Our Public Health System has Been Severely Compromised under Trump

The New York City Health Department posted a message on its website this week about the Ebola outbreak spreading across the Democratic Republic of Congo and Uganda. “Risk to New Yorkers remains low,” it read. That statement is technically accurate. It’s also dangerously misleading, because it answers the wrong question.

The risk that should terrify every New Yorker isn’t whether Ebola is easy to catch. It isn’t. The risk is that the public health infrastructure that should detect, contain, and coordinate the response to an Ebola case landing at JFK or LaGuardia has been systematically dismantled. That’s the threat. And none of our elected officials are raising that alarm.

Cast your mind back to March 2020. As COVID-19 was catastrophically spreading through the city, Governor Cuomo and Mayor de Blasio were publicly feuding over who had authority to close schools and order a shelter-in-place. While they argued jurisdiction, the virus moved. Days later, Cuomo ordered the very lockdown he’d dismissed. By then, New York City had become the epicenter of the worst outbreak in the country.

The lesson, not learned, is that fragmented authority, political ego, and bureaucratic confusion cost lives during a fast-moving outbreak.

On May 17, the World Health Organization declared the Ebola outbreak in the DRC a Public Health Emergency of International Concern, the highest alarm level short of “pandemic.” This outbreak is caused by the Bundibugyo strain, for which there’s no approved vaccine and no specific treatment. There are now over 1,000 suspected cases and over 200 deaths, with the virus spreading across provincial borders in DRC and into Uganda, with cases confirmed in Kampala. Case fatality rates in previous Bundibugyo outbreaks have ranged from 30 to 50 percent. This isn’t influenza.

I know what it takes to contain an Ebola outbreak. In 2014, I was part of the UNICEF and UN interagency team coordinating the response to the West Africa epidemic, the largest in history, which killed more than 11,000 people. What I learned is that this disease isn’t stopped by travel bans or press conferences. It’s stopped by sustained institutional infrastructure: disease detection networks, trained rapid-response teams, diagnostic capacity, and tight coordination between local, national, and international health authorities. The US is now failing on all fronts.

By late 2025, roughly 24 percent of CDC staff had been laid off. The proposed FY 2026 budget cuts the agency by 53 percent compared to 2024 levels. The CDC’s Public Health Emergency Preparedness program faces a 52 percent funding cut. The United States also withdrew from the WHO on the first day of this administration, pulling $678 million annually, nearly 15 percent of WHO’s total budget, from the international detection and response network we now desperately need.

So when the NYC Health Department says “risk to New Yorkers remains low,” what they mean is that Ebola’s hard to transmit casually. What they’re not saying is that the federal agency responsible for detecting an imported case and coordinating the response has been cut nearly in half. That’s the risk. And it’s high.

The FIFA World Cup began June 11. More than a million international visitors will come through the New York metropolitan area alone, with the final played at MetLife Stadium on July 19. The Bundibugyo strain has an incubation period of up to 21 days. A traveler can be exposed, board a plane, clear customs at JFK, take the subway to a hotel in midtown, and show no symptoms.

Bellevue Hospital has been running drills for exactly this scenario. NYC Health + Hospitals has trained 500 health care providers across the region. Our local public health system is doing what it can. But local preparedness can’t substitute for a functioning federal government. When a suspected case arrives at a New York hospital, the response depends on federal diagnostic support, federal coordination with other jurisdictions, and federal communication with international health authorities. That chain of command runs through an agency that’s lost a quarter of its staff.

The administration’s response has been to invoke Title 42 to ban travelers from DRC, Uganda, and South Sudan, then extend that ban to lawful permanent residents, barring green card holders from returning to the country where they live and pay taxes. This hasn’t been done before. Not during COVID. Not during the 2014 Ebola outbreak. Never.

Now, according to reporting in the Washington Post and New York Times, Americans exposed to Ebola won’t be brought home for treatment, as every previous administration has done. They’ll be sent to Kenya. This isn’t a public health strategy. It’s a constitutional question dressed in epidemiological clothing.

This city sends two senators and a House minority leader to Washington. In a crisis posing a direct threat to New York, host to the world’s busiest international airports and the World Cup final, New Yorkers deserve to hear from Chuck Schumer and Hakeem Jeffries. Not a press release. A direct, urgent, public demand that Congress restore CDC capacity and rejoin the WHO.

In March 2020, Cuomo and de Blasio spent two weeks fighting while the virus didn’t wait. New York paid a catastrophic price. Six years later, its hospitals are drilling and its health commissioner is planning. Its federal delegation hasn’t said a word.

We have a deadly disease with no vaccine spreading out of control, a World Cup final coming to our backyard, and leaders in Washington who’ve been silent. This isn’t a warning. This is a public health emergency. And we’re not prepared.

Nina Schwalbe is the founder of Spark Street Advisors, a former senior health official at UNICEF, and a candidate for Congress in New York’s 12th congressional district.