Governments have been advised to impose ‘sin taxes’ on tobacco, alcohol and other unhealthy products to offset the severity of cuts to official development assistance (ODA), World Health Organization (WHO) Director General Dr Tedros Adhanom Ghebreyesus told a tuberculosis meeting on Thursday.

His statements came two days after the administration of US President Donald Trump formally requested his country’s Congress to cancel previously approved budget allocations for global health programmes and projects amounting to $9.4 billion. Tuesday’s request was made by Russ Vought, head of the Office of Management and Budget in Trump’s office, and co-author of Project 2025, the conservative blueprint for the Trump presidency based on expanded presidential power and an ultra-conservative social vision.

Should Congress agree, this would officially endorse the cuts already made in grants to the US Agency for International Development (USAID) and US President’s Emergency Plan for AIDS Relief (PEPFAR) by the Department of Government Efficiency (DOGE) under the leadership of Elon Musk, who resigned from his DOGE role this week as well. Congressional action would also cement cuts to UN agencies including the WHO, UN Children’s Fund (UNICEF), UN Development Program (UNDP), and the UN Population Fund (UNFPA).

“In the past few months, I have spoken to many ministers, and the impact on their  programmes of the sudden cuts in official development assistance is severe,” Tedros told a WHO Town Hall meeting on tuberculosis.

“We are seeing treatment interruptions, clinics closed, health workers losing their jobs, disruptions and more – not just for TB, but for malaria, HIV, neglected tropical diseases, vaccinations, maternal and child health, sexually transmitted infections, family planning and so on.”

The WHO’s advice to countries trying to raise domestic resources to offset the cuts is to start immediately with the “sin taxes” while, in the longer-term, implementing social health insurance and community-based health insurance, Tedros added.

‘Reject rescission package’

Meanwhile, the Global Health Council urged US Congress to reject the rescission package, describing it as “a systematic effort to diminish the longstanding role of the United States as a global health leader” that puts lives at risk.

The One Campaign also called on Congress “to reject rushed attempts to override their previous decisions and to continue supporting smart, effective international assistance programs.”

One Campaign added that the rescissions package “gives scant detail about the nature and impact of the proposed cuts. When lifesaving assistance is at stake, Congress needs real details. For example, the package cuts nearly a billion dollars from health and infectious disease funding which deserves more explanation than 11 vague sentences.”

Trump claims the cuts are aimed at “wasteful foreign assistance spending” to “eliminate programs that are antithetical to American interests”.

Speaking in the US Senate on Thursday, Democratic Senator Dick Durbin asked “why in the world would we cut such low cost but impactful programmes?”

“If there were international programmes that were ineffective, and I admit such work can be difficult and with mistakes, the place to fix them is through the regular appropriations process, not the wholesale gutting of a complete programme like USAID.”

The US Congress has 45 days to consider the proposal.

Gutting of USAID

The Trump administration wants to rescind $500 million of the USAID’s global health programs for “activities related to child and maternal health, HIV/AIDS, and infectious diseases”, claiming that this would not reduce treatment but “eliminate programs that are antithetical to American interests and worsen the lives of women and children, like ‘family planning’ and ‘reproductive health,’ LGBTQI+ activities, and ‘equity’ programs.”

Projections from March indicated that up to 29,000 health workers had lost or were at risk of losing their jobs in Uganda alone due to cuts in foreign assistance. Other African countries severely affected by the US cuts include Ethiopia, Nigeria, and the Democratic Republic of Congo.

“As Uganda’s health workers and Ministry of Health were mounting an effective, coordinated response to contain the Ebola outbreak, the sudden freeze of US foreign assistance created serious challenges,” said Irene Atuhairwe, Seed Global Health’s Country Director in Uganda.

“Health workers lost their jobs, and contact tracing and surveillance efforts had to be scaled back. With limited resources and reduced staffing, health officials were forced to narrow their efforts, potentially increasing the risk of further spread,” added Atuhairwe.

“Diseases like Ebola don’t stay within borders. It takes just one infected traveller boarding a plane or crossing borders for a local outbreak to go global. The very abrupt cuts to foreign assistance have made all of us less safe.”

There were more than 50 USAID-funded staff dedicated to outbreak response in Uganda, but that number has been reduced to just six, who are now responsible for preparedness and response efforts for Ebola, Marburg virus, mpox, and bird flu.

The Trump administration also wants to rescind $400 million of the $6 billion appropriated for HIV programmes, namely the PEPFAR grants administered via USAID.

Numerous African HIV treatment programmes receiving PEPFAR grants through USAID have had to scale down or close because their grants have been terminated, potentially affecting 20 million people.

Also on the rescinding chopping block is $2.5 billion in USAID development assistance to “end extreme poverty and promote resilient, democratic societies”, and $496 million for international disaster assistance in response to natural disasters, conflicts, and other emergencies.

Trump wants to rescind  $1.7 billion from the Economic Support Fund for “countries of strategic importance to the US”, claiming this has been used “to fund radical gender and climate projects.” However, it has largely assisted countries transitioning to democracy and for Middle East peace talks.

Trump also wants to jettison the entire $125 million allocated to the Clean Technology Fund, as it invests in “climate-friendly projects in developing countries that do not reflect America’s values or put the American people first”. 

The fund provides low-cost finance for “promising low-carbon technologies in developing countries”, including “renewable energy, energy efficiency, sustainable transport, and green industry projects.”

International organisations and programmes

The entire $437 million allocated to international organisations and programmes is up for rescission, which would eliminate funding for the UNICEF, UNDP, UNFPA and the Montreal Protocol, which regulates ozone-depleting substances. 

“Eliminating these programs will do real harm,” said Global Health Council President and CEO, Elisha Dunn-Georgiou. 

“These are not fringe initiatives. They make the world safer, healthier, and more just. When the US invests in equitable, inclusive, and evidence-based global health programs, we don’t just improve lives abroad – we strengthen public health security, global cooperation, and America’s reputation as a principled and effective leader.”

The council urged people to “push back against efforts to politicise public health”, noting that “these proposed cuts are about ideology, not money. And they put lives at risk.”

Image Credits: Reuters Youtube, USAID Press Office.