U.S. Retreat From Global Vaccine May Increase Diseases, Experts Warn

Forbes

4 days ago

LONDON, ENGLAND - MAY 19: The Palace of Westminster lit up by Global Citizen in a striking call to ... More action: Renew UK funding for Gavi, the Vaccine Alliance on May 19, 2025 in London, England. (Photo byfor Global Citizen)
A decade of protection. That's what Elizabeth Khayumbi was seeking for her six-month-old daughter, Jaisley, on a recent trip to a local public health clinic near Nairobi, Kenya.
'I know immunisation protects her, as I too was protected,' Khayumbi recently told Gavi, the Vaccine Alliance. Over the past twenty-five years, Gavi has helped immunize more than 1.1 billion children just like Jaisley. Working across 78 low-income countries, the organization has prevented nearly 19 million deaths from diseases like pneumonia, diarrhea and measles while creating stronger health systems to help combat other viruses like HIV.
Last week, Gavi held its sixth fundraising replenishment, securing $9 billion in pledges—$2.9 billion short of its goal, but more than expected given the turbulent year for global health, especially for multilateral institutions. Portugal increased its contribution by 54%. Indonesia, a country that once received Gavi funding became its newest donor, showing that progress is possible. And the European Commission, Australia and Spain all increased their pledges. But there was one noticeable absence from the donor list: The United States.
In a video that was released by the Department of Health and Human Services, Secretary Robert F. Kennedy Jr., a longtime vaccine skeptic, announced that the U.S. would not pledge any money to Gavi, saying the organization had 'ignored the science' around vaccine safety.
It was a move that doctors described as stunning and calamitous. The U.S. was an original donor to Gavi in 2001 and a rapid retreat from the organization could jeopardize thousands, if not millions, of children's lives.
A World With More Deaths And Diseases
If you want to see Gavi's impact, just look at a country like Kenya. In 1989, only 44% of Kenyan children were vaccinated. By 2023, that number had risen to over 93%. The organization followed a simple recipe: As Gavi raised more money, it purchased and distributed more life-saving vaccines. As a result, more children were vaccinated against devastating viruses, and more were lives saved. Between 2000 and 2023, Kenya's child mortality rate plummeted from 96 deaths per 1,000 live births to 40 deaths per 1,000 live births. Yes, Gavi invested a lot of money in Kenya, nearly $1 billion, but the Kenyan government also increased its domestic health resources, too. Thanks to their collective efforts, well over one million child deaths were averted.
Without U.S. assistance, Gavi will have to make some tough decisions. The organization may have to reduce the number of vaccines it offers or curb the number of countries it helps. Roughly 13% of the organization's budget comes from American taxpayers. Absent U.S. generosity, as many as 75 million fewer children will be vaccinated and an additional one million children could die.
Kennedy's announcement, which aligns with President Trump's 'America First' rhetoric, may have also given other countries permission to step back from the world's most vulnerable. The United Kingdom, historically Gavi's top donor, issued a pledge that constituted a 40% cut in real terms from the last commitment made under conservative Prime Minister Boris Johnson.
'Many thousands of children who could have lived will instead die – it's hugely disappointing to see the UK government backsliding rather than driving progress on global poverty,' Dr. Sandy Douglas, a senior vaccinologist at Oxford University's Jenner Institute, told the Guardian.
Gavi directly supports vaccination campaigns against roughly 20 diseases ranging from Ebola to malaria. Fewer resources could cause more diseases and infections. Experts fear this could trigger health setbacks for both low-income countries and for Western ones, too, as viruses and diseases do not require passports. Children with less access to vaccines are more likely to contract opportunistic infections that are prevalent among immunocompromised individuals living with viruses like HIV. And a pullback in health system strengthening and capacity building could lead to fewer maternal and newborn health services and higher mother-to-child transmission rates.
Who Will Step Up?
When countries like the U.S. and U.K. step back, the world does not stand still. Others, like China, tend to step forward. The country's Belt and Road Initiative is well documented. But less has been written about China's efforts to leverage vaccine diplomacy.
During the Covid-19 pandemic, China donated hundreds of millions of vaccines to Africa, the Asia-Pacific and Latin America. To date, some Chinese vaccines companies have shunned Gavi-backed markets. However, as Chinese biotechnology companies develop drugs at a faster, cheaper clip than the U.S., they may well be positioned to fill the vacuum.
On a hopeful note, Gavi announced new private sector partnerships worth over $149 million to strengthen digital and supply chains. Zipline and Gavi will continue scaling up their vaccine drone-based delivery efforts across Ghana, Côte d'Ivoire, Kenya, and Nigeria. Integrate Health and partners are aiming to further vaccine equity across Guinea and West Africa. And the UPS Foundation committed to helping improve supply chain networks to better deliver vaccines to children in low-income countries. While experts caution there is no substitute for public sector leadership, private sector innovation and expertise can be transformative.
What's Next?
Following Secretary Kennedy's announcements, advocacy organizations, including the U.S. Global Leadership Coalition underscored the bipartisan nature of America's longstanding support for Gavi and the need for Congress to have the ultimate say. The plea's came as the House and Senate continue the appropriations process that is expected to culminate before the start of the fiscal year on October 1st.
In the meantime, Gavi will plow ahead with its essential work. The $9 billion haul of mostly new pledges helps put the organization another step closer to supporting its goal of vaccinating 500 million children from preventable disease and averting between 8 and 9 million future deaths.
'In a very, very dire moment for global health… this is far better than I hoped it would be,' Sania Nishtar, Gavi's Chief Executive, told Reuters. 'But we have to be mindful that if we fall short… there will be lives we are unable to save.'