The Trump administration is to halt its funding for Gavi, which helps buy vaccines for children in poor countries, and reduce its efforts to combat malaria, among more than 5 000 cuts revealed in a document prepared by the US Agency for International Development (USAID).
However, it will continue to fund some grants that pay for drugs that treat HIV and TB, and provide food aid to nations where civil wars and natural disasters are occurring, reports The New York Times.
The 281-page document lists 898 programmes that will remain active, totalling $78bn in spending, much of which it says has already been disbursed.
In total, 5 341 awards will be terminated, representing just under $76bn, the document says. The government has made a legal commitment to spend around $48bn of that amount.
The cover letter of the document details the skeletal remains of USAID after the cuts, with most of its funding eliminated, and only 869 of more than 6 000 employees still on active duty. The memo said 3 848 staff were on “administrative leave” and 1 602 are in the process of being laid off. Of 300 probationary employees who were initially fired, 270 have returned to work after a court order prohibiting their dismissal.
A spokesperson for the State Department, which now runs what is left of USAID, confirmed the terminations on the list were accurate and said that “each award terminated was reviewed individually for alignment with agency and administration priorities, and terminations were executed where Secretary Rubio determined the award was inconsistent with the national interest or agency policy priorities”.
The memo presents the plan for foreign assistance as a unilateral decision. However, because spending on individual health programmes such as HIV or vaccination is congressionally allocated, it is not clear that the administration has legal power to end those programmes.
This issue is currently being litigated in multiple court challenges.
Among the programmes terminated is funding for the United Nations Food and Agriculture Organisation, which conducts surveillance for diseases that can be transmitted from animals to humans, including bird flu, in 49 countries.
Some major programmes to track and fight malaria have also been ended.
Dr Austin Demby, Health Minister of Sierra Leone, which relies on Gavi’s support to help purchase vaccines, said he was “shocked and perturbed” by the decision to terminate US funding and warned that the ramifications would be felt worldwide.
“This is not just a bureaucratic decision, there are children’s lives at stake, global health security will be at stake,” he said.
“Supporting Gavi in Sierra Leone is not just a Sierra Leone issue, it’s something from which the region, the world, benefits.”
In addition to trying to reach all children with routine immunisations, Sierra Leone is currently battling an mpox outbreak, for which Gavi has provided both vaccines and critical support to deliver them, he said.
“We hope the US Government will continue to be the global leader it has always been – putting money in Gavi is not an expenditure, it’s an investment.”
The United States contributes 13% of Gavi’s budget. The terminated grant was worth $2.6bn until 2030, and the organisation was counting on a pledge made last year by President Joe Biden for its next funding cycle.
New vaccines with the promise to save millions of lives in low-income countries, such as one to protect children from severe malaria and another to protect teenage girls against HPV, have recently become available, and Gavi was expanding the portfolio of support it could give those countries.
The loss of funds will set back the organisation’s ability to continue to provide its basic range of services, like immunisation for measles and polio, to a growing population of children in the poorest countries, let alone expand to include new vaccines.
By Gavi’s own estimate, the loss of US support may mean 75m children do not receive routine vaccinations in the next five years, with more than 1.2m children dying as a result.
Gavi said that US support for its operations was “vital”.
“With US support, we can save more than 8m lives over the next five years and give millions of children a better chance at a healthy, prosperous future,” it said in a statement.
Gavi estimates it has saved 18.8m children’s lives since its inception in 2000 by helping countries buy routine childhood vaccines to protect against deadly diseases ranging from measles to diphtheria, reports Reuters.
The New York Times article – U.S. to End Vaccine Funds for Poor Countries (Restricted access)
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