Ebola is spreading fast in the Democratic Republic of Congo, and the US response looks shaky — bad news for global health readiness, even if Ebola itself is unlikely to go global.

• The DRC outbreak is already the third worst on record, with hundreds of deaths and the fastest spread health experts have seen.
• It was caught late because it is a rare strain, the area is a rebel stronghold, and USAID workers who used to flag early warnings are gone.
• Uganda closed its border with Congo against WHO advice, and locals are attacking aid tents and storming hospitals to take back bodies for burial, which is one of the main ways Ebola spreads.
• Ebola is not expected to become a COVID-style pandemic because it only spreads through direct contact with bodily fluids and kills hosts too quickly to travel far.
• The bigger worry is US public health capacity itself: USAID was dismantled, the US pulled out of the WHO, CDC staff was cut deeply, and the CDC is now asking for volunteers to screen airports.
• Trust in public health is broken on both sides — many still distrust the Fauci-era response, and many also distrust RFK Jr. and the new HHS leadership.

Outlook: Ebola probably stays contained, but if a more contagious virus hits next, the US is far less prepared to detect or respond than it was a few years ago.