President Donald Trump's administration has notified Congress in a new letter they intend to eliminate several foreign aid programs critical for public health, including efforts to combat malaria and a grant to a program responsible for vaccinating millions of children in the developed world, The New York Times reported.
Trump has previously moved to dismantle the U.S. Agency for International Development entirely, but a series of federal court orders has pushed back on this, as the office is authorized by Congress. For a while, the administration appeared to be defying the courts on the issue — but at this point, while the matter plays out in the courts, they have settled for aggressively scaling back the agency while preserving a handful of programs that were explicitly passed by Congress, like HIV relief and food aid for natural disasters.
However, that still leaves the vast majority of USAID on the chopping block — including programs essential to public health not just in lower-income countries but all around the world.
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"In all, the administration has decided to continue 898 U.S.A.I.D. awards and to end 5,341, the letter says," per the report. "It says the remaining programs are worth up to $78 billion. But only $8.3 billion of that is unobligated funds — money still available to disburse. Because that amount covers awards that run several years into the future, the figure suggests a massive reduction in the $40 billion that U.S.A.I.D. used to spend annually."
Among those terminated programs include "funding for the United Nations Food and Agriculture Organization, which conducts surveillance for diseases that can be transmitted from animals to humans, including bird flu, in 49 countries. Some major programs to track and fight malaria, one of the world’s top killers of children, have also been ended." But the termination that has some public health officials particularly up in arms is the end of grants to Gavi, the nonprofit that secures vaccines for children in developing countries.
"By Gavi’s own estimate, the loss of U.S. support may mean 75 million children do not receive routine vaccinations in the next five years, with more than 1.2 million children dying as a result," said the report.
These programs are essential for containing the spread of outbreaks of preventable disease. Sierra Leone Health Minister Dr. Austin Demby, whose country relies on the vaccination program, laid bare the stakes of this decision to The Times: “This is not just a bureaucratic decision, there are children’s lives at stake, global health security will be at stake. Supporting Gavi in Sierra Leone is not just a Sierra Leone issue, it’s something the region, the world, benefits from.”