African countries will have “no option” but to find other sources of support for their public health programmes if the United States pulls back – and Korea, China and Japan have already provided help during recent disease outbreaks.

This is according to Dr Ngashi Ngongo, a senior Africa Centres for Disease Control and Infection (Africa CDC) official, at a media briefing on Thursday.

On his first day in office on Monday, US President Donald Trump withdrew from the World Health Organization (WHO) and froze all foreign aid for 90 days to “re-evaluate and realign” its support.

There is also pressure from conservatives for Trump to defund and reform the US President’s Emergency Plan for AIDS Relief (PEPFAR).

“Some of the decisions made by President Trump on WHO, on PEPFAR, are of great importance to Africa…  given the weight of the US government when it comes to the funding of public health in Africa,” said Ngongo, who is principal advisor to the Director General of Africa CDC.

“They are one of the main contributors of public health in Africa. PEPFAR is funding HIV programmes in many countries that have very much relied on the American investment.”

The WHO assists African countries with technical assistance to “improve the delivery of health programmes” and the US withdrawal of funds will be a “blow” to the continent, he added. The WHO will lose around 20% of its funding when the US cuts its funds.

Although the US is obliged to give a year’s notice of withdrawal from the WHO, Trump’s executive order directs State officials to “take appropriate measures, with all practicable speed” to “pause the future transfer” of US of government “funds, support, or resources to the WHO”.

Rwanda health financing meeting

On 14 February, Rwandan President Paul Kagame is hosting a meeting of African leaders on health financing where alternative funding sources can be discussed, he added.

More domestic spending to ensure “more sustainable, predictable financing for public health”, the establishment of an African epidemic fund and identifying new sources of support are all options to fill any gap left by a US withdrawal, he added.

“We’ve received support from many countries – from [South] Korea, from China, Japan, many have come forward to provide funding, either the cash or equipment,” he added.

“We will be exploring the opportunities of also broadening the resource mobilization of those other countries that are really willing to step in.”

The rationale Trump has give for the 90-day funding freeze is that the “foreign aid industry and bureaucracy are not aligned with American interests and in many cases antithetical to American values”.

 In addition, they “destabilize world peace by promoting ideas in foreign countries that are directly inverse to harmonious and stable relations internal to and among countries”.

The new US Administration is likely to use the 90 days to exert pressure on countries – particularly on issues such as  abortion, LGBTQ rights and support for Palestine.

Mpox outbreak 

Meanwhile, mpox continues to spread on the continent with 5,842 new cases reported in the past week. The DRC continues to be the epicentre of the outbreak, but the outbreak is speading in Uganda, which reported four deaths over the past two weeks.

Meanwhile, Burundi’s outbreak is showing signs of slowing down, said Ngongo, whereas cases in Sierra Leone have jumped from one to 12.

Uganda’s outbreak was spread initially by truck drivers but is now in the general population, according to Africa CDC epidemiologist Dr Merawi Aragani. 

The capital of Kampala is the epicentre of Uganda’s outbreak, with slightly over 1,000 cases.

Around 400,000 people have been vaccinated against mpox. The Central African Republic (CAR) started its vaccination campaign this year.

Tanzania confirms second Marburg case 

In Tanzania,  nine of the 10 people suspected to have been infected with the Marburg virus have died. Only two of these were confirmed to have been infected with Marburg. 

A further 29 suspected cases have tested negative, but Ngashi said that Africa CDC had no reason to question the accuracy of Tanzania’s testing.

“The results are being conducted in the national public health laboratory in Dar es Salaam, which confirmsis the highest laboratory in the country,” said Ngongo.

“We trust the result. As you know, Tanzania is one of the countries that Africa CDC has really supported in terms of capacity development, infrastructure upgrading, bringing equipment, and the distribution of sequencing machines. The capacity is quite high in that country, and we tend to believe the reliability of the result.”

Meanwhile, Africa CDC has deployed the same team of experts that dealt with Rwanda’s Marburg outbreak to Tanzania to help build its response. These include “epidemiologists that will support the surveillance pillar” and laboratory specialists “that are assisting with mobile laboratories.

Image Credits: WHO.