Witkoppen Clinic’s HIV services in Johannesburg was one of many African clinics receiving PEPFAR funds via USAID.

Two to four million additional Africans are likely to die annually as a result of the shock aid cuts by the United States and other key donors, according to Dr Jean Kaseya, who heads the Africa Centre for Disease Control and Prevention.

Kaseya heads to Washington next week to coincide with the end of US Congress’s reauthorisation of the US President’s Emergency Plan for AIDS Relief (PEPFAR) on 25 March.

Numerous PEPFAR projects have already been terminated in the past two months by Trump appointee Elon Musk’s Department of Government Efficiency (DOGE) and it is unclear what the Republican-dominated Congress envisages for the plan.

Kaseya said he planned to meet members of the Trump administration, PEPFAR officials and Members of Congress next week in a bid to restore US aid.

“It is a disaster,” Kaseya told a media briefing on Thursday, disclosing that some African countries relied on “external assistance” for 80% of their HIV and malaria responses.

‘Overnight, everything is gone’

“Overnight, everything is gone,” he said, noting that 30% of Africa’s health expenditure comes from official development assistance (ODA) – yet there had been a 70% cut in ODA this year from $81 billion to $25 billion.

Aside from the gutting of virtually all the US Agency for International Development (USAID) grants, major European donors have also cut ODA.

Earlier in the week, the World Health Organisation (WHO) reported that Kenya, Lesotho, South Sudan, Burkina Faso and Nigeria would run out of antiretroviral medicine for HIV within the next few months as a result of USAID cuts.

WHO Director-General Dr Tedros Adhanom Gebreyesus said that while the aid withdrawal was the right of the US administration it “has a responsibility to ensure that, if it withdraws direct funding for countries, it is done in an orderly and humane way to allow them to find alternative sources of funding.”

Kaseya reported that he has been travelling the breadth of the continent and internationally to secure three key pillars of support for health on the continent: increased domestic funding, “innovative financing” for outbreaks and “blended financing”.

Africa CDC is pursuing three sources of funds to address the enormous gap left by the US withdrawal of aid.

The aid cut will “reverse two decades of health achievements in maternal, child health and infectious diseases”, warned Kaseya, adding that entire health systems “could collapse”.

Alongside the cuts is a surge in disease outbreaks – up 41% in the past two years.

The African health response is also hampered by countries’ debt servicing burden and dependence on imported medical countermeasures, said Kaseya.

Africa CDC projects an additional 39 million people will be pushed into poverty as part of the ODA cuts. The calculations are based on CDC modelling.

Kaseya has held several briefings with health ministers and African Union leaders to address the crisis, particularly focusing on alternative sources of funding.

Only two of the 55 member states – Botswana and Rwanda – spend 15% of their GDP on health – something that African states pledged to do in the Abuja Declaration back in 2001.

Only 16 countries have national health financing plans.

Kaseya said the Africa CDC is also trying to ensure that the health sector access to some of the $95 billion contributions made by the diaspora, including possibility via taxes.

With blended finance, Kaseya said private sector investment is needed “mostly in local manufacturing, electrification of health centres, connectivity, digital health and supply chain infrastructure”.

Mpox plateaus – but fall in testing is to blame

While mpox cases appear to have plateaued, this is due to challenges related to testing – particularly in the Democratic Republic of Congo (DRC) – rather than the disease being controlled, said Kaseya.

Conflict in eastern DRC and the loss of USAID funding that was covering the transportation of mpox samples to laboratories have led to a 16% drop in testing in the DRC over the past week alone. Less than a quarter of suspected cases were tested. Meanwhile, the turnaround time for testing has increased in many regions due to transport problems.

Image Credits: International AIDS Society, Witkoppen Clinic.

The method used in carcass sampling utilizes the knowledge and experience gained during previous outbreaks and the samplers work in pairs and in wearing personal protective equipment

The proposed pandemic agreement being negotiated at the World Health Organization (WHO) represents a critical opportunity for the global community to prevent future pandemics – including through coordinated multi-sectoral surveillance across human, animal, and environmental health data. As WHO member states gather in closed meetings over the next few week, three experts in wildlife health policy and research present field-based evidence that such a surveillance approach is critical to prevent pandemics.

The next pandemic is not a matter of if, but when, unless strong action is taken. The world remains highly vulnerable to outbreaks of zoonotic diseases that jump from animals to humans due to increasing urbanization, deforestation, and globalized travel.

As the world scrambles to strengthen pandemic prevention, preparedness, and response, the proposed pandemic agreement being negotiated at the WHO represents a critical opportunity for the global community to prevent future pandemics. 

Central to this effort is Article 4 of the draft Pandemic Agreement , which calls for countries to develop plans for coordinated multi-sectoral surveillance across human, animal, and environmental health data. While some countries express concerns about feasibility, such surveillance is not only necessary but entirely achievable with the right global commitment.

Multi-sectoral surveillance takes a One Health approach that recognizes the interdependence of human, animal, and environmental health. Given that the majority of emerging infectious diseases originate in animals, particularly wildlife, this type of surveillance is essential to prevent future pandemics.

In practice, it involves human health workers, veterinarians, environmental scientists, empowered citizens, and others on the spillover frontlines working together to detect early warning signs of potential pathogen emergence and outbreaks.

Lessons from Republic of Congo 

Dr. Alain Ondzie leading educational outreach on Ebola at a village in northern Republic of Congo

The Republic of Congo (RoC) provides a compelling example of effective multisectoral surveillance. Following devastating Ebola virus outbreaks that took thousands of lives and threatened great ape populations, a collaborative effort between wildlife experts and the Congolese Ministry of Health established a low-cost wildlife mortality reporting network covering 50,000 km².

This system serves as an early warning mechanism for potential Ebola virus outbreaks, which have historically been linked to infected wildlife and consumption of animal carcasses, especially in the Congo Basin. 

The program demonstrates how resource-efficient surveillance can function in challenging settings. Local personnel were trained in safe specimen collection protocols, and geographically distributed bases were equipped with sampling kits.

Critically, the system established in-country diagnostic capabilities for Ebola virus testing, reducing turnaround time from months to hours. The program not only monitored wildlife mortality but also provided educational outreach to over 6,600 people in rural northern RoC. That outreach aimed to encourage behavioral changes to reduce human activities that lead to pathogen spillover.

 This initiative represents the essential elements of multi-sectoral surveillance: cross-sector collaboration, community engagement, strategic resource allocation, and rapid diagnostic capabilities.

While the RoC has not experienced an Ebola epidemic since 2005, this surveillance system has detected anthrax in carcasses and continues to function as an early warning mechanism in a high-risk region, protecting both human communities and the country’s globally significant great ape populations.

Carcass sampling a great ape in the Republic of Congo.

Southeast Asia’s wildlife surveillance

Similarly, the WCS initiative WildHealthNet in Southeast Asia has shown how national wildlife health surveillance programs can be built on partnerships with local governments, existing resources, and targeted technical support.

Such wildlife health surveillance programs were first to detect African Swine Fever, a devastating domestic pig disease, in free-ranging wildlife in Laos, Cambodia and Vietnam, and identified biosecurity breaches that contributed to its spread. 

The network also identified a significant transnational outbreak of Highly Pathogenic Avian Influenza (HPAI) in multi-use wetlands, rapidly informing public and livestock health partners to limit onward transmission to domestic animals and humans.

The governments of Lao PDR and Cambodia have now formally adopted legislation codifying the network’s reporting structures and standard operating protocols. Building on this regional progress, WCS has expanded WildHealthNet to additional regions and is helping lead a global community of practice (Wildlife Health Intelligence Network-WHIN).

Some countries with large animal populations are concerned that multi sectoral surveillance, particularly an obligation to identify settings and activities where humans and animals interact, would be onerous and not implementable due to resource limitations and coordination challenges.

Developing countries also worry that institutions, companies, and other countries could profit from the data they share. Meanwhile, developed countries are keen to include multisectoral surveillance so that outbreaks can be detected and mitigated as soon as possible.

Coordination, data-sharing and sovereignty

Coordination between health, animal, and environmental sectors presents challenges, but establishing clear communication protocols, creating joint task forces, and standardizing data-sharing procedures can streamline collaboration. Emerging One Health governance platforms help formalize these mechanisms, ensuring smoother cross-sectoral cooperation.

Regarding data-sharing concerns, the proposed WHO agreement can establish frameworks that protect data sovereignty while enabling critical information exchange. Tiered data sharing – where non-sensitive data is shared widely, while sensitive data remains under member State control – can balance sovereignty with global health security.

Technology significantly reduces the burden of cross-sectoral surveillance. Digital platforms, mobile data collection, and analytics facilitate real-time surveillance without excessive cost and present additional savings through adoption and scaling of common tools.

The RoC initiative demonstrates that even with limited resources, establishing strategic diagnostic capabilities can dramatically reduce response times. Low-cost technologies, like instant messaging groups, can ensure effective communication and surveillance even in low-resource settings.

Those sampling dead wild animals now wear full personal protective equipment.

The cost-benefit case 

The economic benefits of investing in multi-sectoral surveillance far outweigh the costs. The COVID-19 pandemic cost the global economy trillions of dollars (and millions of deaths), while preventative measures would have been exponentially cheaper.

Early detection and containment of future zoonotic threats could prevent not only countless lives lost but also devastating economic consequences. Ebola outbreaks can run from the millions to tens-of-billions for the 2014 West Africa outbreak. The RoC’s surveillance system represents a modest investment compared to the potential costs of another Ebola epidemic.

The draft pandemic agreement, through its Article 4, has the potential to make multi-sector surveillance both achievable and sustainable by facilitating international cooperation, channeling resources, fostering capacity-building, and ensuring standardized protocols. It can empower governance frameworks that formalize multi-sectoral surveillance while safeguarding national sovereignty. 

The stakes are simply too high to exclude coordinated multi sectoral surveillance from the agreement. The perceived challenges are not insurmountable; they are challenges the global community is well-equipped to solve. A world without catastrophic pandemics is within reach, but only if we dare to work together. The time for action is now.

 

Sarah Olson is director of health research for the health program at the Wildlife Conservation Society (WCS). She provides leadership and research support to field veterinarians and conservation staff around the world. Her research with WCS has focused on frontline wildlife conservation and One Health challenges, including the wildlife trade and emerging infectious diseases, Ebola virus in great apes and bats, avian influenza in wild birds, and white-nose syndrome in North American bats. She is currently focused on understanding and mitigating wildlife health and zoonotic disease threats  and helping grow sustainable and effective wildlife health surveillance systems.

Manoly Sisavanh is  the WCS Deputy Country Director for Laos Program. She leads the policy dialogue with government in the areas of environmental policy on protected areas, forest and wetland management, supervises counter-wildlife trafficking and One Health programs, and oversees office operations. 

Dr Michel Masozera is WCS director of policy and institutional partnerships for Africa. He is an experienced professional in the field of biodiversity conservation, protected areas management and sustainable development. He received the National Geographic/Buffet Award for Leadership in African Conservation in 2004 for his role in the creation of Nyungwe Forest National Park, one of the largest remaining mountain forests in Rwanda.  

 

Image Credits: Sebastien Assoignons/ Wildlife Conservation Society, Sarah Olson/ Wildlife Conservation Society, Wildlife Conservation Society Congo, Wildlife Conservation Society.

Record warming has led to cascading impacts, such as a higher rate of glacier melting and ocean warming, which threaten fisheries and freshwater supplies.

The past ten years (2015-2024) were the ten warmest years on record, individually and collectively, according to the State of the Global Climate 2024 report released on 19 March.

The year 2024 was also the warmest year in the 175-year observational record of temperature tracking, according to the United Nations’ agency World Meteorological Organization (WMO), in the annual report.

And it was the first calendar year during which average temperatures were “likely” more than 1.5°C above the pre-industrial era (1850-1900) baseline, WMO experts said at a press conference on the report’s findings on Tuesday.

They use the term “likely” due to a highly technical scientific debate over what exactly may be considered the pre-industrial temperature baseline.

2024 was likely the warmest year on record and an estimated 1.55°C above the pre-industrial average, with a margin of error of ±0.13 C.

Key climate indicators worsening

Key climate indicators have worsened and some of the consequences are irreversible over hundreds if not thousands of years, said, Chris Hewitt, WMO’s Director of Climate Services at Tuesday’s press briefing.

“The climate has always been changing, if we look back at the distant past, then these rates of change are pretty high and not very welcome,” he said.

Among those, atmospheric concentrations of the greenhouse gas (GHG), carbon dioxide (CO2), are now at the highest levels it has been in the last 800,000 years.

The largest three-year loss of glacier mass on record also occurred over the past three years. This has pushed up the rate of sea level rise which has doubled since satellite measurements began.

In 2024, extreme weather events like tropical cyclones, floods, droughts, and other hazards led to the highest-ever number of people displaced in the past 16 years. Those events also contributed to worsening food crises and caused massive economic losses.

“While a single year above 1.5°C of warming does not indicate that the long-term temperature goals of the Paris Agreement are out of reach, it is a wake-up call that we are increasing the risks to our lives, economies and to the planet,” said WMO Secretary-General Celeste Saulo in a press statement.

See related story: Many of the World’s Glaciers Will Not Survive This Century With Dire Consequences for Hundreds of Millions

Rising planetary distress

Record temperatures extended over a wide area.

Rising heat is also affecting the integrity of the world’s oceans, critical habitats for fish, upon which around 16% of the world’s population depends as a key source of protein, with each of the past eight years having set a new record for ocean heat content.

“Our planet is issuing more distress signals — but this report shows that limiting long-term global temperature rise to 1.5°C is still possible. Leaders must step up to make it happen — seizing the benefits of cheap, clean renewables for their people and economies  —  with new National climate plans due this year,” United Nations Secretary-General António Guterres said in a press statement.

Right now, the contrary is happening in the world’s largest economy and second-largest GHG emitter, the United States.  The US government has fired key scientists affiliated with the National Oceanic and Atmospheric Administration (NOAA), which monitors oceans and temperatures; removed key climate data and pollution references from websites; abolished climate-related Environmental Protection Agency pollution regulations, rescinded incentives for clean energy production.

See related story: US EPA Rollback of Dozens of Air, Water and Chemical Pollution Regulations Threatens America’s Health, Experts Warn

In the case of the 2024 report, data was not affected, WMO experts at the conference said. But they did not elaborate on the extent to which scientific collaborations with US government scientists were still continuing.

“So, in the world of meteorology, whether in climates and oceanography, we exchange and share data and science and knowledge. So that would apply to any country and the US is clearly one of the world leaders in the field of climate. So, we certainly value the engagement in collaboration with us scientists and US organizations,” Hewitt said.

Scientists also stressed that the WMO report relies on multiple datasets, including, but not limited to data provided by NOAA.

Long-term warming hasn’t yet exceeded 1.5°C

While the average temperature in 2024 may have been above 1.5°C, the average over the past several decades was estimated at 1.34-1.41°C above the 1850-1900 baseline, the scientists said. Effectively, this means that the 1.5°C limit set out in the 2015 UN Paris Agreement, hasn’t yet been formally breached.

The record global temperatures seen in 2023 and broken in 2024 were also due to the ongoing rise in GHG emissions, coupled with a shift from a cooling La Niña to warming El Niño event, the report said.

Several other factors may have contributed to the unexpectedly unusual temperature jumps, including changes in the solar cycle, a massive volcanic eruption and a decrease in cooling aerosols, according to the report.

A WMO team of international experts is working to ensure even more reliable tracking of long-term global temperature changes, in collaboration with the Intergovernmental Panel on Climate Change (IPCC) – the UN body set up to assess science related to climate change.

Why oceans are warming faster

Annual global ocean heat content down to 2000 m depth for the period 1960–2024.

Around 90% of the energy trapped by GHGs in the earth’s system is absorbed by the oceans. The rate of ocean warming over the past two decades, 2005-2024, is more than twice that in the period 1960-2005.

“The ocean is warming, and it’s a continued warming, and in 2024 we observed ocean heat content which reached the highest levels in a 65-year observational record,” Karina von Schuckmann, an oceanographer at Mercator Ocean in France said during the press conference.

“Data for 2024 show that oceans continued to warm, and sea levels continued to rise. The frozen parts of Earth’s surface, known as the cryosphere, are melting at an alarming rate: glaciers continue to retreat, and Antarctic sea ice reached its second-lowest extent ever recorded. Meanwhile, extreme weather continues to have devastating consequences around the world,” said Saulo of WMO.

The 18 lowest Arctic sea-ice extents on record were all in the past 18 years.

Cascading impacts of extreme weather events

In 2024 extreme weather events worsened around the world.

Meanwhile, extreme weather driven by rising temperatures, such as cyclones, forest fires and floods, displaced over 100,000 people, the highest number since 2008, and destroyed homes, critical infrastructure, forests, farmland and biodiversity.

The compounded effect of various shocks, such as intensifying conflict, drought and high domestic food prices drove worsening food crises in 18 countries globally by mid-2024, the WMO report said.

Tropical cyclones were responsible for many of the highest-impact events of 2024. Tropical cyclone Chido on 14 December 2024 caused casualties and economic losses in the French Indian Ocean island of Mayotte, Mozambique and Malawi.

But high displacement numbers are not all bad, experts stressed.

“Early warning systems, when they’re effective, say, for a tropical storm, can often mean that people have moved out of an area and may be counted amongst displaced people,” explained John Kennedy, co-chair of WMO’s expert team on Climate Monitoring and Assessment.

“So rather than seeing casualties, we see people being moved to safer areas.”

Ocean warming will continue until the end of the century, even in low-carbon scenarios

Real-time data from specific locations show that levels of the three main GHGs – carbon dioxide, as well as methane and nitrous oxide – already at the highest levels in the last 800,000 years – continued to increase in 2024.

Gases like carbon dioxide remain in the atmosphere for generations, trapping heat.

Ocean warming leads to the degradation of marine ecosystems, biodiversity loss, and reduction of the ocean’s ability to act as a carbon sink. It fuels tropical storms and contributes to sea-level rise. Ocean warming is even more irreversible – on centennial to millennial time scales.

Climate projections thus show that ocean warming will continue for at least the rest of the 21st century, even for low-carbon emission scenarios.

Along with the urgent need to reduce GHG emissions, experts stressed on the need to strengthen early warning systems for countries.

Investments in weather, water and climate services are more important than ever to meet the challenges and build safer, more resilient communities, Saulo stressed.

“Only half of all countries worldwide have adequate early warning systems. This must change,” said Saulo.

Image Credits: WMO, WMO , WMO.

WHO head of immunisation Dr Kate O’Brien and Dr Joachim Hombach, WHO senior health advisor and SAGE Executive Secretary

Cuts to global immunisation budgets are hitting measles vaccine coverage, disease surveillance, laboratory networks and outbreak response the hardest, according to the Strategic Advisory Group of Experts on Immunization (SAGE).

SAGE, which advises the World Health Organization (WHO) on immunisation, issued the warning at a media briefing on Tuesday after its four-day biannual meeting.

It warned that the recent cuts by the Trump administration in the United States create a risk of further backsliding in immunisations “just when countries are recovering from the impact of the COVID-19 pandemic”. 

“The number of zero dose children, meaning those children that have not received any vaccines, have increased, even though the big [post-COVID] catch-up has helped,” SAGE chair Dr Hanna Nohynek told the media briefing.

Dr Kate O’Brien, WHO’s head of immunisation, said that vaccines have saved at least 154 million lives over the past 50 years, “and 60% of those lives saved were attributable to the measles vaccine”. 

Measles labs shutdown

However, WHO’s global measles and rubella network of more than 700 laboratories, funded solely by the US, faces “imminent shutdown”, WHO Director-General Dr Tedros Ahhanom Ghebreyesus told a media briefing on Monday. 

The collapse of the network, called Gremlin, would mean that outbreaks would not be detected – either at all or not rapidly, said O’Brien.

“Measles is one of the most infectious viruses, and it can have serious consequences, including infections of the brain, of the lung, pneumonia and  encephalitis,” she noted.

“The purpose of detecting [measles outbreaks] rapidly is to stamp them out at source as quickly as possible and to respond,” said O’Brien. 

She warned that measles was already surging, with 57 countries having outbreaks last year, in comparison to 35 countries in the two prior years. 

“Without that lab network and the epidemiologists, scientists and public health workers that are part of that response, we will certainly see many, many more outbreaks, many, many more deaths and many, many more cases,” said O’Brien.

Gremlin costs $8million a year, which O’Brien described as a “best buy” investment to save lives. It had been funded by the US Centers for Disease Prevention (CDC) not the US Agency for International Development (USAID).

The major theme of the four-day meeting was the “very high concern” of SAGE members of the impact of the funds cut on the “eradication, elimination and control of diseases”, added O’Brien.

Polio transmission

SAGE is “highly concerned” about the continued transmission of wild poliovirus in Pakistan and Afghanistan and the circulation of vaccine-derived poliovirus type 2 and its expansion into new areas, including European countries.

SAGE also reviewed updated evidence and concluded that a polio vaccination schedule with a minimum of three vaccine doses of the inactivated poliovirus (IPV), starting at six weeks of age or later is adequate, without the need for a scheduled IPV booster dose (4th dose). 

SAGE reaffirmed that three doses of pneumococcal conjugate vaccines (PCVs) is the most effective way to prevent childhood pneumococcal disease. 

SAGE noted that PCV10 by the Serum Institute of India had recently received WHO-prequalified for the immunization of infants, joining PCV10 (GlaxoSmithKline) and PCV13 (Pfizer).

It also recommended varicella vaccines, using a two-dose schedule with a minimum four-week interval between doses, for children in populations where varicella is an important public health problem. 

Varicella vaccination could also be introduced for special populations, such as immunocompromised people, those living with well-controlled HIV infection and health workers in areas where they 

SAGE also received a report from the global vaccine platform, Gavi. Highlights include that Gavi’s HPV vaccine initiative is on track to immunise 86 million girls by the end of the year,  while significant progress has been made in rolling out malaria vaccines.

Gavi will invest $800 million in polio vaccines this year and $5.6 million to address mpox.

Gavi aims to launch a new strategy in 2026 that will focus on introducing new vaccines, strengthening country programmes, and reducing zero-dose children.

 

Cows grazing

Europe has successfully controlled many livestock diseases over the years, but the threat of animal diseases is never truly over – and climate change is increasing this threat.

In 2023, the continent saw an outbreak of bluetongue virus that cost the Netherlands alone an estimated €200 million.

Earlier this year, Germany experienced its first foot-and-mouth outbreak in more than three decades, resulting in bans on German meat and dairy exports.

These recent outbreaks have underscored  the perennial threat of animal disease to the security of food, health, and economic systems across the continent. They cause massive losses to livestock farmers, present risks to human health, and damage food availability.

Perhaps most importantly, the danger of these diseases is predicted to grow as global warming changes Europe’s climate.

Take bluetongue virus, for instance. The disease is endemic to the tropics but began to migrate to Europe in the 1990s and has moved further north in the last decade as a result of rising temperatures, allowing for a virus adapted to warmer climates to thrive across Europe.

The shorter, milder winters have allowed for a longer transmission period for the virus. These changes are likely to be seen in other livestock diseases as well.

Sustainable future

Given these conditions, improving animal health is integral to ensuring a healthy, sustainable future for the livestock sector and all Europeans. As consultations continue on the European Union (EU) Animal Health Law and work starts on a sustainable livestock strategy, concrete measures to improve animal health should be at the centre.

This first means bringing the animal health sector, which represents the manufacturers of animal medicines, vaccines and other animal health products, to the table by allowing a regular and constructive dialogue with veterinary authorities.

The animal health sector can assist in achieving greater sustainability of livestock. Current strategies largely consist of shared principles and approaches amongst member states, but they lack the solid measures needed to make real impacts.[1]  This marks a huge blind spot in the potential strategy.

Animal health experts can offer actionable measures to improve animal health that will ultimately benefit all of Europe.

For example, investing in preventative tools allows governments to curb risks before they become full crises. This includes improving vaccinations, advancing disease surveillance and early warning systems, and implementing biosecurity upgrades and farm-level prevention practices.

Disease prevention is also critical for reducing the livestock sector’s emissions. Fewer losses mean fewer wasted resources and less resources needed to make up the difference.

It also reduces the need to cull animals and spend public money to compensate farmers for these losses.

Reducing disease levels also helps address concerns around antimicrobial resistance (AMR), which threatens the health of people and animals across the continent. AMR occurs when microorganisms no longer respond to antimicrobial treatments. While this can happen naturally, it is accelerated by the improper use of antimicrobial medicines in human and veterinary medicine.

 Thankfully, antimicrobial use in animals has dropped 53% in the EU since 2011, largely due to the dramatic increase in prevention products such as vaccines that reduce the need for antibiotics in the first place.

Supporting improved breeding can also help reduce the sector’s climate impact. This includes genomic testing to support farmers to select breeds for traits such as disease resistance, reduced emissions, and climate adaptation.

In New Zealand, for example, the government has been working with researchers to breed high-productivity, low-methane ruminants like sheep, which have produced 12% lower methane emissions than traditional breeds.

With more than 220 million ruminants in Europe, including innovative breeding approaches such as those in the Sustainable Livestock Strategy can make a big impact on the continent’s emissions.

Disease prevention

Disease prevention and breeding strategies go a long way to improving the sustainability of livestock farming from an environmental perspective, but they are also central to improving animal welfare and farm economics.

For example, new technologies such as sensors used to detect cows’ rumination can detect disease up to five days before clinical signs of the disease.

Calving prediction technologies give alerts from six to 12 hours in advance of calving, reducing calf mortality, and automatic feeding machines can be used to detect bovine respiratory disease in calves with high accuracy at least one day before clinical diagnosis.

Integrating policies on preventative measures, new technology use, and improved breeding, can offer exponential benefits for people and animals.

The EU is one of the world’s largest trading blocs, with nearly 450 million people relying on policymakers to protect them from economic and health crises.

 The continent cannot afford a passive approach to animal health and disease prevention, especially as animal diseases persist despite the measures already in place.

 An EU-wide strategy needs more than just shared principles and approaches. It needs tangible policies and best practices to be effective, covering the full livestock supply chain. Without decisive and inclusive action, the next major outbreak is not a question of “if” but “when”—and Europe cannot afford to be unprepared for “Disease X”.

Pierre Sultana is the Public Affairs Director of AnimalhealthEurope, which represents the manufacturers of animal medicines, vaccines and other animal health products in Europe.

 

Image Credits: pxfuel, Charyse Reinfelder.

WHO Director-General Dr Tedros Adhanom Ghebreyesus

A grim picture is emerging of people running out of food, countries running out of medicine and hospitals closing as a result of the shock slashing of global health budgets by the United States, according to multiple World Health Organization (WHO) staff addressing a media briefing on Monday.

Meanwhile, the WHO is mulling “terrible choices” as it tries to trim 25% of its budget in the wake of the US withdrawal from the body.

Malaria: Additional 15 million cases this year?

“There are now severe disruptions to the supply of malaria diagnostics, medicines and insecticide-treated bed nets due to stockouts, delayed delivery or lack of funding,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus, reporting on the early impact of the US Agency for International Development (USAID) funding cuts.

Over the last 20 years, the US has been the largest bilateral malaria control donor, helping to prevent an estimated 2.2 billion cases and 12.7 million deaths.

“If disruptions continue, we could see an additional 15 million cases of malaria and 107,000 deaths this year alone, reversing 15 years of progress,” said Tedros.

HIV: Imminent disruption to ARV supplies

Dr Meg Doherty, WHO’s head of HIV, hepatitis and STIs

“It’s a similar story with HIV,” said Tedros. “The suspension of most funding to PEPFAR, the President’s Emergency Plan for AIDS Relief, caused an immediate stop to services for HIV treatment, testing and prevention in more than 50 countries. 

“Eight countries now have substantial disruptions to antiretroviral (ARV) therapy and will run out of medicines in the coming months. Disruptions to HIV programmes could undo 20 years of progress, leading to more than 10 million additional cases of HIV and three million HIV-related deaths, more than triple the number of deaths last year.”

The eight countries in the most immediate danger of running out of ARVs are Haiti, Kenya, Lesotho, South Sudan, Burkina Faso, Mali, Nigeria and Ukraine.

Dr Meg Doherty, WHO’s head of HIV, hepatitis and STIs, said there have already been reports of deaths of mothers and babies in settings such as South Sudan who were unable to get ARVs. In other settings, overdose deaths among injecting drug users soared within a week of opioid substitution therapy being stopped, a complementary therapy designed to reduce risks of acquring HIV infection from contaminated needles. 

“We are just going to need time to be able to get the data in, but we are seeing effects on the ground right now,” said Doherty.

‘Crippling breakdowns’ in TB response

WHO’s Director of TB, Dr Tereza Kasaeva

“On tuberculosis, 27 countries in Africa and Asia are facing crippling breakdowns in their response, with shortages of human resources, disruptions to diagnosis and treatment, data and surveillance systems collapsing and vital community engagement work deteriorating,” said Tedros.

“Nine countries have reported failing procurement and supply chains for TB drugs,  jeopardising the lives of people with TB.”

Over the past 20 years, US support for TB services has saved almost 80 million lives. 

WHO Director of TB Dr Tereza Kasaeva, said that during COVID-19, there were 700,000 additional TB deaths as a result of service disruptions, and this was a grim indication of what to expect.

“When [service] disruptions last more than three months, even a 20% drop in [diagnosis] will lead to a significant increase in TB deaths,” said Kasaeva.

Threat to immunisation

WHO head of immunisation Dr Kate O’Brien

WHO’s global measles and rubella network of more than 700 laboratories, funded solely by the US, faces “imminent shutdown”, said Tedros. 

“This comes at the worst possible time when measles is making a comeback. Last year, there were 57 live or disruptive measles outbreaks, and that number has been increasing for the past three years.”

WHO head of immunisation Dr Kate O’Brien described the cuts to immunisation programmes as “life-threatening”, although the results may only become clear in the years to come.

“We estimate that there will be hundreds of thousands of additional deaths as a result of the actions to compromise the vaccine programmes in place now, and many hundreds of thousands more as a result of the failure to deploy and introduce vaccines that are ready to go and to protect communities around the world, including the malaria vaccine,” said O’Brien.

Collapsed humanitarian response

Teresa Zakaria, WHO head of humanitarian relief.

“Almost 24 million people living inside crisis are at risk of not being able to access essential health services,” said Tedros.

“More than 2,600 health facilities in 12 humanitarian crises have already suspended services at least partially, or will do very soon.”

 In Afghanistan, funding shortages could force the closure of 80% of WHO-supported essential health care services. By the first week of March, 167 health facilities had already closed, denying lifesaving medical care to 1.6 million people across 25 provinces.

“Without urgent intervention, over 220 more facilities could close by June 2025, leaving an additional 1.8 million Afghans without access to primary health care,” said the WHO in a statement on Monday.

“In Cox Bazar in Bangladesh, the largest refugee camp in the world, diagnosis and treatment of hepatitis C has been disrupted, and disease surveillance, primary and secondary health care, laboratory services, procurement of supplies and salaries of health workers,” said Tedros.

Teresa Zakaria, WHO head of humanitarian relief, said that over 300 million people in 72 countries “require urgent humanitarian assistance to remain alive”. 

With data from only 12 countries, 23.8 million people are “directly affected by reduced health services” and “without urgent life saving health services, all of these individuals will be at risk of dying”. 

In these 12 countries, over 2,600 health facilities have been impacted and 900 hospitals in and over 1200 primary healthcare facilities are at risk of closing. 

It’s very early in our determination and quantification of the entire impact, but already we’re seeing how bad the situation is,” said Zakaria.

‘Terrible choices’ with WHO restructuring

WHO executive director of health emergencies, Dr Mike Ryan, is also chairing the WHO’s prioritisation committee

WHO executive director of health emergencies, Dr Mike Ryan, is also chairing the WHO’s prioritisation committee to determine how to reduce costs while maintaining essential programmes.  

“We’re severely containing our costs to $4.9 billion over the next two years,” said Ryan, adding that a re-prioritised budget will be presented to the World Health Assembly in May.

The health emergencies budget needs to be cut from $1.2 billion for two years to around $872 million.

“That will result in a 25% contraction of the emergencies programme,” said Ryan. “What do you want to stop doing? Do you want to stop doing Ebola? Do you want to stop doing emergency medical teams responding to major disasters in the world? Would you like to stop intelligence gathering so that we know what the next epidemic or pandemic will be? There are some terrible choices to be made.”

All departments are “making similar terrible choices we would never have wanted to make,” said Ryan. 

“But we will ensure that this organisation moves into the future. We will be smaller, but we will be efficient as ever, and we will be stronger, and we will be ready to to to grow again when the time is right.”

To meet the crisis, WHO has already frozen new staff hires, laid off temporary staff, and offered early retirement packages to employees over the age of 55. But it has not responded to the Health Policy Watch report on the dramatic rise in numbers of consultants and expansion of senior WHO Directors, and particularly those at the top  (D2) level, which occurred since Tedros took over as Director General in 2017 – with corresponding costs increases.

EXCLUSIVE: Number of WHO Senior Directors Nearly Doubled since 2017, Costs Approach $100 million

US responsible for ‘orderly and humane withdrawal’

“The US administration has been extremely generous over many years, and of course, it’s within its rights to decide what it supports and to what extent,” said Tedros.

“But the US also has a responsibility to ensure that, if it withdraws direct funding for countries, it is done in an orderly and humane way, to allow them to find alternative sources of funding. 

“We ask the US to reconsider its support and help, which not only saves lives around the world, it also makes the US safer by preventing outbreaks from spreading internationally,” he added.

Meanwhile, Ryan said that he mourns the loss of his US colleagues, “not for the dollars, but for the loss of contact”. 

“I’ve worked in this space for 30 years. We speak every day with colleagues in the United States, with institutions around the United States. They are the core of global public health. They are the heroes of disease control.”

How can health inequality be reduced?

This was the topic of the most recent episode of the Global Health Matters podcast with Dr. Garry Aslanyan.

Understanding Health Inequality

“Health inequity is produced by and within social relations that govern the production and exchange of concrete material things that we need to survive and flourish, to ensure well-being, like health,” explained guest Hani Kim, executive director of the Right Foundation in Seoul, Korea. “By material conditions, I mean how much we own and control various economic resources—resources that can produce things like money, land, credentials, and labour. What you own and how much of these resources you control critically determine what you have to do to get what you need to ensure your well-being.”

In other words, she explained, the relationships amongst different actors within global health—be it nations, non-governmental organisations, private philanthropies, or stakeholder groups within nations—are deeply embedded in a system that perpetuates inequalities of resources and power both amongst and within countries.

“These inequalities, along with material and power relations, have a profound impact on the strategies and directions that the field of global health employs to meet its goals,” Kim added.

The Role of Local Voices

Kim pointed out that global health efforts are often led by elites who impose solutions from above, assuming they have the best answers. This tendency normalises and universalises their perspectives at the cost of marginalising views that do not align with them.

She has made it a priority to invite and listen to partners from countries facing local health challenges. While she has seen some progress in this area, she emphasised that there is still a long way to go. Moreover, she cautioned that simply including local voices is not enough—it is essential to ensure they are truly representative, not just elites from their own communities.

“We live in a structure where inequalities of resources and power are so pervasive that even within these countries, the degree of inequality is immense. So, figuring out what the working classes and communities really want cannot be achieved simply by selecting a few so-called representatives,” Kim said. “The needs and wants of these communities are best expressed through movements and actions led by the members of those communities and working-class groups in their local context. This is inherently difficult to capture by simply selecting one or two representatives for forums, meetings, and conferences hosted by elites.”

Taking Action

Kim stressed that achieving change requires individuals to act within their own domains—whether as students, researchers, or professors—and to acknowledge their inherent limitations.

“Let us guard ourselves against the temptation to portray a world-view where what we can do, just because it is something we can do, is the most important or the best approach,” Kim added. “Solving health inequity is possible only when inequalities and material relations are addressed. And history teaches us that struggles for equality have been fought and won by the oppressed and exploited classes, not by elites.”

Building Sustainable Change

Another guest on the podcast, Seye Abimbola, an associate professor of health systems research at the University of Sydney’s School of Public Health, echoed much of what Kim said but added another critical perspective: many change efforts fail because people assume change will happen on its own.

“Change doesn’t just happen by accident or on autopilot,” Abimbola emphasised. “You have to build things, and be part of building structures that consistently do right by the people on whose behalf, with whom, and for whom we ought to be working.”

Listen to more Global Health Matters podcasts on Health Policy Watch >>

Image Credits: TDR Global Health Matters.

“There is ability in disability,” says Mulikat Okanlawon, a Noma survivor from Nigeria.

Okanlawon shared this message on a recent episode of the Global Health Matters podcast with Dr. Garry Aslanyan. The episode was one of two focused on the real-life experiences of people living with neglected tropical diseases (NTDs).

Noma primarily affects children. The disease begins in the mouth and spreads rapidly, destroying facial tissue. About 90% of those affected die quickly. However, if diagnosed early, Noma is preventable, treatable, and not contagious.

For Okanlawon, the disease left lasting physical and emotional scars. She explained to Aslanyan how it deeply impacted her self-esteem.

“It affected me so much that I couldn’t go out or go anywhere. Even if I wanted to, it had to be in the evening, and I would cover my face before leaving,” she said. “I cried all the time when I looked at myself in the mirror. Of course, because I looked different. It really affected me emotionally.”

Noma caused a deep, open wound on Okanlawon’s cheek and nose, also damaging the bone around her eye. As a result, she struggled to eat and speak. So far, she has undergone five surgeries and is preparing for a sixth.

Despite these challenges, Okanlawon decided to take action. She co-founded the Elysium Foundation, which supports survivors in six countries and advocates globally to raise awareness about Noma and improve care for those affected.

Thanks to the tireless advocacy of survivors like her, the World Health Organization officially recognised Noma as an NTD in 2023.

“It changed everything to have Mulikat or another survivor at the table, speaking with decision-makers,” said Claire Jeantet, an award-winning documentary film-maker who has worked with Okanlawon for over eight years to share the stories of Noma survivors. “It’s estimated that less than 10% of people survive the disease, so meeting someone who has lived through it is very powerful for most people.”

Okanlawon’s journey sheds light on the devastating impact of Noma. Yet, her story is also one of resilience, strength, and the power of advocacy, Aslanyan noted.

‘Hoping to get to heaven’

In the second part of the series, Aslanyan interviewed Dan Izzett, a former civil engineering technician and pastor who has dedicated his retirement to advocating for people living with leprosy.

Izzett developed leprosy as a child but wasn’t diagnosed until years later—after he was already married. By then, the disease had progressed, leaving him severely disabled.

“I like the term ‘fat man with one leg, three toes, nine fingers hoping to get to heaven one day,’” Izzett said on the podcast.

When he was first diagnosed, his biggest fear was the stigma.

“It’s a precast case, the stigma of leprosy—the movies that are put out, the pictures, the jokes. As a young man, I can remember telling jokes about lepers,” he explained, adding that he feared rejection.

Over time, Izzett not only came to accept his disability but also turned it into a force for good. He wanted to help ensure that others wouldn’t suffer as he had. In his case, the delayed diagnosis led to severe complications and permanent loss. His wife, Babs, who also had leprosy, was diagnosed early and never developed any serious issues.

“I have no problem with being called disabled because technically that is what I am,” Izzett said. “I think with self-acceptance, self-proclamation, self-declaration, it doesn’t matter any more that I’m disabled because that’s what I am. In fact, I’ve actually been able to embrace my disabilities and use them to advance our advocacy work.”

Peter Waddup, CEO of the Leprosy Mission in Great Britain, emphasised the connection between discrimination and disability.

“For many people with neglected tropical diseases, it’s not the disease itself that’s the problem,” he said. “Most of them, if diagnosed early, can get the pills or whatever it takes to clear up the disease. But the discrimination stops them from coming forward and acknowledging it. They hide the early signs. And the sad thing about that is—that’s when the disability starts to occur.”

Dan Izzett (left) and Peter Waddup
Dan Izzett (left) and Peter Waddup

Despite his challenges, Izzett has transformed adversity into purpose.

“You can either live in the negative—you can choose to stay there and dwell on it—or you can live in the positive. We’ve chosen to make it positive,” he said.

Listen to more Global Health Matters podcasts on Health Policy Watch >>

Image Credits: TDR Global Health Matters.

EPA
The US EPA announced it would target 31 key environmental regulations.

The US Environmental Protection Agency announced it would seek to roll back 31 climate, air and water pollution, and emissions regulations, declaring this is the “biggest deregulatory action” in US history.

Leading environmental health voices say that rolling back pollution and climate regulations will inextricably harm the public’s health, though the Trump administration asserts that no such link exists.

In a flurry of press releases, the US Environmental Protection announced it would review or revise dozens of landmark regulations dating back decades – though it is not clear which regulations would be weakened or eliminated. 

“Today is the greatest day of deregulation our nation has seen. We are driving a dagger straight into the heart of the climate change religion to drive down cost of living for American families, unleash American energy, bring auto jobs back to the US and more,” said EPA Administrator Lee Zeldin in a press statement.

If the EPA’s actions are approved through a period of public comment, the Trump administration will eliminate “trillions of dollars” in regulatory costs and “hidden taxes,” according to Zeldin.

Under attack is a 2009 EPA finding that climate change-causing pollutants, including methane and carbon dioxide, harm human health. Without this “endangerment” clause, the EPA will clear the way for widespread dismantling of greenhouse gas emission regulations. 

“I’ve been told the endangerment finding is considered the holy grail of the climate change religion,” Zeldin said in a video posted on X. 

But environmental health experts warn reversing this finding will directly affect health, and point to how protecting public health seemed second to lowering energy costs and regulatory burden for the EPA now.

“The potential increase in health-related expenses, environmental degradation, and the stifling of innovation will lead to higher costs for consumers and impede economic growth,” said Margo Oge, former EPA director of transportation and air quality. 

“These actions will not make America great – they will just make Americans sicker,” she said in a LinkedIn post.

President Trump’s chief environmental officer also announced plans to target 31 key regulations that would reduce wetland protections, loosen climate pollution from vehicles and power plants, wastewater from coal plants, and air pollution from the energy and manufacturing sectors – including restrictions on mercury, a known neurotoxin. The administration also plans to overturn the “good neighbor rule,” which requires states to address pollution carried downwind to other states. 

Wednesday’s announcements follow similar actions upending the US’s environmental protection, including shuttering offices dedicated to environmental justice, firing hundreds of EPA staff, and removing key scientific advisors from leadership.

Clean air ‘inextricably’ linked to better health

Air pollution from fossil fuels is a leading risk factor for mortality globally.

Currently, the EPA has operated under the Endangerment Finding, which determined that climate change pollutants threaten public health and welfare. This has led to multiple actions establishing pollution standards for power plants, cars and freight trucks, and oil and gas facilities, according to an Environmental Defense Fund (EDF) analysis.    

The EPA claims that its actions reflect “updated science” since the Supreme Court’s 2007 ruling that greenhouse gases are considered pollutants under the Clean Air Act. But experts posit that the scientific evidence linking climate change to adverse health outcomes has only grown.

Recent epidemiological modelling studies attribute 5-10 million deaths from air pollution each year. Particulate matter and ozone air pollutants can trigger heart disease, strokes, chronic pulmonary diseases, in addition to asthmas and respiratory diseases.

clean air act modelling
The Clean Air Act has averted 230,000 premature deaths in the US between 1990 and 2020. Visibility projections with and without the Clean Air Act.

More broadly, climate change can disrupt access to health care services, threaten infrastructure, and pose physical and mental health risks, according to a still-active EPA webpage. Extreme weather, poor air and water quality, flooding, droughts, and insect-borne diseases are all expected to increase as the global climate continues to change.

But under the EPA’s cornerstone Clean Air Act, which until this week included greenhouse gas emissions, returns $9 to public health, the environment, and productivity for every $1 spent reducing mobile source emissions, according to an EPA webpage.

 “We have ample evidence that climate change pollutants, both directly and indirectly, are profoundly harming health,” said Dr Lynn Goldman, dean of the George Washington Milken School of Public Health, and former EPA official in a statement to Health Policy Watch.

“We need to confront the dangers of harmful pollution using a multitude of tools whether regulatory or via providing economic incentives. There seems to be an intention of willfully cutting off both of these avenues but putting our heads in the sand, while providing some with short term profits, is no solution to the challenge of climate change.”

When asked for comments, researchers at other US universities declined to comment based on policies against issuing public statements.

Clean water regulation also under attack

Antibiotic manufacturing water pollution
Among the 31 regulations under scrutiny are those protecting American wetlands and streams from pollution.

The EPA specifically singled out how the agency would define “waters of the United States,” which guides how waterways are protected. A 2023 Supreme Court ruling narrowed the definition of waterways the Clean Water Act protects, saying the Act only extends to “wetlands with a continuous surface connection to bodies that are ‘waters of the United States’ in their own right”.

The Trump-era EPA leadership has since asserted that it should only protect “continuously flowing body of waters,” excluding smaller, seasonal streams and revoking protections for more than half of US wetlands. 

But environmental groups contend that an attack on wetlands is an attack on water quality.  

“Without Clean Water Act protections for the more than half of the wetlands in the United States targeted by this rule, Americans can expect: lower quality drinking water resulting in poorer human health, less resilience to flooding,” said Jared Mott, Conservation Director for the Izaak Walton League, a conservation and recreation group.

Though Zeldin has promised to protect America’s water, the administrator argued that  “[t]he previous Administration’s definition of ‘waters of the United States’ placed unfair burdens on the American people and drove up the cost of doing business.

“Our goal is to protect America’s water resources consistent with the law of the land while empowering American farmers, landowners, entrepreneurs, and families to help Power the Great American Comeback.” 

A win for industry to ‘unleash American power’

EPA admin Lee Zeldin confirmation hearing Jan 2025 forever chemicals
Lee Zeldin, EPA administrator under president Trump, positioned the EPA’s mission as focused on lowering energy costs and unburdening industry from regulations.

The fossil fuel, chemical, and vehicle industries have lobbied for these rollbacks since the first Trump administration, arguing that regulations stifle growth.

The EPA said it would obtain input from stakeholders “sidelined” during the Biden administration, such as ranchers, developers, and larger industry. 

“While accomplishing EPA’s core mission of protecting the environment, the agency is committed to fulfilling President Trump’s promise to unleash American energy, lower cost of living for Americans, revitalize the American auto industry, restore the rule of law, and give power back to states to make their own decisions,” the agency said in a statement.

Though the EPA’s efforts appear to combat the rising costs of energy for US households, analysts expect the costs to increase nonetheless as Trump’s tariff wars escalate. Oil production in the US’s vast energy sector relies on metal now tariffed from Canada and Mexico, according to industry experts. 

Furthermore, the EPA’s plans are likely to be challenged in court. “In the face of overwhelming science, it’s impossible to think that the EPA could develop a contradictory finding that would stand up in court,” said David Doniger, a climate expert at the Natural Resources Defense Council, an environmental group.

Responding to criticism that the EPA would leave the environment vulnerable to degradation, Zeldin wrote in a WSJ opinion “[n]othing could be further from the truth. Under the Trump administration, the EPA’s core mission remains safeguarding human health and the environment. The difference lies in how we achieve these goals—through partnership rather than prescriptive bureaucracy, through collaboration rather than regulation.”

But critics say rolling back decades of regulation undermines the US’s position as an environmental health protection leader. “We are sacrificing our ability to lead the world in developing common sense solutions,” said Goldman. 

Last updated 17 March.

Image Credits: AP/Sierra Club, Janusz Walczak/ Unsplash, EPA, Janusz Walczak, Face the Nation.

pandemic
USAID assisted health workers in Guatemala to maintain antenatal services and social support for pregnant women during COVID-19.

The list of United States Agency for International Development (USAID) projects that the Trump administration has cancelled runs to 368 pages and provides a rare glimpse of the extent of the US international influence.

READ HERE: USAID Terminated Awards (6 March 2025)

Projects vary from huge infrastructure support programmes (14 to unspecified countries worth $800 million each) to a $10 million investment in developing insect-resistant eggplants.

They range from supporting famine early warning system networks (three projects worth $900 million each) to establishing an American Chamber of Commerce in Belarus. Almost every country is affected – from Albania to Zambia.

A huge $520 million ‘Prosper Africa’ programme to foster trade between the US and Africa has been terminated, and so too have programmes to improve the soybean yield in sub-Saharan Africa and to assist African health ministries to deal with infectious diseases.

There are some surprises. Venezuela received a few grants, including one to secure its agricultural sector. Although the communist government of Venezuela is a sworn enemy of the US, it was no doubt prudent for the US to try to support the country to stem the tide of immigrants.

Grants were also made to Iraq and Syria for “technical assistance to repatriate families” and to assist with child immunisation despite the rancour between the US and those countries.

Grants for “humanitarian assistance for persecuted people in Cuba” and to promote “religious and ethnic freedom” in Asia were also cancelled.

Numerous projects aimed at bolstering food security, and combatting malaria, tuberculosis and HIV were also canned. 

So too were projects to combat corruption and cybercrime. The door is wide open for new donors – and criminals – to take advantage of the resource vacuum. 

HIV sector warns of millions of deaths

Earlier this week, over 530 HIV doctors, researchers, scientists, and public health experts gathered at the 2025 Conference on Retroviruses and Opportunistic Infections (CROI) in San Francisco wrote to Rubio calling for “an urgent reversal of recent decisions by the Trump administration that are doing catastrophic harm to the global and US response to the AIDS pandemic”.

The signatories wrote that the termination of projects on 26 February – “virtually eliminated” all US President’s Emergency Plan for AIDS Relief (PEPFAR) programming implemented by USAID, and US-supported malaria and tuberculosis programmes – will “result in millions of preventable deaths around the world while decimating global progress over the last 25 years”.

They also expressed alarm at the defunding of clinical trials that have “stranded study participants without clinical support” and the stripping of scientific institutions of staff and funding.

“Over time, these policy decisions may be proven illegal in US courts but the human suffering and loss of lives happening now cannot be reversed by any court order,” they note.

Meanwhile, the US State Department has refused to comment on reports that over 700 diplomats have signed a letter addressed to US Secretary of State Marco Rubio condemning the cuts for endangering US security.

An extract of the letter, said to have been filed on a staff channel that allows anonymous contributions, says: “The decision to freeze and terminate foreign aid contracts and assistance awards without any meaningful review jeopardizes our partnerships with key allies, erodes trust, and creates openings for adversaries to expand their influence.”

An online group to track job losses from USAID closures, USAID Stop Work, estimates that over 50,000 US citizens and 100,000 global workers have lost their jobs. It has been able to confirm 14,762 US jobs and 64,910 global jobs lost so far.

Image Credits: MSH.