WHO director details health disruptions from US funding cuts, urges a more humane approach

Global infectious disease outbreaks could kill millions, including Americans

Lisa Schnirring

"Make the Plague Great Again"

The United States has been extremely generous for many years with its support for global health projects and is well within its rights to set its own priorities and funding levels, but the country has a responsibility to withdraw direct funding in an orderly and humane way that allows countries and groups to find alternative support, the head of the World Health Organization (WHO) said at a briefing.

Comments from WHO Director-General Tedros Adhanom Ghebreyesus, PhD, his most direct to date on the US cuts, come as regional health groups take stock of the impact of the cuts and seek to bolster other alliances and ways to boost domestic spending to address urgent health threats.

Malaria, HIV, TB programs already disrupted

Tedros also said the WHO is already seeing an impact from the Trump administration's freeze on foreign aid and its plans to shutter the US Agency for International Development (USAID), an independent US government agency established in 1961 and tasked with administering foreign aid and developmental assistance.

For example, over the past two decades the United States has been the biggest bilateral donor in the battle against malaria, which Tedros said has helped prevent 2.2 billion cases and 12.7 million deaths. "There are now severe disruptions to the supply of malaria diagnostics, medicines, and insecticide-treated bed nets due to stock outs, delayed delivery, or lack of funding," Tedros said, adding that if disruptions continue, hot spot countries could see 15 million malaria cases and 107,000 deaths this year alone, reversing 15 years of progress.

Suspensions of most funding for the President's Emergency Plan for AIDS Relief (PEPFAR) has led to an immediate stop in HIV treatment, testing, and prevention in more than 50 countries. The director-general added that eight countries are experiencing substantial disruptions in antiretroviral therapy, with some set to run out in the months ahead.

Regarding tuberculosis (TB), Tedros said 27 countries in Africa and Asia are experiencing crippling response breakdowns, with 9 reporting failing supply chains for TB drugs, putting the lives of patients at risk. "Over the past two decades, U.S. support for TB services has helped to save almost 80 million lives. Those gains, too, are at risk," Tedros said.

Global measles tracking in danger amid surging cases

Also, he said the WHO's global measles and rubella lab network was funded solely by the United States and faces a shutdown at the worst possible time as measles cases surge and number of outbreaks increase for the third year in a row.

Tedros encouraged the United States to reconsider its support for global health, which he said saves lives and also makes the United States safer. 

"Whether or not U.S. funding returns, other donors will need to step up, but so too must countries that have relied on U.S. financing, to the extent they can," he said. "WHO has long called for all countries to progressively increase domestic health spending, and that is now more important than ever."

Africa CDC bolsters ECDC connections, launches regional epidemic fund

The Africa Centre for Disease Control and Prevention (Africa CDC) has said that the US funding cuts come against a backdrop of an overall decline in support from Western countries over the past 4 years, and African health ministers are in the process of taking stock of the situation and looking at other sustainable financing options.

On March 11, Africa CDC announced the launch of a new African Epidemic Fund, which is designed to streamline and speed deployment of support for outbreak responses. The financing is a collaboration between Africa CDC, the African Union Commission, and the African Union Development Agency.

Africa is grappling with multiple health threats, which increased from 152 in 2022 to 213 in 2024. A multi-country mpox outbreak has affected 23 African nations, some of which have battled other recent outbreaks, including Ebola Sudan and Marburg virus.

Africa CDC Director-General Jean Kaseya, MD, MPH, met today with European Centres for Disease Prevention and Control (ECDC) Director Pamela Rendi-Wagner, MD, at ECDC headquarters in Stockholm to discuss deeper collaboration between the two groups.

In a statement, Rendi-Wagner said the work has already begun through ECDC contributions to Africa CDC–led outbreak responses. The agencies will also collaborate on "One Health" workforce development, which the ECDC said is essential for addressing the antimicrobial resistance threat. 

Funding shortages threaten healthcare in Afghanistan

Though some donors continue to support Afghanistan's healthcare sector, shifting developmental aid priorities have significantly reduced funding, the WHO Eastern Mediterranean Regional office said yesterday.

The office warned that the funding shortages could force the closure of 80% of WHO-supported healthcare services in Afghanistan by June. As of March 4, the funding cuts shuttered 167 healthcare facilities, cutting off medical care to 1.6 million people across 25 of the country's provinces.

Without intervention, 220 more could close by June, the regional office said, leaving 1.8 million more without care.  "In the worst affected regions--Northern, Western and Northeastern Afghanistan--more than a third of health care centres have shut down, raising alarms about an imminent humanitarian crisis," the group said.

Edwin Ceniza Salvador, MD, the WHO's representative in Afghanistan, said the closures affect mothers giving birth, children missing vaccinations, and entire communities left vulnerable to disease outbreaks. "The consequences will be measured in lives lost."