By Robert Farley, Kentucky Lantern · May 28, 2026

Earlier this month, Ebola touched the Commonwealth of Kentucky, if only indirectly.  Dr. Peter Stafford, who completed his residency at the University of Kentucky School of Medicine in 2018, was diagnosed with Ebola and flown to Germany for treatment. Dr. Stafford had been working as a physician and missionary in the Democratic Republic of Congo, where he contracted the disease after performing surgery on a patient who later died. 

The outbreak Stafford left behind continues to expand, with a reported 177 deaths and some 750 cases. The United Nations World Health Organization has raised its national risk level assessment of DRC to “very high,” and US travel alerts have expanded to Uganda and South Sudan. 

Dr. Stafford’s connection with Kentucky may seem incidental, even accidental. However, he is hardly the only Kentuckian to have worked on the front lines of aid and health provision in Africa. Until 2025, the United States Agency for International Development (USAID) served as a firewall for containing and treating outbreaks of disease far from US borders. With USAID gone, we run a greater risk of diseases abroad finding their way here. Despite our best efforts, life in the commonwealth is connected to everything that happens outside of our borders. 

DOGE cuts to USAID

Part of the premise of USAID was the idea that bad things abroad will inevitably find their way here. The wages of dire poverty include violence, extremism, and terrorism, but also infectious diseases and organisms that travel along lines of trade and migration. The current outbreak is on pace to become one of the worst on record, in part because our early warning system is breaking down. In the past, the work of identifying and containing outbreaks of Ebola and other diseases has fallen to a coalition of local authorities and international medical personnel, the latter including many Americans sponsored by USAID.

In addition to general development work, USAID served as the backbone for a system of disease detection and surveillance in Africa and elsewhere. This system allowed epidemiologists and physicians to detect outbreaks, identify the likely avenues of travel, and establish firewalls to prevent disease from reaching the United States.

The politics of aid

The politics of foreign aid have always invited controversy, but the idea that USAID supported American national interests was a bipartisan belief for almost the entire history of the organization. Development assistance was part of the package, but both Democrats and Republicans saw USAID as a tool of competition with the Soviet Union and the People’s Republic of China. Indeed, the administration of George W. Bush massively expanded support for AIDS prevention in Africa under the auspices of the President’s Emergency Plan for Aid Relief (PEPFAR), a program administered by USAID. Senator Mitch McConnell was a strong supporter of USAID for nearly his entire career, valuing it as a tool of influence in Burma and elsewhere.

This consensus broke down in the first Trump administration, reflecting broader shifts in the foreign policy outlook of the GOP. Trump’s transactional approach rejected the developmental goals of USAID in favor of pursuing more concrete returns on investment. This perspective was hardly alien to the GOP; Senator Paul’s views on USAID have always been decided dark, representing a rare point of foreign policy agreement with the Trump administration.  Representative Thomas Massie shared this negative view of USAID, and Representative Andy Barr became one of the organization’s harshest critics. 

All of this came to a head in February 2025, when President Trump set loose Elon Musk’s Department of Government Efficiency (DOGE) on the US foreign policy apparatus. Instead of eliminating specific programs that lawmakers found objectionable, USAID was fed into the wood chipper, its personnel recalled and its programs shuttered.  As much of the spending on USAID went to US organizations and US agricultural producers, the impact on Kentucky was felt immediately. USAID helped fund research at the University of Kentucky which generated innovation that benefited farmers and scientists at home and abroad. 

The public failure to understand the role and purpose of USAID is dispiriting. Knee-jerk criticism of foreign aid plays well on the stump but doesn’t offer an effective guide to policy. USAID mattered because in addition to providing aid it gave the US eyes on the ground in sensitive regions around the world, and tools to manage problems as they developed. Now the chickens are coming home to roost; Ebola may not find its way to Kentucky this time, but Americans are less safe and will be less prosperous without USAID’s work.