The recent decision by the United States to withdraw from the World Health Organization (WHO) marks a pivotal moment in global health governance. This move raises significant concerns about the repercussions for health programmes across the African continent, a region heavily reliant on WHO-supported initiatives to combat infectious diseases, address public health emergencies, and strengthen fragile healthcare systems.
Africa has historically benefitted from numerous WHO initiatives, including vaccination campaigns, disease surveillance systems, and support for healthcare infrastructure development. Programmes such as the Global Polio Eradication Initiative and malaria control efforts have made substantial progress, saving millions of lives across the continent. The US has been a major financial contributor to the WHO, providing nearly 15% of its budget. With the withdrawal, there is an immediate risk of funding cuts to these critical initiatives, potentially reversing gains in disease prevention and control.
One stark example that underscores the importance of US funding is the President’s Malaria Initiative (PMI), a flagship global health programme supported by both the US and the WHO. Over the past two decades, PMI has worked in collaboration with African governments to scale up the distribution of insecticide-treated mosquito nets, antimalarial drugs, and indoor residual spraying. In sub-Saharan Africa, these efforts contributed to a dramatic 44% reduction in malaria-related deaths between 2000 and 2019, according to WHO data. A withdrawal of US funding threatens the sustainability of these interventions, putting millions of lives—particularly children under the age of five—at risk.
Another critical area affected is the fight against HIV/AIDS. Through collaborations with the WHO and other organisations, Africa has made strides in reducing the prevalence of HIV, improving access to antiretroviral therapy, and addressing stigma. The US President’s Emergency Plan for AIDS Relief (PEPFAR)—the largest commitment by any country to combat a single disease—has worked closely with WHO to deliver lifesaving treatments and prevention services across Africa. In countries like South Africa, which has the highest burden of HIV globally, PEPFAR and WHO have jointly supported the rollout of antiretroviral drugs to over 5.4 million people. Without the US’s financial backing of WHO, these partnerships face serious challenges in maintaining treatment access and prevention programmes.
Another area of concern is pandemic preparedness and response. Africa remains at high risk for emerging infectious diseases, as demonstrated during the 2014–2016 Ebola outbreak in West Africa. WHO’s role in coordinating regional and international responses was instrumental in containing the epidemic. A diminished WHO budget could weaken Africa’s ability to respond effectively to future outbreaks, endangering both regional and global health security.
Public health experts have expressed alarm over the potential impact of this decision. Dr Matshidiso Moeti, WHO Regional Director for Africa, emphasised the need for robust multilateral collaboration to address the continent’s health challenges: “The withdrawal of significant funding could delay lifesaving interventions, undermining decades of progress in tackling diseases like polio, HIV, and malaria.”
In addition to funding losses, the withdrawal undermines the broader principle of international cooperation in health. Africa’s health systems often depend on technical guidance, capacity building, and logistical support from the WHO. The absence of a unified global framework could result in fragmented responses to pressing health challenges, leaving African countries to navigate these issues with fewer resources and diminished international solidarity.
While the US decision is rooted in broader geopolitical considerations, the collateral damage to vulnerable populations in Africa is undeniable. Policymakers, multilateral organisations, and donors must explore alternative mechanisms to fill the funding gap and ensure the continuity of vital health initiatives. African governments, too, may need to intensify regional cooperation and invest more in health systems to mitigate the fallout from this decision.
In conclusion, the US withdrawal from the WHO risks significant disruption to health programmes in Africa, threatening to reverse progress in disease control and public health preparedness. The international community must prioritise solutions that uphold the integrity of global health systems and protect the most vulnerable populations from the consequences of this decision.
