Making a stand for global health

A flurry of executive orders from US President Donald Trump has withdrawn US participation and funding from foreign assistance and international global health programmes – withdrawing the US from the World Health Organization, suspending PEPFAR, dismantling USAID and suspending foreign aid – as well as hollowing out key functions of the FDA and CDC, and cutting or suspending research funding from the NIH and NSF.

Nominally made in the service of countering waste, these decisions are likely to harm the health and security of American citizens, and even the US economy itself. Our research has proven that investment in global health R&D, for example, not only provides an outstandingly good return to society globally – returning $405 in societal value for every $1 invested – it also boosts the economy on a national level by generating jobs, creating value in intellectual property, and stimulating private investment.

Given the scale of the US contribution to the global health ecosystem, though, and the nature of the programmes and funding being cut, it’s clear that the true impact will be global, significant and far reaching, and will fall disproportionately on those who are most vulnerable. Such a rapid withdrawal will have both immediate and long-term effects, and will undoubtedly cost lives.

But while the rapidity and severity of the withdrawal from this space is unprecedented, it doesn’t occur in a vacuum. We highlighted, just two weeks ago in our latest G-FINDER report, another decline in annual global investment in R&D for neglected diseases, driven by a significant drop in funding from the US and other high-income country governments. Meanwhile the government of the UK is expected to significantly pare back its support to Gavi, having long been one of the vaccine alliance’s largest single donors, while ODA budgets across the globe are being cut. Multilateralism and international cooperation are out of favour, and nationalism is on the rise.

At the same time, discussions around the likely impact of the US withdrawal highlight the unhealthy degree to which global health financing and governance has historically depended on the contribution of the US in particular, and a small cohort of high-income countries in the global north in general. We clearly saw the limits of this system in the inequities of the global response to COVID-19, and we can hear the growing voices of those who see the current moment as an opportunity to address this power imbalance.

Impact Global Health is committed to making a stand for global health, and doing our part to help shape a sustainable future. Over the next 12 months we commit to host a series of dialogues with global health R&D leaders in Brazil, Rwanda, South Africa, India, the UK, Australia, Brussels, Berlin and Geneva, on the future of global health R&D investment. Through these conversations we will co-create an R&D investment roadmap that is fit for the current moment, as well as the future we want to see: one that is focused on sustainability, equity and innovation. It is time to shape a new ecosystem of funding.

Stay tuned for further information on the schedule of dialogues. If you are interested in participating, collaborating, or supporting these efforts, please get in touch at partnerships@impactgh.org.  

Nick Chapman, CEO of Impact Global Health