Actualité

𝐆𝐋𝐎𝐁𝐀𝐋 𝐇𝐄𝐀𝐓𝐇 – 𝐔𝐒𝐀𝐈𝐃 𝐆𝐑𝐀𝐍𝐓 𝐄𝐍𝐃𝐄𝐃 – 𝐆𝐥𝐨𝐛𝐚𝐥 𝐡𝐞𝐚𝐥𝐭𝐡 𝐚𝐭 𝐚 𝐜𝐫𝐨𝐬𝐬𝐫𝐨𝐚𝐝𝐬: 𝐖𝐡𝐨 𝐰𝐢𝐥𝐥 𝐟𝐢𝐥𝐥 𝐭𝐡𝐞 𝐠𝐚𝐩?

By Jürg Utzinger – Director of Swiss Tropical and Public Health Institute

Photo credit – main illustration : Karen Kramer

Wednesday, March 05, 2025
Switzerland – Basel

A Precarious Moment for Global Health

Over the past few decades, global health has been a story of progress. Investments in research, innovation and international cooperation have led to better medicines, stronger health systems and more equitable access to healthcare. But today, that progress is at risk.

The withdrawal of the United States from the World Health Organization (WHO) and the freeze on USAID funding has sent shockwaves throughout the world. Programmes are being disrupted at every level – from national health systems to the most vulnerable patients who rely on them. At the same time, international development budgets are shrinking, including in Switzerland. The question is no longer whether these decisions will have consequences – it is how severe they will be.

At Swiss TPH, we are already seeing the impact. The USAID freeze has led to immediate funding losses for critical projects and partners, affecting some of the world’s most marginalized communities:

Malaria research and control in Tanzania: Our long-standing partner, the Ifakara Health Institute (IHI), will lose a USD 17.9 million USAID grant, endangering progress towards malaria elimination.
HIV treatment in Tanzania: In the Kilombero Valley, 4,500 HIV patients may soon lose access to life-saving antiretroviral treatment, risking a resurgence of infections and the development and spread of drug resistance.
Health system support in Ukraine: Swiss TPH-led projects have been left without salaries for local staff due to USAID cuts. We are covering wages for three months, but this is not sustainable.

These are not abstract concerns – this is what a global health crisis looks like when the funding disappears. Across the world, essential health programmes are being scaled back or shut down. Millions of people who rely on HIV treatment, malaria prevention or neglected tropical disease (NTD) control are being left behind.

The Impact of Funding Cuts: A Shrinking Global Health Budget

Since the new millennium, global health has seen remarkable progress. Now, that trend is reversing. The latest data from the Institute for Health Metrics and Evaluation (IHME) shows that after a historic peak during the COVID-19 pandemic, funding for global health is now on the decline.

This is happening at a time when the world faces mounting health threats: climate-driven disease outbreaks, rising drug resistance and weakened health systems still recovering from the pandemic or struggling in wartime conditions. Instead of increasing investment, governments and funding institutions are pulling back.

Several trends highlight the scale of this decline:

The United States have historically been the largest donor to global health, contributing approximately 25% of total funding. Its exit from WHO and the USAID freeze leaves a massive gap that no single donor can fill.
Major funding institutions are scaling back: The World Bank, the President’s Malaria Initiative (PMI), and the US President’s Emergency Plan for AIDS Relief (PEPFAR) have also seen significant reductions, limiting their ability to sustain past achievements and respond effectively to emerging health threats.
Bilateral government contributions are falling: While some private philanthropy has remained steady, many national budgets for global health in countries like the UK, Germany, and Japan are shrinking.

The consequences are already unfolding. HIV treatment programmes are at risk. Malaria and tuberculosis (TB) control efforts are losing momentum. NTDs, which are already struggling to attract funding, risk being pushed even further down the global health agenda. USAID-backed mass drug administration campaigns for diseases like schistosomiasis and lymphatic filariasis, which have provided essential treatment to millions, are now in jeopardy.

This is an urgent shortfall. If global health financing continues to decline, decades of progress could unravel and millions will be left without essential care.

Switzerland’s Role: A Decisive Moment

Switzerland is also scaling back its commitment in development and cooperation, including global health. The government has announced drastic cuts – CHF 110 million for 2025 and an additional CHF 321 million through 2028 – including a withdrawal from UNAIDS, a key player in the fight against HIV/AIDS. These cuts do not just threaten life-saving programmes; they reduce Switzerland’s ability to shape global health policy and respond to emerging challenges.

The cost of inaction – measured in human lives, economic stability and global security – might far exceed the cost of sustained investment. Of course, Switzerland cannot replace USAID’s funding, but it has an opportunity to lead on critical health investments, particularly in disease prevention, health system strengthening and financing sustainable interventions.

A Call to Action: What Switzerland Can Do

Switzerland has long been a leader in global health. Now is time to reaffirm its commitment. Concrete steps that could be taken include:

Increase targeted funding – Programmes for HIV/AIDS, malaria, TB and NTDs must remain a priority. Without sustained investment, millions risk losing access to essential treatment and elimination efforts will falter, leading to rising infections, human suffering and premature death.
Strengthen partnerships – As the United States step back, Switzerland should increase coordination with the EU and other global health actors to fill critical gaps and preserve Switzerland’s position in health diplomacy.
Champion new financing models – Switzerland can play an important role in scaling up innovative financing mechanisms, such as public-private partnerships, to sustain long-term health investments without over-reliance on traditional funding structures.
Ensure long-term health system resilience – Instead of fragmented, short-term cooperation, Switzerland should prioritize investments that strengthen local health infrastructure, disease surveillance, and outbreak preparedness, ensuring that countries can respond to future health crises.

Swiss TPH: A Trusted Partner for Action

Swiss TPH has played a central role in global health for over 80 years. With over 400 active projects in 127 countries and hosting three WHO Collaborating Centres, we work with international organizations, governments, NGOs and local partners to strengthen health systems, fight infectious diseases of poverty and non-communicable diseases and train the next generation of public health specialists. However, with financial support under increasing pressure, our collective ability to translate research into action and sustain essential health services is under threat.

However, this crisis is not just about institutions like Swiss TPH – it is about the millions who will lose access to treatment, the frontline health workers left without support and the disease control programmes that will be abandoned. Without sustained investment, governments will struggle to provide essential healthcare, elimination efforts will stall and the world will be less prepared for future health threats.

At a time when global health leadership is needed most, Switzerland has the opportunity to reaffirm its commitment – and Swiss TPH stands ready to play its part.