Global health chiefs urge EU to step up amid US funding cuts

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Global health leaders are urging the European Union to step up to protect lifesaving health programs amid what they see as a “moment of reckoning” after the United States and other countries cut foreign aid spending.

The U.S.’s cuts to international development threaten the lives of millions of people and decades of progress in disease prevention and treatments, the leaders warned in interviews with POLITICO. They also said they worry these funding cuts present a worrying trend among some of the world’s richest — and traditionally most generous — countries.

“There are huge uncertainties,” said Peter Sands, CEO of the Global Fund to Fight AIDS, Tuberculosis and Malaria. “And the huge uncertainty is not just about the U.S., but about what other partners, what other donors, are going to do. And I think it comes down to a question of political will.”

Shortly after his January inauguration, U.S. President Donald Trump moved to dismantle the U.S. Agency for International Development (USAID), scrapping over 80 percent of its programs and slashing funding for numerous initiatives including those focused on HIV, tuberculosis and malaria prevention.

The U.S. administration is also reviewing foreign aid with its “America First” policy, leaving many organizations that depend on federal financial support anxious about their future.

The trend extends beyond the U.S. In February, the U.K. announced it will cut international development spending and instead boost its defense budget, while the Netherlands also said it is cutting foreign aid by €2.4 billion. Germany and France rolled back foreign aid budgets last year amounting to another €3 billion cut.

In this uncertain political landscape, global health leaders want the EU to step up.

“As some countries of the world backtrack from development assistance, it would be very important for the EU to signal — to Africa in particular — that development is still a priority and that the EU is a reliable partner,” said Sania Nishtar, CEO of Gavi, the Vaccine Alliance.

As Europe increases its defense expenditure, Nishtar said she recognizes security is an important priority. “But health security is a very important aspect of the security paradigm,” she added.

“Both for the European Commission itself and for the EU as a whole, there is a real opportunity to demonstrate leadership (in global health).”

The Commission didn’t immediately respond to a request for comment.

Laurent Muschel, acting director general at the EU’s Health Emergency Preparedness and Response Authority (HERA), said at a recent event that the Commission is “committed to continue to support global health.”

Bracing for impact

The Global Fund and Gavi both have replenishment rounds this year — and U.S. contributions can make a large difference to their operations.

The U.S. has traditionally been The Global Fund’s largest donor, contributing $1.7 billion in 2024. The government also gave $300 million to Gavi in 2024, and former U.S. President Joe Biden made a five-year pledge of at least $1.58 billion last year. The potential impact of further foreign assistance cuts would be enormous.

Gavi has vaccinated over 1.1 billion children over the past 25 years, saving nearly 19 million lives, according to its statistics. “Vaccination is one of the most cost-effective life-saving interventions on this planet,” Nishtar said. “Now more than ever, it’s very important that EU and countries in the EU step up and signal the importance of this life-saving intervention.”

The Global Fund says it has contributed to cutting the combined death rate from AIDS, TB and malaria by 61 percent over the past two decades, saving 65 million lives.

“We’re talking about disease programs that affect millions of people,” Sands said. There are roughly 25 million people on antiretroviral treatment in the countries where PEPFAR (the President’s Emergency Plan for AIDS Relief) and the Global Fund are investing, he said — “people whose health is potentially at risk from disruptions to programming.”

These HIV funding cuts also come as the world has a “game changing opportunity” to bring forward the end of HIV as a public health threat, he added, thanks to the latest drugs.

The World Health Organization (WHO) has already warned that the recent funding cuts will have a “devastating impact” on tuberculosis (TB) programs worldwide, given that the U.S. has historically been the largest donor. In some countries cuts are already causing severe disruptions, and the timing couldn’t be worse: The European region is experiencing a 10 percent surge in childhood TB cases.

In malaria treatment and prevention, where progress had already stalled due to challenges such as climate change, drug resistance and ongoing conflicts, “now we run the risk that we go backwards,” Sands said.

Health leaders are warning that these cuts will impact those living in the most vulnerable communities, including low- and middle-income countries and war zones.

Andriy Klepikov, executive director of the Alliance for Public Health, one of the largest HIV- and TB-focused NGOs in Ukraine and Eastern Europe, said that rumors that the White House is considering shutting down the HIV prevention division of the Centers for Disease Control and Prevention (CDC) are “worrying.”

“It would be a disaster,” he told POLITICO. “We would be dealing with thousands of undiagnosed people, with all range of consequences, like spikes in HIV infections, but also health consequences and complications.”

The alliance receives about one-third of its funding from the U.S. and its operations have already been disrupted, with USAID cuts threatening to halt one of their mobile clinics — delivering health care to people on the frontline and in rural areas.

“We managed to find money but it’s a short-term solution,” Klepikov said.

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