prevention, and – following the COVID pandemic – the Pandemic Fund and Gavi’s Day Zero Response Fund.
Unfortunately, COVID-19 has changed the game in unexpected and very damaging ways. We are contending with new challenges like nationalism, worsening inequities, and mistrust in science and public health institutions. The United States has withdrawn from the WHO and shut down the U.S. Agency for International Development. Across the board, we’ve seen massive cutbacks in official development assistance (ODA) from major countries. The uncertainty in funding, leadership, and coordination for global preparedness is of grave concern.
Last year, as pandemics fell off the political agenda, the G20 High Level Independent Panel – a group of senior economists and health leaders of which I served as co-chair – was reconvened, with the NAM as Secretariat, to recommend actions for the G20 and world leaders. We recommended five specific, practical actions that should be taken by world leaders to avoid the exact crises we are facing today, including investment in domestic resource mobilization and non-ODA financing; medical countermeasures access and surge manufacturing; development bank incentives; tests, treatments, and personal protective equipment; and investment in the Pandemic Fund [2].
Indeed, Ebola is not the only outbreak the world is currently experiencing. The hantavirus outbreak on a cruise ship, though of less pandemic potential than Ebola, is causing significant public anxiety. Both viruses are deadly, and neither has an approved vaccine available, nor a widely available and specific antiviral treatment. Indeed, many world leaders appear to be surprised and unprepared. .
But this shouldn’t be a surprise. It is highly predictable that new diseases – like the Andes strain of hantavirus – can and will spill over into people. This is the seventeenth – not the first – outbreak of Ebola in the Democratic Republic of Congo (DRC). We know more outbreaks are inevitable, and risks are increasing. Preparedness isn’t an option; it’s a requirement for our health and for national security.
As of May 24, the current Ebola outbreak is believed to have over 1,000 cases and more than 100 deaths, already far beyond the earliest publicly reported figures from the 2014 West Africa outbreak [3]. In a best-case scenario, the outbreak is likely to spread for months, while partners race to find cases, communicate risks, build community trust, surge tests and supplies, and protect healthcare workers. More likely, it will take much longer. It took nearly two years for the 2018 Ebola outbreak in the DRC to conclude, and in that case, because the outbreak was caused by the more common Zaire strain of the virus, a vaccine was available.
Organizations like CEPI and Gavi are already scrambling to find, test, and arrange advanced procurement for vaccine candidates. But it’s still a pick-up game. There needs to be a sustained response and financing strategy to ensure the necessary research, incentives, speed, and scale required to stop these types of outbreaks at the source. Despite recent progress and focus on the 100 Days Mission – the world’s plan to have vaccines, tests, and treatments on the shelf for every viral family capable of causing such devastation—the work remains significantly under-powered.
In previous outbreaks, the United States didn’t stay on the sidelines. Instead, we led. America’s unique position in global health security provided many benefits. It allowed us to learn first about how to stop an emerging disease and access countermeasures, and it decreased political and economic instability in fragile states. These things helped Americans, and they are now at risk. Recent actions in United States, particularly the diminishment of the federal public health infrastructure designed to keep Americans safe by monitoring and managing pathogens both here and abroad, are of great concern.
Despite the fear, panic, and enormous economic and social costs of these outbreaks, somehow global political will is still not strong enough to invest fully in preparedness. There is a perplexing pattern of panic followed by neglect to take appropriate action.
The conclusion I heard again and again in Geneva last week was that we are less prepared today for a biological threat that could gravely impact Americans and the world than we were in 2020. U.S. leadership has always been crucial during a global crisis. We need it now more than ever.
The outlook is grim, but failure is not inevitable. We have a playbook for preparedness that can save countless lives and billions of dollars. What we need is the political will to implement it.
References
- National Academy of Medicine. 2016. The Neglected Dimension of Global Security: A Framework to Counter Infectious Disease Crises. Washington, DC: The National Academies Press. https://www.nationalacademies.org/publications/21891 (accessed May 25, 2026).
- G20 High Level Panel on Financing the Global Commons for Pandemic Preparedness and Response. 2025. Closing the Deal: Financing Our Security Against Pandemic Threats. https://nam.edu/pandemic-financing (accessed May 25, 2026).
- U.S. Centers for Disease Control and Prevention. 2026. Ebola Disease: Current Situation. https://www.cdc.gov/ebola/situation-summary/index.html (accessed May 25, 2026).
Panic, Neglect, Repeat: The 2026 Ebola Outbreak Shows Us We Must Change the Pattern for Global Pandemic Preparedness and Response
As I stepped onto a plane to attend the 79th Annual World Health Assembly last week, I learned with a sense of déjà vu that the World Health Organization (WHO) had declared the newest Ebola outbreak a public health emergency of international concern. In Geneva, my conversations with global health leaders gravitated to the most alarming elements of the outbreak: the failure of existing diagnostics to detect the rare ebolavirus strain Bundibugyo, which allowed the outbreak to grow undetected for some time; the lack of a vaccine or specific treatment for Bundibugyo viral disease; and the disarray across global health funding and response mechanisms that has hampered a coordinated response.
The bottom line is we were not ready for this outbreak, and we aren’t ready for the next one. I still remember the panic in the United States and around the world when Ebola emerged in West Africa 2014. National and global health leaders were universally resolved to be more prepared for outbreaks in the future.
At the time, I was a year into my tenure as president of the National Academy of Medicine (NAM). I found myself in the office of World Bank president Jim Kim, who encouraged me to lead an evaluation of the global response to Ebola, especially the role of the WHO, and recommend actions to prevent another such crisis in the future. The NAM launched the Commission on a Global Health Risk Framework for the Future, which proposed a collective global investment of $4.5 billion per year to prevent pandemics and the expected economic losses [1]. That investment should support three major priorities: strengthening public health systems, building capacity for global and regional coordination, and accelerating research and development. Chaired by Peter Sands, now Executive Director of the Global Fund to Fights AIDS, Tuberculosis, and Malaria, the Commission’s report was truly bold and forward looking for its time, highlighting pandemics as a major threat to the global economy and national security as well as health and humanity.
In the years that followed, the WHO established the Contingency Fund for Emergencies (CFE), creating a pooled-financing facility to provide rapid aid in the face of outbreaks, as well as the Health Emergencies Program to unify emergency resources and better provide rapid response. The U.S. Congress voted to fund the Global Health Security Agenda, which allowed for programs in the DRC and other countries to accelerate their capacity to prevent, detect, and respond to diseases that can threaten the world personally, economically, and politically. Several other critical organizations were chartered, including the Coalition for Epidemic Preparedness Innovations (CEPI), the Africa Centres for Disease Control and Prevention, and – following the COVID pandemic – the Pandemic Fund and Gavi’s Day Zero Response Fund.
Unfortunately, COVID-19 has changed the game in unexpected and very damaging ways. We are contending with new challenges like nationalism, worsening inequities, and mistrust in science and public health institutions. The United States has withdrawn from the WHO and shut down the U.S. Agency for International Development. Across the board, we’ve seen massive cutbacks in official development assistance (ODA) from major countries. The uncertainty in funding, leadership, and coordination for global preparedness is of grave concern.
Last year, as pandemics fell off the political agenda, the G20 High Level Independent Panel – a group of senior economists and health leaders of which I served as co-chair – was reconvened, with the NAM as Secretariat, to recommend actions for the G20 and world leaders. We recommended five specific, practical actions that should be taken by world leaders to avoid the exact crises we are facing today, including investment in domestic resource mobilization and non-ODA financing; medical countermeasures access and surge manufacturing; development bank incentives; tests, treatments, and personal protective equipment; and investment in the Pandemic Fund [2].
Indeed, Ebola is not the only outbreak the world is currently experiencing. The hantavirus outbreak on a cruise ship, though of less pandemic potential than Ebola, is causing significant public anxiety. Both viruses are deadly, and neither has an approved vaccine available, nor a widely available and specific antiviral treatment. Indeed, many world leaders appear to be surprised and unprepared. .
But this shouldn’t be a surprise. It is highly predictable that new diseases – like the Andes strain of hantavirus – can and will spill over into people. This is the seventeenth – not the first – outbreak of Ebola in the Democratic Republic of Congo (DRC). We know more outbreaks are inevitable, and risks are increasing. Preparedness isn’t an option; it’s a requirement for our health and for national security.
As of May 24, the current Ebola outbreak is believed to have over 1,000 cases and more than 100 deaths, already far beyond the earliest publicly reported figures from the 2014 West Africa outbreak [3]. In a best-case scenario, the outbreak is likely to spread for months, while partners race to find cases, communicate risks, build community trust, surge tests and supplies, and protect healthcare workers. More likely, it will take much longer. It took nearly two years for the 2018 Ebola outbreak in the DRC to conclude, and in that case, because the outbreak was caused by the more common Zaire strain of the virus, a vaccine was available.
Organizations like CEPI and Gavi are already scrambling to find, test, and arrange advanced procurement for vaccine candidates. But it’s still a pick-up game. There needs to be a sustained response and financing strategy to ensure the necessary research, incentives, speed, and scale required to stop these types of outbreaks at the source. Despite recent progress and focus on the 100 Days Mission – the world’s plan to have vaccines, tests, and treatments on the shelf for every viral family capable of causing such devastation—the work remains significantly under-powered.
In previous outbreaks, the United States didn’t stay on the sidelines. Instead, we led. America’s unique position in global health security provided many benefits. It allowed us to learn first about how to stop an emerging disease and access countermeasures, and it decreased political and economic instability in fragile states. These things helped Americans, and they are now at risk. Recent actions in United States, particularly the diminishment of the federal public health infrastructure designed to keep Americans safe by monitoring and managing pathogens both here and abroad, are of great concern.
Despite the fear, panic, and enormous economic and social costs of these outbreaks, somehow global political will is still not strong enough to invest fully in preparedness. There is a perplexing pattern of panic followed by neglect to take appropriate action.
The conclusion I heard again and again in Geneva last week was that we are less prepared today for a biological threat that could gravely impact Americans and the world than we were in 2020. U.S. leadership has always been crucial during a global crisis. We need it now more than ever.
The outlook is grim, but failure is not inevitable. We have a playbook for preparedness that can save countless lives and billions of dollars. What we need is the political will to implement it.
References
Dzau, V. J. 2026. Panic, Neglect, Repeat: The 2026 Ebola Outbreak Shows Us We Must Change the Pattern for Global Pandemic Preparedness and Response. NAM Perspectives. Commentary, National Academy of Medicine.
To be assigned.
Victor J. Dzau, MD, is President of the National Academy of Medicine.
None to disclose.
This commentary benefited from the contributions of Elizabeth Cameron, Brown University; and Laura DeStefano and Melissa Laitner, National Academy of Medicine.
DISCLAIMER
The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.
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