Scientists are trying to measure the impact on global health of funding for funding by the US administration. Credit: Luis Tato / AFP via Getty
The United States has spent around $ 12 billion on world health in 2024. Without these annual expenses, around 25 million people could die over the next 15 years, according to models that have estimated the impact of these discounts on tuberculosis, HIV, family and child and child health planning programs.
The United States has long been the largest donor of health initiatives in poor countries, representing almost a quarter of all world aid on donor health. These investments have contributed to coherent public health gains for more than a decade. The deaths of HIV, for example, fell 51% worldwide between 2010 and 2023, and deaths due to tuberculosis fell by 23% between 2015 and 2023.
But the administration of the American president Donald Trump reduced billions of dollars in spending for global health, in particular the dismantling of the American agency for international development (USAID) and freeze abroad Contributions – some of which have been temporarily restored.
The researchers tried to study the potential impact of financing cuts. John Stover, a modeling of infectious difficulties in the future Health, a global-health organization in Glastonbury, Connecticut, and its colleagues have used mathematical models to estimate the results for health, if all American funding for global health were to be reduced and not replaced, compared to the results if the funding provided in 2024 should continue at 2040.1.
Source: Stover / Preprints with Lancet
Researchers “use a combination of robust, well -established and tested mathematical models and analytical approaches to estimate the impact,” explains Andrew Vallely, a clinical epidemiologist at the Kirby Institute of the University of New South Wales in Sydney, Australia. “Their conclusions are devastating to read” and “an alarm clock so that we all work in global health”.
James Trauer, an infectious disease modeler at Monash University in Melbourne, Australia, adds: “These models are probably as good as we have for the moment to predict the direct effects of funding reductions on these different programs.”
On March 28, Marco Rubio, the US Secretary of State, said the government redirected its foreign assistance programs to align with the country’s priorities. “We are pursuing essential rescue programs and carrying out strategic investments that strengthen our partners and our own country.”
HIV and AIDS
The researchers have modeled the impact of the reduction in the US President’s emergency plan for the relief of AIDS (PEPFAR) in the 55 countries he supports, in particular by stopping the delivery of treatments, tests and interventions that prevent transmission. The program was allocated by financing freezing.
Without Pepfar, there would be 15 million deaths of AIDS by 2040 that if the program continued (see “A World Without US Aid”). More than 60% of these deaths would take place in six African countries, including Mozambique, Nigeria and Uganda. About 14 million additional children would become orphans following these AIDS deaths – a trend that was to decrease over the next 15 years. And 26 million more people could be infected with HIV without Pepfar.
Source: Stover / Preprints with Lancet
The impact varies considerably according to the dependence of a country on the support of the United States government, explains Stover. In Uganda, for example, 65% of the financing of HIV research comes from the United States, he said. Some models have estimated the effects of a partial financing scenario; In this case, continuous financing of treatment alone could avoid 97% of additional deaths and 90% of new additional HIV infections.
Tuberculosis
The world number of infections of Mycobacterium tuberculosis – The bacteria that causes the deadliest infectious disease in the world – should also accelerate without funding for American aid. Researchers have examined the impact of USAID discounts and American contributions to the Global Fund to combat AIDS, tuberculosis and malaria in 79 low and intermediate income countries – although it is not yet clear by the quantity of American contributions to the Recresh Fund in the coming years. These would contribute to 69 million more Mr. Tuberculosis Infections and 2 million additional deaths by 2040.
These estimates are largely consistent with other efforts to assess the impact, explains Trauer.
“There have been enormous progress made in global health in the past two decades and we risk losing a lot of this,” said Katherine Horton, epidemiologist at the London School of Hygiene & Tropical Medicine, who has contributed to modeling on tuberculosis.