The Ebola outbreak in East Africa is escalating quickly. Cases have been confirmed in major cities in the Democratic Republic of Congo and Uganda. Experts and health workers on the ground report that the response has been hampered by the minimal involvement of the United States, a country that was traditionally at the forefront of handling such crises.

Previously, the United States funded extensive disease monitoring systems in the region. These networks included emergency teams ready for crises like the current outbreak. However, much of this structure ended with the closure of the U.S. Agency for International Development last year. Additionally, the U.S. Centers for Disease Control and Prevention has lost hundreds of experts, including those based in the Democratic Republic of Congo, who could have played crucial roles in containing the epidemic.

Those who worked on previous Ebola outbreaks note that the delay in bringing this outbreak to international attention is a clear consequence of these weakened surveillance networks. The outbreak was only brought to the attention of American officials nine days after the World Health Organization learned of it, and almost a month after the initial death. This delay partly stemmed from laboratory samples being mishandled, a process that U.S.A.I.D. previously managed.

As of Wednesday, the World Health Organization reported that 600 people were believed to be infected, and 139 had died. This represents a sharp increase over a few days. The numbers are expected to rise as contact tracing and testing ramp up, helping to gauge the virus’s spread.

Confirmed infections include cases in Goma, a Congolese city with a population of over a million near the Rwandan border. Cases are also present in Bunia, home to around 800,000 people, and Kampala, Uganda’s capital, with a population of 1.9 million. These developments suggest the virus has a significant geographical reach. Goma is located approximately 350 miles from where the first cases were detected.