Global health aid is set to drop to a 15-year low, with steep U.S. cuts threatening critical programs.
Global health aid is projected to fall to its lowest level in 15 years, according to a new report, with U.S. cuts playing a major role in the downturn.'These are drastic cuts,' said lead author Dr. Angela E.
Apeagyei, research assistant professor at IHME, in an interview with Newsweek. 'Their sudden nature makes urgent response efforts essential to prevent serious disruptions in health programs around the world.'The United States slashed its global health funding by at least 67 percent in 2025 compared to last year, according to the Institute for Health Metrics and Evaluation . These cuts are already threatening essential health programs across low-income countries, particularly in sub-Saharan Africa, which is forecast to see a 25 percent drop in aid since last year, with another 7 percent decline projected over the next five years.The cuts are also expected to impact the health workforce both abroad and in the U.S., as programs lose staff responsible for delivering essential services.IHME's Financing Global Health 2025 report estimates that development assistance for health will plummet by 51 percent from its pandemic-era peak. After reaching $80 billion in 2021 during COVID-19, aid will drop to just $39 billion this year, with further declines likely—potentially falling to $36 billion by 2030.The steep drop could imperil progress made against HIV/AIDS, tuberculosis, malaria and maternal care—sectors heavily reliant on foreign aid. 'Low-income countries in this region are heavily donor-dependent and often lack the domestic resources to offset funding gaps,' Apeagyei said.Should aid remain at the reduced level, the broader consequences for the world will be dependent on the global response to the cuts.The new level of aid reflects a 21 percent decrease from 2024 and a staggering 50 percent drop from the peak levels seen during the COVID-19 pandemic in 2021. However, Apeagye noted that even this reduced figure is comparable to what was once considered a high point in 2009.If aid delivery and administration can be made more efficient, there's potential for countries to maintain—or even enhance—health outcomes despite the reduced funding, according to Apeagye.Yet, she cautioned that without such gains in efficiency—or if critical funding gaps in health systems persist—countries could see worsening health indicators. 'The health outcomes will worsen and global responses to international public health emergencies such as COVID-19 may be compromised,' Apeagye warned.The downturn comes as donor commitment continues to fade post-COVID. 'What we're seeing now is a return to the 'panic and neglect' cycle in global health,' she added. 'Despite warnings, the funding surge during COVID-19 was not sustained. The downward trend signals that long-term commitment to global health remains fragile and volatile.'This volatility is amplified by ongoing U.S. policy shifts. Lawmakers are currently debating a proposal to rescind previously allocated foreign aid, and additional U.S. cuts were announced following last month's Gavi vaccine summit.Multilateral institutions such as Gavi, the Global Fund and the World Health Organization are already under pressure. Gavi's recent replenishment fell short of its goal, and the WHO is undergoing restructuring amid financial strain. 'What's clear is that all are urging donors to step up in light of shortfalls.'She also noted that weakening the global aid infrastructure makes it harder to respond to future health crises.While development assistance for health has always been volatile, Apeagyei emphasized the need for reforms that build resilience.She pointed to efforts such as the 2005 Paris Declaration and the recent Financing for Development conference in Seville. These initiatives aim to reduce aid instability by promoting harmonization, strengthening accountability and leveraging private and multilateral funding sources.Donors and recipient countries alike are responding to the aid cuts in a number of ways.For instance, China is reported to have pledged an additional 500 million to WHO over the next five years. Nigeria is also reported to have increased its budget by 200 million in response to the aid cuts. In some countries, reorganization of the health workforce to cover some of the service gaps left behind from the closure of programs is where efforts have been made.As global health aid falls and donor commitment fades, the world faces a fragile and volatile future—one where hard-won progress could be undone and responses to future health crises dangerously compromised.
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