The World Health Organization’s chief said on Tuesday that he was “deeply concerned about the scale and speed” of an Ebola outbreak in the Democratic Republic of Congo and Uganda that has resulted in a spike in deaths — to at least 130 — and more than 500 suspected cases. The outbreak is complicated by the rare strain of the disease, known as Bundibugyo, that standard field tests often miss and for which there are no vaccines or therapeutics.

Experts say Trump administration policies — like dismantling the U.S. Agency for International Development and withdrawing from WHO — have further undermined global health security and negatively impacted the response to the outbreak. WHO Director-General Tedros Adhanom Ghebreyesus warned of emerging cases in urban areas, including reports of cases in Uganda’s capital, Kampala, and Goma, a crossroads city in Congo that borders Rwanda.

The Intercept reported on the porous borders and worrying public health responses in Goma during an Ebola outbreak in 2019. At the time Anthony Fauci — then the head of the U.S. National Institute of Allergy and Infectious Diseases — laid out the dangers of Ebola spreading in that urban center. “Since Goma is a city of millions of people, and since it has an international airport, it is a great concern,” he explained. “If Ebola could get into Goma and spread in Goma, that increases the likelihood that it could spread beyond the DRC into neighboring and distant countries.”