With Ebola surging, Risch helped undermine global public health | Opinion
The Bundibugyo strain of Ebola is spreading right now through the Democratic Republic of Congo and into Uganda — more than 1,000 cases and over 230 deaths in a matter of weeks, with 10 more African nations flagged as at risk. Within two days of confirmation, the World Health Organization declared it a global health emergency.
Unlike the more familiar Zaire strain, Bundibugyo has no approved vaccine and no approved treatment, and it routinely slips past standard field tests. It is exactly the kind of threat that has to be caught early and contained at the source — the international work USAID was built to do.
Sen. Jim Risch, R-Idaho, chairman of the Senate Foreign Relations Committee, was no helpless bystander when that agency was dismantled. He had the platform and the obligation to defend it. Instead, he publicly backed folding USAID into the State Department, casting the move as a response to what he calls the nation’s gravest security threat — the national debt.
Idaho once sent Frank Church to chair this very committee — a senator who built his name on independent oversight and challenging presidents of either party. Risch opened his own chairmanship by announcing the reverse: that his “repertoire does not include sparring publicly with the president.” On a matter of life and death, that deference stops looking like prudence and starts looking like abdication.
But gutting the agency that detects pandemics at their source is not fiscal discipline. It is strategic negligence.
USAID was never simply charity. It was one of America’s most effective early-warning systems, built to catch outbreaks at their source, long before they reach our borders. It did all of this for about 17 cents per American per day. Independent public health trackers estimate that the disruptions already set in motion have contributed to roughly 600,000 preventable deaths worldwide. A peer-reviewed Lancet analysis projects that continued defunding could lead to more than 14 million additional deaths by 2030, including over 4.5 million children under five.
These are not budget abstractions. They are patients cut off from treatment, clinics with no nutrition program left to run and whole communities with nothing standing between them and the next pathogen.
This is already happening. As The Atlantic reported this week, researchers believe the dismantling of USAID likely delayed the detection of this very outbreak, and infectious-disease experts note that the largest response force on the ground in the region, USAID itself, is simply gone. The agency Sen. Risch helped sideline was, until last year, the first responder these moments require.
As an infectious diseases physician practicing in Idaho for 25 years, I can tell you that vaccine candidates take months or years to reach the field. No clinical trial or future therapeutic can substitute for the infrastructure needed right now: the contact tracers, laboratories, supply chains and hard-won community trust that these cuts have already frayed.
Idahoans understand preparedness. We do not wait for a wildfire to crest the ridge before backing our firefighters, and we do not tear down the smoke lookout and call it savings. USAID, at its best, was America’s smoke lookout for the world’s most dangerous infectious threats.
By backing its dismantling, Sen. Risch embraced a policy that is medically reckless, economically shortsighted and strategically indefensible. As my senator and as chairman of Foreign Relations, he is better positioned than almost anyone to reverse course — and to help rebuild the global health security he helped compromise.
Richard Nathan, DO, FACP, FIDSA, is a board-certified infectious diseases physician and clinical researcher in Idaho Falls.