Impact of U.S. Aid Cuts on Vaccination Progress in Africa

Vaccination programs across Africa have significantly improved public health, saving over 50 million lives in the past five decades, according to the World Health Organization (WHO). Since 2000, more than 500 million children have been reached through routine vaccinations, preventing over 4 million deaths annually. Key milestones include the eradication of wild poliovirus in 2020 and the elimination of maternal and neonatal tetanus in most countries. However, the WHO warns that progress is now slowing, particularly in the wake of the COVID-19 pandemic, which has increased the number of children who have never received a single vaccine.

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The WHO has expressed concern that cuts to U.S. aid, particularly under President Donald Trump’s “America First” policy, are jeopardizing vaccination efforts in Africa. The U.S. withdrawal from the WHO in January 2025 resulted in a loss of approximately 40% of the agency’s overseas development funding. Mohamed Janabi, the WHO regional director for Africa, emphasized the need for African governments to increase domestic health financing to counteract the impact of these aid cuts. Health experts, including Shabir Madhi from South Africa’s University of the Witwatersrand, have identified funding as the "biggest threat" to immunization efforts, with many aid-funded programs already scaling back or shutting down.

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The ongoing war in the Middle East has further complicated the situation, disrupting supply chains and increasing costs for essential resources. Adelheid Onyango, the WHO Africa director for health systems and services, noted that many health facilities in Africa rely on generators, making them vulnerable to rising gas prices. While the full impact of the war on health systems in Africa has yet to be quantified, it poses a significant risk to the delivery of health services, including vaccination campaigns.

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Critics argue that reliance on organizations like the Gavi Vaccine Alliance, while beneficial, is insufficient for sustainable vaccination efforts. Madhi pointed out that continued dependence on external funding is not a viable long-term strategy, highlighting the need for a more robust domestic health financing framework in African nations.

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The WHO has called for urgent action to address the disparities in vaccination coverage, particularly in the ten countries that account for 80% of unvaccinated children in the region. Sania Nishtar, chief executive of Gavi, echoed the need for consistent efforts to reach children in fragile and remote contexts, emphasizing the importance of equitable access to vaccines.

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• “These immunization outcomes reflect very different realities, and we have more work to do to ensure we are consistently able to reach children, even in the most fragile and remote contexts,” — Sania Nishtar, Chief Executive of Gavi

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• “It can’t be that we continue relying on the likes of Gavi Vaccine Alliance, which has done a tremendous amount of work in terms of ensuring that there’s increasing uptake of new vaccines,” — Shabir Madhi, Professor of Vaccinology, University of the Witwatersrand

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As vaccination efforts in Africa face significant challenges from reduced U.S. aid and global conflicts, the WHO and health experts stress the urgency of addressing funding gaps and ensuring equitable access to vaccines. The future of immunization programs in the region hinges on both increased domestic investment and international support.

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