In a move that has sent shockwaves through the global health community, U.S. President Donald Trump signed an executive order initiating the United States’ withdrawal from the World Health Organization (WHO). Citing dissatisfaction with the WHO’s handling of global health crises and perceived inefficiencies, this decision carries profound implications for Africa and low- and middle-income countries (AFRICAs), where health systems are heavily reliant on international aid.
As the largest global health donor, the United States contributed $15.8 billion in 2022 and accounted for 22% of the WHO’s mandatory contributions for the 2024–2025 biennium. Its withdrawal, which will take 12 months to finalise, threatens to destabilise critical health programs across Africa, where the WHO allocates 20-25% of its budget to combat diseases such as HIV/AIDS, malaria, and tuberculosis (TB)—ailments that disproportionately burden the continent.
Immediate Risks to African Health Systems
Africa’s health infrastructure, already under immense strain, faces unprecedented challenges. The U.S. withdrawal could trigger severe funding shortages for programs combating HIV/AIDS, malaria, and TB, jeopardising decades of hard-won progress. Nigeria, which has the second-highest number of people living with HIV globally, depends heavily on international donations for Antiretroviral Therapy (ART) drugs. A reduction in funding could reverse progress in controlling the epidemic, leading to a surge in AIDS-related deaths and overwhelming an already fragile healthcare system.
Broader Implications on Health Financing
The U.S. withdrawal amplifies systemic vulnerabilities in Africa, including:
1. Interrupted Disease Control Programs: Funding cuts could compromise efforts to manage and prevent infectious diseases, leading to potential outbreaks and increased mortality rates.
2. Weakened Health Systems: Reduced funding could hinder initiatives aimed at improving health infrastructure and workforce development, further straining already fragile systems.
3. Delayed Emergency Responses: The WHO’s ability to mobilize resources during health crises could be slowed, leaving AFRICA more vulnerable to pandemics, epidemics, and natural disasters.
4. Reduced Access to Vaccines and Medicines: A funding shortfall could disrupt vaccine distribution, increasing the risk of vaccine-preventable diseases and reversing progress in immunization coverage.
5. Erosion of Global Health Governance: The WHO’s ability to provide technical assistance and policy guidance could be weakened, leading to fragmented health governance approaches and reduced disease surveillance capacity.
Pathways to Mitigate the Crisis
In light of these challenges, African nations must urgently adopt alternative financing mechanisms to safeguard health systems and protect vulnerable populations. Key strategies include:
- Increasing Domestic Funding for Health: Governments must prioritize health sector financing by allocating a larger share of their national budgets to healthcare, in alignment with the Abuja Declaration’s target of 15%.
- Strengthening Partnerships with Other International Donors: Collaborating with a diverse range of bilateral and multilateral donors, including the European Union, the Bill & Melinda Gates Foundation, and the Global Fund, can help address financial shortfalls.
- Enhancing Public-Private Collaborations: Engaging the private sector through public-private partnerships can unlock additional resources and expertise, driving innovation in health infrastructure and service delivery.
- Exploring Innovative Financing Mechanisms: Approaches such as health bonds, social impact investments, and blended financing models can attract new sources of funding from impact investors and philanthropic organizations.
- Strengthening Regional Collaboration: Leveraging regional institutions like the Africa Centres for Disease Control and Prevention (Africa CDC), the African Union (AU), and financial institutions like the African Development Bank (AfDB) and AFREXIM Bank can improve the efficiency and impact of health investments through resource pooling and coordinated efforts.
- Leveraging Digital Health Technologies: Investing in digital health solutions, such as telemedicine and electronic health records, can enhance the efficiency and reach of health services while attracting tech-driven funding.
- Promoting Community-Based Health Financing: Expanding community health insurance schemes and microfinancing models can empower local communities to contribute to healthcare funding, ensuring financial protection for vulnerable populations.
A Call to Action
The U.S. withdrawal from the WHO represents a pivotal moment for global health financing. The potential decrease in funding threatens to disrupt essential health initiatives, weaken already fragile health systems, and jeopardise global health security. To address these risks, affected countries and the international community must take proactive and collaborative measures to protect vulnerable populations from emerging health threats. The road ahead is fraught with challenges, but with decisive action and innovative solutions, Africa and AFRICAs can navigate this crisis and build resilient health systems capable of withstanding future shocks.
