Hours after Elon Musk reassured Cabinet members on Wednesday that efforts to contain the Ebola outbreak in Uganda had only been “accidentally canceled very briefly,” the Trump administration terminated at least four of the five contracts for Ebola-related work in that country.
The four canceled contracts were a tiny fraction of the 10,000 contracts and grants at the United States Agency for International Development and the State Department that the Trump administration ended on Wednesday.
But they were important: Since January, Uganda has experienced a serious Ebola outbreak, from which the country is only just emerging. The contracts funded Ebola screening at airports and protective equipment for health workers, and helped prevent transmission by survivors of the disease, according to a former U.S.A.I.D. official.
Mr. Musk told cabinet members that the administration had “restored the Ebola prevention immediately, and there was no interruption.” But his statement was inaccurate, according to two former U.S.A.I.D. officials with knowledge of the situation in Uganda. (The officials asked to remain anonymous for fear of retaliation.)
In theory, waivers allowed for some work to continue on containing pathogens like Ebola, Marburg and mpox, as well as preparedness for bird flu. But very little money had actually been delivered.
Few organizations providing those services had the financial reserves to continue, and even fewer trusted that they would be reimbursed.
Their fears may have been justified. On Wednesday night, the Supreme Court’s chief justice, John G. Roberts Jr., ruled that U.S.A.I.D. and the State Department did not need to immediately pay for more than $1.5 billion for work that had been already completed.
The work underway without those payments was interrupted, contrary to Mr. Musk’s claim.
At the airport in Entebbe, Uganda, screening for Ebola was on pause for more than two weeks, according to a former U.S.A.I.D. official with knowledge of the situation. The organization doing it decided a few days ago to resume work with its own funds.
The group’s contract was terminated on Wednesday night.
The White House declined to clarify Mr. Musk’s comments and directed inquiries to the man himself. Mr. Musk did not immediately respond to a request for comment.
There were other gaps. The first Ebola patient in the current outbreak had gone to six facilities before he died and was diagnosed, prompting the Ugandan government to request protective gear for exposed health workers.
U.S.A.I.D. stockpiles such gear at a warehouse in Nairobi. But the facility was managed by the World Health Organization, and U.S.A.I.D. employees were not allowed to communicate with the W.H.O., let alone pay it to release the gear.
After more than a week awaiting permission to contact the W.H.O., officials were abruptly ordered to come up with another solution. They eventually paid about $100,000 to procure the protective equipment elsewhere.
“So much for cost-effectiveness,” said a former official with knowledge of the events. The contract with the alternate provider, too, has now ended.
Even the waiver process was riddled with confusion. The Trump administration asked for specifics on how many lives each intervention would save, and U.S.A.I.D. staff struggled to link minor resources like hand sanitizer or risk communication messages to a specific number of lives saved.
The staff purge at U.S.A.I.D. has left few people in place. The agency had more than 50 people dedicated to outbreak responses, the result of a congressional push to beef up pandemic preparedness.
That number was initially cut by half, including some from the core Ebola team, and then on Sunday to just six. Those fired included the organization’s leading expert in lab diagnostics, and the manager of the Ebola response.
“I have no idea how six people are going to run four outbreak responses,” said one official who was let go. “It’s complicated at the best of times when you’re fully staffed.”
