At a press conference on Monday, WHO officials laid out the many ways countries around the world are being impacted in real-time by the U.S. withdrawal of crucial humanitarian aid funds.
The impacts are being felt on the heels of the Trump administration’s rapid dismantling of USAID, a key agency that oversees humanitarian, development and security programs in some 120 countries. Global health experts say that USAID has practiced a form of soft power around the world.
WHO Director-General Tedros Adhanom Ghebreyesus would not comment on Trump's decision to withdraw the U.S. from the WHO. Instead, he focused on the “serious disruptions” being caused by cuts through USAID. “In many countries, the abrupt loss of U.S. funding threatens to reverse progress,” Tedros said, on many issues from immunizations to maternal health to emergency preparedness.
For instance, the U.S. has been the largest contributor to the fight against malaria over the past two decades, Tedros said. If cuts continue, there could be an additional 15 million cases of malaria and 107,000 deaths in 2025. A similar story is happening with HIV, he said: suspension of U.S. funding could lead to an additional 10 million cases of HIV and 3 million unnecessary deaths.
Gains made in tuberculosis, immunizations and polio are similarly at risk.
“It’s within its rights to decide what it supports and to what extent, but the U.S. also has a responsibility to ensure that if it withdraws direct funding for countries, it’s done in an orderly and humane way that allows them to find alternative sources if funding. We ask the U.S. to reconsider its support for global health,” Tedros said.
This funding not only helps international communities, he added, but also keeps the U.S. safer by preventing the spread of outbreaks.
If the U.S. ultimately decides not to restore direct funding, the WHO requests that the U.S. at least engage in a dialogue with affected countries to help them transition to sustainable alternative funding solutions “without disruptions that cost lives," Tedros said. Regardless of what happens, other donors need to step up and member states need to increase their own domestic health spending.
In terms of immediate deaths already being seen as a result of U.S. policy, The New York Times recently reported anecdotal evidence that mothers and children have died in South Sudan without access to life-saving HIV medications. Among the countries most at-risk are Haiti, Kenya, South Sudan, Nigeria and Ukraine.
But it is hard to estimate the exact impact to lives so far, experts at the press conference cautioned. For instance, because vaccines are preventive, the effects of disruptions may take time to materialize. “The quantification of deaths right now is not the matter,” Katherine OBrien, M.D., M.P.H., director of the Department of Immunization, Vaccines and Biologicals at WHO, said. “It’s that the actions right now are life-threatening.”
“What we’re seeing now is just laying the groundwork for hundreds of thousands of deaths that will happen on an annual basis because of the withdrawal right now," OBrien added.
When it comes to people in humanitarian crisis zones that depend on aid to survive, such as in Gaza, WHO estimates a closure of more than 900 hospitals and 1,200 primary care sites across a dozen countries. Because of this, WHO estimates a quarter of this type of population is at risk of death.
Speaking about WHO’s plan for sustainable funding going forward, Michael Ryan, executive director of the WHO Health Emergencies Programme, said the organization is adapting in real-time. Its first priority is severe cost containment, including reconsidering WHO travel and meetings where appropriate.
WHO is continuing its fundraising work and needs more contributions from member states, Ryan said, echoing Tedros. This would also empower member states to set their own aid priorities. Over the last few months, WHO raised a successful funding round. But because of the recent budget drop from the U.S. and reductions from other donors, Ryan said, WHO teams have been instructed by the director general to reduce their budget expectations for the future. Ryan’s own 2-year budget for the emergencies program has dropped from $1.2B to $872M. That means a 25% contraction in the program, he said.
“The question is, what do you want to stop doing?” Ryan said. “There are some terrible choices to be made… choices we would never have wanted to make.”
The WHO has 194 member states today and coordinates with 900 healthcare partners across 30 countries.