The Watchtower Abandoned: Hantavirus, Ebola, and a Presidency That Walked Away

May 28, 2026

The Watchtower Abandoned: Hantavirus, Ebola, and a Presidency That Walked Away

Three simultaneous outbreaks. One executive order. A country that quit the global early-warning system months before it needed it most — and a president whose judgment Congress is now openly questioning under Section 4 of the 25th Amendment.

On May 2, 2026, the World Health Organization received an urgent dispatch from a Dutch-flagged expedition cruise ship anchored off the coast of Cape Verde: a cluster of severe respiratory illness, two passengers already dead, one critically ill. Within four days, WHO laboratory partners had identified the pathogen as the Andes hantavirus — a New World hantavirus and the only one known to spread person-to-person, with a historical case-fatality rate near 38 percent. Within nine days, the United States had 41 people under monitoring across multiple states. Eighteen of them were quarantined in Nebraska and Atlanta.

Two weeks later, on May 17, the WHO declared the Ebola outbreak in the Democratic Republic of the Congo and Uganda a public health emergency of international concern — only the eighth time in the agency’s history it has invoked that authority. The strain is Bundibugyo, for which no approved vaccine exists. As of this writing, the WHO has counted at least 139 deaths and roughly 600 suspected cases, with confirmed cross-border spread to Kampala. An American physician working in the DRC has been evacuated to Germany.

And as that emergency expanded, the U.S. measles outbreak that began in West Texas in early 2025 surged past 1,900 confirmed cases for 2026 alone, spread across 40 jurisdictions and 27 new outbreak clusters. In November, the Pan American Health Organization will decide whether the United States has lost the measles elimination status it has held since 2000. A Lancet analysis published this month concluded it is “highly likely” that we have.

Three viral threats. Three jurisdictions where the World Health Organization is the early-warning system, the coordinating body, the laboratory network, the convening power. And one inescapable fact: on January 22, 2026, the United States formally ceased to be a member of that system, the consequence of an executive order President Donald Trump signed on the first day of his second term.

This is not a coincidence of calendars. It is a policy choice, made by a single man, that the Constitution did not require him to make alone.

1. The Order: A single signature that severed sixty years of biosecurity

On January 20, 2025, Donald Trump signed Executive Order 14155, directing the United States to withdraw from the World Health Organization. The order revoked President Biden’s 2021 letter rescinding Trump’s first-term withdrawal attempt, scrapped Executive Order 13987 that had created a White House COVID-19 response coordinator, and directed Secretary of State Marco Rubio and the Office of Management and Budget to halt “future transfer of any United States Government funds, support, or resources” to the agency.

The justifications in the order’s preamble are familiar: WHO’s “mishandling” of COVID-19, “failure to adopt urgently needed reforms,” and an assessment formula that, the order claimed, required the United States to subsidize a Chinese government with nearly five times the U.S. population. Six days later, the administration imposed a gag order prohibiting any communication between the Centers for Disease Control and Prevention and the WHO — a restriction that has never been formally rescinded and has now been rendered permanent by withdrawal itself.

The Geneva-based agency, which had been preparing for the second Trump withdrawal since November 2024, expressed regret. So did the experts who had spent decades building the architecture that the executive order dismantled.

“We cannot make WHO more effective by walking away from it. The decision to withdraw weakens America’s influence, increases the risk of a deadly pandemic, and makes all of us less safe.”

— Dr. Tom Frieden, Former Director, CDC

Lawrence Gostin of Georgetown, who directs the WHO Collaborating Center on Global Health Law, was more direct still: withdrawal would “make it more likely that we could see novel diseases spinning out of control, crossing borders, and potentially sparking a pandemic.” Instead of being first in line for vaccines and surveillance data, Gostin warned, the United States would now be at the back of it.

Sixteen months later, that warning is not theoretical. It is the lived reality of CDC scientists who, when a suspected Ebola case surfaced in the DRC in early 2025, could not pick up the phone and ask their counterparts what was happening. As Brown University’s Jennifer Nuzzo put it in describing that episode: the CDC “couldn’t call them and ask what’s going on.” For sixteen months, it still cannot — at least not officially, and not as a member at the table.

2. The Evidence: What the United States gave up

Critics of the WHO are correct that the agency is imperfect, that its COVID-19 response was uneven, and that the assessed contribution formula deserves scrutiny. None of those critiques justifies what the United States actually traded away. Four pieces of evidence make the cost concrete.

Cost Differential

4.4×

The Trump administration has proposed spending roughly $2 billion per year to duplicate the global disease surveillance functions the U.S. previously accessed through WHO membership at a fraction of the cost. Source: Federal Register / Executive Order 14155 fact record.

WHO Staff Reduction

2,371

Approximately one-quarter of WHO’s global workforce is being shed by mid-2026, with the African Regional Office hit hardest — directly degrading emergency response capacity for the ongoing Ebola PHEIC. Source: WSWS analysis of WHO restructuring.

CDC Workforce Cuts

2,400+

The CDC was ordered to lose roughly 18 percent of staff in April 2025 under HHS Secretary Robert F. Kennedy Jr., on top of multiple subsequent rounds of cuts and a $600 million grant clawback later contested in court. Source: STAT News reporting.

U.S. Measles Cases, 2026

1,912

As of mid-May, 2026 measles cases have already surpassed last year’s pace, with 93 percent of cases unvaccinated or unknown status. The U.S. is on track to lose its measles elimination status this November. Source: U.S. News measles tracker.

The president has not, despite the order’s promise to “fortify biosecurity,” built any credible domestic replacement for the international surveillance, laboratory, and coordination functions WHO performs. The administration’s own published plan acknowledges the duplication would cost more. The CDC, which would have to do most of that work, is simultaneously being eviscerated. Both can’t be true; neither can be defended.

3. The Timeline: How sixteen months made the world less safe

The chronology matters because it shows what the executive order chose, and what it foreclosed.

January 20, 2025

Executive Order 14155 directs WHO withdrawal on Trump’s first day in office. The one-year notice period begins under U.S. statutory obligations.

January 26, 2025

HHS issues a gag order halting all CDC communication with WHO. Public health officials lose access to outbreak intelligence in real time.

February 2025

Suspected Ebola case surfaces in the DRC. Jennifer Nuzzo of Brown University’s Pandemic Center publicly notes that the CDC “couldn’t call them and ask what’s going on.”

April 1, 2025

HHS Secretary Robert F. Kennedy Jr. announces 10,000 layoffs across federal health agencies, including 2,400 at the CDC and 3,500 at the FDA.

January 22, 2026

The United States formally exits the World Health Organization at the end of the statutory notice period. Argentina has joined; no other major democracy follows.

May 2, 2026

WHO is notified of the Andes hantavirus cluster aboard the M/V Hondius. CDC must now coordinate with the agency from outside its governance structures.

May 14, 2026

CDC confirms 41 people under U.S. surveillance for hantavirus exposure across multiple states. Eighteen are quarantined at Nebraska Medicine and Emory.

May 17, 2026

WHO Director-General Tedros Adhanom Ghebreyesus declares the Ebola Bundibugyo outbreak a Public Health Emergency of International Concern. The U.S. has no vote in those proceedings.

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The lesson of those eight dates is not subtle. Withdrawal happened first; emergencies followed. The argument for staying inside an imperfect institution is precisely that the next pathogen does not wait for the next administration. It arrives on the timeline of the virus, not of the president.

4. The Priorities: What the president chose instead

It is worth asking what received presidential attention during the months WHO membership was being terminated and the CDC was being hollowed out. The answer is on the public record. In January 2026, Trump wrote to Norwegian Prime Minister Jonas Gahr Støre that, having been denied the Nobel Peace Prize, he “no longer feel[s] an obligation to think purely of peace” and would pursue the acquisition of Greenland. On Easter Sunday in April 2026, he posted a profanity-laced threat to bomb civilian infrastructure in Iran, declaring on Truth Social: “Tuesday will be Power Plant Day, and Bridge Day, all wrapped up in one, in Iran.”

These are the messages a president sent to the world while WHO was triaging an Ebola PHEIC and the CDC was scrambling 100-plus staff onto a hantavirus response. They are not policy. They are not strategy. They are the public output of a chief executive who has decided that the institutions which protect American lives — international agencies, career scientists, the assessed contribution to global surveillance — are negotiable, and that his grievances are not.

The administration’s response to NPR’s reporting on the Ebola outbreak was to call accurate claims about USAID’s dismantling — claims sourced to WHO’s own representative in Congo, Anne Ancia, who said the cuts had a “tremendous impact” — “false.” This is the priorities question in miniature: the president is more invested in denying the consequences of his decisions than in revisiting them.

“The exact surveillance system meant to catch these viruses early — the Trump administration cut it. There is no version of this where the country is safer outside the WHO.”

— Matthew M. Kavanagh, Georgetown Center for Global Health Policy & Politics

5. The Constitution: When public health policy becomes a question of capacity

It is one thing for a president to make a policy choice that experts believe is wrong. It is another for a president to make a sequence of choices — at speed, in defiance of evidence, and in apparent indifference to the consequences — that suggests something has gone wrong with the office itself. That distinction is not editorial flourish; it is the precise question the Twenty-Fifth Amendment was designed to ask.

Constitutional Analysis · 25th Amendment, Section 4

The Drafters anticipated a presidency that could no longer discharge its duties. They built a remedy. It has never been used.

Section 4 of the Twenty-Fifth Amendment, ratified in 1967, provides that when the Vice President and a majority of “the principal officers of the executive departments, or of such other body as Congress may by law provide” determine that the President is “unable to discharge the powers and duties of his office,” the Vice President becomes Acting President. Congress has the power to create that “other body” — but in fifty-eight years, it has never done so.

On April 14, 2026, House Judiciary Ranking Member Jamie Raskin introduced legislation to finally establish the Commission on Presidential Capacity to Discharge the Powers and Duties of Office. Raskin’s bill came days after he sent a formal letter to White House Physician Captain Sean Barbabella demanding a comprehensive cognitive and neurological evaluation of the president. He is not alone:

Senator Ed Markey (D-Mass.) called for invocation following the Greenland-Norway letter. Senator Chris Murphy (D-Conn.) urged Trump’s Cabinet to “spend Easter calling constitutional lawyers about the 25th Amendment” after the Iran threat. Representative Raja Krishnamoorthi (D-Ill.) called on Vice President Vance and the Cabinet to act immediately. Representative Jasmine Crockett (D-Tex.) delivered a formal letter stating the president is “deranged, likely suffering from dementia.” Representatives Eric Swalwell, Sydney Kamlager-Dove, and Yassamin Ansari have all publicly joined the call.

The legal mechanism here is narrow and specific. Section 4 does not address bad judgment or policy disagreement. It addresses capacity. The case that the WHO withdrawal raises capacity concerns is straightforward: it terminates participation in an early-warning system without a functioning replacement; it imposes a known and material increase in pandemic risk for a savings the administration’s own budget proposal admits is illusory; and it is one of a documented pattern of decisions — Iran threats, Greenland letters, dismissal of career biosecurity staff — that even some of the president’s onetime allies have described as detached from the disciplines of office.

The Honest Barriers

The path is hard. Section 4 requires Vice President Vance and a majority of Cabinet officers — all appointed by Trump and confirmed by his Senate — to certify incapacity. Raskin’s commission bill cannot pass the current Republican House. Even if it did, the president would not sign it. Should the Vice President and Cabinet act, the president can reclaim his powers by written declaration, triggering a 21-day congressional review requiring a two-thirds vote in both chambers to remove him. The political math is not favorable.

Why the Barriers Don’t Settle the Question

None of that negates the constitutional and moral case. The Twenty-Fifth Amendment exists precisely because the framers of the modern constitutional order understood that the danger of an impaired presidency is not erased by the difficulty of remedying it. The argument for using Section 4 is not that it will succeed; it is that the public record now justifies the conversation. To refuse the conversation while a measles outbreak ravages forty states, a hantavirus is quarantined in Nebraska, and an Ebola PHEIC unfolds without American presence at the WHO table — that is the abdication.

6. The Stakes: What survives a presidency that quits the watch

There is a temptation, in moments like this, to retreat to procedure: to argue that WHO membership is a discretionary policy choice, that pandemic preparedness can be reconstructed, that the next administration can rejoin and the world will accept us back. Each of those propositions contains a sliver of truth and a wider falsehood.

The wider falsehood is that institutions of biosecurity are rebuildable on a presidential calendar. They are not. The relationships that make a global surveillance network function — the CDC scientists with two decades of WHO contacts, the laboratory partnerships in Geneva and Goma and Kinshasa, the trust that allows an African ministry of health to text a CDC counterpart before a press release goes out — those are built over years and broken in months. They have been broken in months. UNC Health’s David Wohl, who worked the 2014 Ebola epidemic, described the U.S. position in the current outbreak as “noticeably absent” — the polite phrasing for a country that withdrew the watchtower and is now surprised to find the perimeter unguarded.

The narrower truth is that this presidency has not merely declined to participate in international public health. It has actively dismantled the domestic backstop. CDC veterans describe an agency that has lost institutional memory, trust, and the rapid-response infrastructure built over twenty-five years. The decision to leave WHO and the decision to gut the CDC are not two decisions. They are the same decision, made twice, by the same man, against the same evidence.

That is what Section 4 of the Twenty-Fifth Amendment is for. Not because the path through it is easy, but because the framers understood that capacity for office is not measured by election results. It is measured by the choices made between them.

Editorial Conclusion

A president who walks his country out of the global early-warning system while three pathogens advance has chosen, in the most concrete way, where his loyalties lie — and they are not with the public he was elected to protect. The remedy the Constitution provides for a presidency that has lost the capacity to discharge its duties is hard. It is supposed to be. That is the wrong reason not to use it. The right reason to use it is that hantavirus does not wait for the midterms; Ebola does not wait for 2028; and measles is already in the schools of forty states. The watchtower is empty. The question is whether the country has the constitutional courage to staff it again — and to remove, by lawful means, the official who abandoned the post.