A Stress Test the World Is Failing

The World Cup is underway across the United States, Mexico, and Canada, with stadiums full and a record 1.3 million fans already through the gates.

Could the World Cup accelerate Ebola’s spread or carry it to new regions? No mass gathering is immune to disease threats, and the World Cup won’t be either. But Ebola isn’t the threat to worry about here.

Ebola isn’t airborne and doesn’t spread through casual contact. It requires direct contact with the body fluids of someone who is ill. In 2014, a far larger Ebola outbreak in West Africa coincided with the World Cup in Brazil. Nothing spread there. A traveler could be exposed to Ebola and infect others, but Ebola will not spread widely at the World Cup.

Diseases that pass easily between people, such as measles and influenza, pose more risk. For the first time, a non-governmental Health Security Operations Center was launched for the World Cup, pulling together wastewater surveillance, hospital data, and social monitoring across all host cities. This is the kind of work the federal government should support.

A new Resolve to Save Lives case study describes how the Caribbean Public Health Agency deployed a regional surveillance platform at the 2024 T20 Cricket World Cup that detected 146 disease cases across the tournament with no documented spread. The system worked because it was built before the event, not put together hastily during it.

When it comes to Ebola, controlling spread in the Democratic Republic of the Congo is the most pressing challenge. I wrote about the outbreak when it was first recognized and when the reported numbers hid how fast it was moving. It was found late and continues to spread faster than the response.

In late May I wrote that this outbreak would test whether the world can respond effectively to urgent health threats. It’s a stress test, and the world is failing it. We’re responding with a gutted toolkit. USAID has been dismantled. The U.S. has withdrawn from WHO. CDC has lost nearly 3,000 scientists and doctors, with more cuts proposed, including closure of most of its global outposts.

Outbreaks take hold where basic health care is thin or absent—a clinic with no diagnostic tests, a district with no laboratory, a community with no health worker to notice the first deaths. In those gaps, a new pathogen can spread for weeks before anyone identifies it, and by then it may have traveled far from where it began.

Preparedness has to be built everywhere. The foundation is basic health services in every community; surveillance depends on clinics people go to and health care workers they trust.

Our team has championed the 7-1-7 target: every outbreak detected within 7 days, reported within 1, and all essential control measures in place within 7. Countries that meet it find problems sooner and stop them faster. The world needs the same discipline on a far larger scale, with money behind it—rapid-response funds released in days, supplies positioned before the emergency, and responders ready to move before a local outbreak becomes a regional one.

While matches take place in North America, people in parts of the DRC face grave risk. The outbreak there continues to accelerate. Health workers are reporting shortages of PPE and test kits. Testing delays and roadblocks mean the official count is the floor. Conflict complicates the response, and WHO’s Director General has called on warring parties in eastern DRC to agree to a ceasefire so medical teams can reach patients.

The World Cup will end in July. Even with a much faster response, the DRC outbreak could last at least another year. The outbreak can be stopped, but it needs full funding and fast execution now. The biggest test is whether we learn from the preventable diseases we keep facing and build the community care, public health, and rapid-response capacity needed for a safer world.

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