The United States has long been a generous supporter of global health initiatives, providing significant funding for programs aimed at combatting diseases such as malaria, HIV, and tuberculosis. However, recent decisions to cut financial aid have sparked serious concerns among health organizations worldwide. At a briefing on March 18, 2025, World Health Organization (WHO) Director-General Dr. Tedros Adhanom Ghebreyesus addressed the implications of these U.S. funding cuts, describing them as catastrophic for ongoing health programs.
Dr. Tedros explicitly stated, “The United States has been the biggest bilateral donor in the battle against malaria for two decades, helping prevent 2.2 billion cases and 12.7 million deaths.” Despite this success, the director noted that recent disruptions caused by funding cuts are reversing years of progress. He warned that if current funding issues persist, hot spot countries could experience an astonishing 15 million malaria cases and 107,000 deaths within the year.
The impact of these cuts is also felt in the realm of HIV treatment. According to Dr. Tedros, the suspension of funding for the President’s Emergency Plan for AIDS Relief (PEPFAR) has halted HIV testing, treatment, and prevention services in more than 50 countries, risking the health of countless individuals who depend on these resources to stay healthy. “Eight countries are experiencing substantial disruptions in antiretroviral therapy. Some are set to run out in the months ahead,” he stated.
Further compounding these issues, tuberculosis (TB) response capabilities are being severely hampered, with 27 countries reporting response breakdowns, and nine of them facing failed supply chains for TB drugs. Dr. Tedros pointed out, “U.S. support for TB services has helped to save almost 80 million lives over the past two decades. Those gains, too, are at risk.”
In a time when the global health landscape is becoming increasingly precarious, outbreaks of measles and rubella are also on the rise, underscoring the urgency of the situation. Dr. Tedros noted that the WHO's global measles and rubella lab network, solely funded by the United States, is now at risk of shutting down, coinciding with rising measles cases globally for the third year running.
Adding to the strain, the Africa Centre for Disease Control and Prevention (Africa CDC) recently announced the establishment of an African Epidemic Fund on March 11, 2025. This initiative aims to provide sustainable financing options amid declining support from Western nations. Africa CDC’s response reflects a newly heightened urgency, considering the range of health threats that increased across the continent from 152 in 2022 to 213 in 2024, driven largely by a multi-country mpox outbreak affecting 23 African nations.
The partnership between Africa CDC and the European Centres for Disease Prevention and Control (ECDC) was also front and center during a recent meeting on March 18, where both organizations discussed enhancing collaboration on health security initiatives. ECDC Director Dr. Pamela Rendi-Wagner highlighted, “Close cooperation between ECDC and Africa CDC is essential for global health security,” further emphasizing the interplay between health threats on opposite sides of the globe.
The ECDC has actively supported local outbreak responses, deploying its experts ten times in 2024 alone to address incidents related to mpox, Marburg, and cholera in Africa. The discussions between ECDC and Africa CDC indicate a joint commitment to building a stronger health workforce to tackle emerging threats, and aims to enhance disease surveillance, epidemic preparedness, and response.
Meanwhile, the strain of funding shortages isn’t confined to Africa alone; Afghanistan’s healthcare sector is facing a similar crisis. The WHO Eastern Mediterranean Regional Office warned that due to shifting developmental aid priorities, 80% of healthcare services supported by the WHO in Afghanistan might close down by June 2025. As of March 4, 2025, 167 healthcare facilities have already ceased operations, affecting 1.6 million people across the country. Without intervention, the closure of an additional 220 facilities by mid-year could leave over 1.8 million more without medical care.
Edwin Ceniza Salvador, WHO’s representative in Afghanistan, lamented, “The consequences will be measured in lives lost.” The loss of healthcare facilities would impact vulnerable populations, particularly mothers giving birth and children needing vaccinations.
As the global health landscape grows more complex, health experts continue to recommend approaches to strengthening domestic health spending. WHO calls for countries relying on U.S. financing to bolster their own health budgets to mitigate the adverse impacts of funding reductions. Dr. Tedros echoed this sentiment, urging nations to progressively invest in domestic health systems.
Ultimately, the recent cuts to U.S. funding for global health programs serve as a stark reminder of how interconnected health systems across the globe truly are. The ripple effects of reduced financial aid will likely extend beyond just those immediate situations and impact broader global efforts to combat infectious diseases and ensure health security.
As international health agencies and nations navigate these changing dynamics, the emphasis on cooperation, partnership, and sustainable development becomes more crucial than ever.
