In recent months, the United States government has significantly reduced its contributions to numerous global health programmes and announced its withdrawal from the World Health Organization (WHO), raising concerns about the future of international health. These policy decisions have already had tangible effects worldwide, particularly in countries heavily reliant on US aid, including Afghanistan, Ethiopia, Ukraine, and the Democratic Republic of the Congo.
Since taking office, President Donald Trump has implemented sweeping budget cuts affecting domestic healthcare and international assistance. According to Professor Karl Blanchet, Director of the Centre for Humanitarian Studies at the University of Geneva, “People have already died and more will die because vital health programmes are no longer funded. Approximately 40% of budgets for UNHCR and UNAIDS previously came from the United States. These cuts place the health of 20 million people living with HIV at risk.”
Professor Alexandra Calmy, Director of the Clinical Research Centre at the University of Geneva and Head of the HIV Unit at Geneva University Hospitals, echoed these concerns. She noted that abrupt financial reductions have disrupted access to antiretroviral treatments and prevention initiatives worldwide, as well as ongoing research projects. “The sudden withdrawal of US support left no time to implement alternative solutions. Global solidarity systems must now be reconsidered,” she emphasised.
The scope of the impact is substantial. The elimination of 92% of USAID contracts, a primary channel of US foreign health aid, is projected to leave millions without essential services. Over 200,000 children may miss polio vaccinations, potentially leading to paralytic cases. Malaria incidence could increase by 18 million infections, and Ebola vaccinations, suspended due to funding gaps, may result in 28,000 additional cases. Professor Antoine Flahault, Director of the Institute of Global Health at the University of Geneva, warned that “viruses do not recognise borders; global health is under threat.” European experts also anticipate a resurgence of tuberculosis, including drug-resistant strains, as a direct consequence of reduced US financing.
The withdrawal of American funding has reverberated through humanitarian organisations. Dr Unni Krishnan, Vice-President of the International Council of Voluntary Agencies (ICVA), reported that two-thirds of member NGOs have had to suspend or reduce essential services, including medical aid and food distribution. Staff reductions have been widespread, with organisations such as Terre des Hommes in Lausanne, Caritas, and Swiss Protestant Aid (EPER) struggling to maintain operations in countries like Afghanistan, Burkina Faso, Kenya, Lebanon, India, Egypt, Ethiopia, Ukraine, and the Democratic Republic of the Congo.
The WHO itself faces significant financial strain, with the US historically providing 14% of the organisation’s budget. Its impending withdrawal by 2026 will reduce the agency’s budget by US$400 million, forcing cuts to staffing and global programmes. Katrin Holenstein, spokesperson for the Swiss Federal Office of Public Health, highlighted Switzerland’s commitment to sustaining WHO operations and effective multilateralism despite these challenges.
Experts emphasise that this crisis exposes the global dependency on US funding and underscores the need for structural reforms in international health governance. Professor Blanchet stressed the importance of supporting local humanitarian organisations and diversifying funding sources to reduce reliance on any single donor. Likewise, Professor Béatrice Schaad, Director of the Centre for Patient, Family and Professional Experiences at the University of Lausanne, noted that social capital — the knowledge, collaboration, and engagement of communities — is now as vital as financial resources in maintaining effective healthcare delivery.
In sum, the US budget cuts represent a profound disruption to global health, affecting research, prevention, and treatment programmes across multiple continents. Without immediate international coordination and alternative funding strategies, millions of vulnerable individuals face an increased risk of disease, diminished access to care, and further humanitarian crises.