The Trump administration’s announcement to reduce US foreign aid funding has sent shockwaves through the global health community. Among the most affected are Gavi, the Vaccine Alliance, and major anti-malaria initiatives. These cuts, part of a broad reduction in programmes managed by the United States Agency for International Development (USAID), have raised significant concerns regarding the future of life-saving interventions in vulnerable nations.
The proposed withdrawal of $2.6 billion from Gavi’s budget is projected to leave 75 million children without access to routine vaccinations over the next five years. Gavi, which has vaccinated children around the world and saved an estimated 19 million lives since its inception, has relied on the US for 13% of its funding. Experts warn that this could result in 1.2 million preventable child deaths.
Malaria control suffers setbacks
The cuts affect malaria prevention and treatment programmes, specifically targeting the President’s Malaria Initiative (PMI). Managed by USAID in collaboration with the Centers for Disease Control and Prevention (CDC), PMI is among the world’s leading anti-malaria efforts. In 2024, malaria funding represented approximately 9% of the US global health budget, totaling around $1 billion.
This reduction could severely disrupt progress in malaria control, one of the leading causes of child mortality worldwide. Aid organisations warn that withdrawing support at this time could reverse the gains achieved over the past decade, endangering the lives of millions in malaria-endemic regions.
Uneven support for health programmes
Despite these cuts, the administration has chosen to uphold specific programmes, including support for HIV and tuberculosis treatments and food aid in regions affected by war and disaster. While this continuation provides some relief, it also indicates a strategic reprioritisation of US foreign health policy – favouring certain conditions while retreating from broader preventive care and immunisation efforts.
Global backlash and concerns over US reliability
The scale of these cuts is staggering: over 80% of USAID programmes are slated for elimination, potentially terminating 5,200 contracts and disrupting tens of billions of dollars in aid. This announcement has caused anxiety among humanitarian organisations and development partners.
Dr Sania Nishtar, CEO of Gavi, urged a reconsideration, emphasising that Gavi’s work is crucial to global health security, including for Americans. Immunisation, she stated, helps prevent disease outbreaks and ensures emergency vaccine stockpiles are prepared for threats like Ebola and cholera.
International donors, including Sweden, Norway, and the Netherlands, are now seeking clarification regarding their co-funding agreements with USAID. This uncertainty has shaken global confidence in US financial partnerships and could potentially jeopardise future collaborative health efforts.