Africa must rethink health funding after Trump’s WHO exit: expert

A public health expert has warned that President Donald Trump’s decision to withdraw the US from the World Health Organization will affect Africa’s health responses and says that the continent must rethink its financing of public health.

“It is time for some of the African member states to rethink the financing of public health,” Ngashi Ngongo, principal advisor to the director general and the continental incident manager for Mpox at the Africa Centre for Disease Control and Prevention (Africa CDC), told a media briefing. 

“We know the role that the WHO has played on the continent… to really improve the delivery of health programmes…The reduction or the cutting of (US) funding is definitely going to affect the response,” he said.

Soon after taking office last week, Trump signed an executive order intending to withdraw the US from the WHO, citing the organisation’s performance during the Covid-19 pandemic and what he claimed was an imbalance in the organisation’s funding between the US and China. The WHO is led by Ethiopian director-general Tedros Adhanom Ghebreyesus, the first African to head the organisation. 

Numerous African countries rely on US investments through the WHO to fund public health initiatives: the US accounts for 15% of total WHO funding. Ngongo said Africa CDC might look to other non-African countries to overcome the expected decrease in WHO support from the US withdrawal.

Fears for HIV/AIDS response

Mthuli Ncube, Zimbabwe’s finance minister, said he feared that the US withdrawal could decrease health support to nations most impacted by HIV and AIDS, including Zimbabwe. 

“Any country with an HIV/AIDS challenge will be impacted.” Ncube said. 

“This is a concern, a fear we are expressing…We need to scale up our funding for health. The earmarked taxes should be directed towards health as we build our capacity to fill the gap should any funding recede,” Ncube told an online briefing from Davos, where he was attending the World Economic Forum annual meeting.

As well as health funding through the WHO, the US historically combats HIV/AIDS in Africa via the President’s Emergency Plan for AIDS Relief (PEPFAR). Zimbabwe currently receives more than $200m a year from PEPFAR, “the largest commitment by any nation to address a single disease” according to the US Embassy in Zimbabwe. The US government says it has given Zimbabwe over $1.7bn since 2006 in order to strengthen health systems and to support people living with HIV.   

However, this week it was announced that nearly all global health funding from the US has been halted immediately by the Trump administration as part of a pause of virtually all US foreign assistance for at least 90 days pending a review. It is unclear whether PEPFAR will be permanently affected. 

Following Trump’s decision to leave the WHO, the organisation released an official statement, in which it expressed its disappointment at the withdrawal.

“The World Health Organization regrets the announcement that the United States of America intends to withdraw from the Organization. The WHO plays a crucial role in protecting the health and security of the world’s people, including Americans, by addressing the root causes of disease, building stronger health systems, and detecting, preventing and responding to health emergencies, including disease outbreaks, often in dangerous places where others cannot go.

“We hope the United States will reconsider and we look forward to engaging in constructive dialogue to maintain the partnership between the USA and WHO, for the benefit of the health and well-being of millions of people around the globe”.