Unprecedented Funding Collapse Threatens Lives Worldwide
The World Health Organization has issued an urgent warning about what its Director-General Dr. Tedros Adhanom Ghebreyesus calls “the greatest disruption to global health financing in memory.” External health aid is projected to drop by 30% to 40% in 2025 compared with 2023, causing immediate and severe disruption to health services in low- and middle-income countries. This dramatic shortfall has already begun costing lives and jeopardizing decades of hard-won health gains across the developing world.
WHO survey data from 108 LMICs collected in March 2025 indicate that funding cuts have reduced critical services – including maternal care, vaccination, health emergency preparedness and response, and disease surveillance – by up to 70% in some countries. The crisis has exposed deep structural vulnerabilities in the global health system, forcing a fundamental reckoning with how the world finances and delivers essential health services.
Devastating Impact on Healthcare Services and Workers
The human cost of these funding cuts is mounting rapidly. More than 50 countries have reported job losses among health and care workers, along with major disruptions to health worker training programmes. In Afghanistan, healthcare centers are closing at an alarming rate, with projections suggesting 220 more facilities could shut down by June, leaving 1.8 million people without access to care.
As many as 14 million additional preventable deaths could take place by 2030 if gaps created by US programme cuts are not closed.
The WHO’s global measles and rubella laboratory network, funded solely by the United States, faces shutdown at precisely the moment when measles cases are surging globally for the third consecutive year. Essential vaccination programs, maternal health services, and disease surveillance systems are collapsing in the countries that need them most.
US Withdrawal Deepens Financial Crisis
The crisis deepened after the United States, formerly the organisation’s biggest funder, pulled out in January, saying the health agency had mishandled the COVID-19 pandemic and other international health crises. The US had previously covered nearly a fifth of WHO’s budget, and its withdrawal has created a massive financial gap that other donors have struggled to fill.
WHO is short nearly $1.9 billion from a planned $4.2 billion budget for 2026-27, along with a $600 million deficit through end-2025. This represents a funding shortfall of nearly 45 percent, forcing the organization to make painful cuts across all operations, including headquarters in Geneva, regional offices, and country-level programs. Some offices in wealthier nations may close entirely as WHO restructures to survive the unprecedented crisis.
WHO Issues Emergency Guidance for Countries
In response to this emergency, WHO has released comprehensive guidance titled “Responding to the health financing emergency: immediate measures and longer-term shifts” to help countries navigate the crisis. WHO’s new guidance urges policy-makers to make health a political and fiscal priority in government budgets even during times of crisis, seeing health spending as not merely a cost to be contained, but an investment in social stability, human dignity, and economic resilience.
The guidance emphasizes several key policy recommendations: prioritizing health services accessed by the poorest populations, protecting essential health budgets, improving efficiency through better procurement and reduced overheads, and integrating externally-funded disease-specific programs into national health systems. WHO and partners will provide technical support through the new UHC Knowledge Hub, launching in December 2025 in partnership with Japan and the World Bank.
Some Countries Take Action Despite Challenges
Despite the crisis, several African nations have demonstrated leadership by increasing domestic health spending. Nigeria increased its health budget by US$ 200 million to offset aid shortfalls, with increased allocations for immunization, epidemic response, and priority programmes. Ghana lifted the cap on excise taxes earmarked for its national health insurance agency, resulting in a 60 percent budget increase, and launched “the Accra Reset,” a framework to reimagine global health governance and financing.
Kenya, South Africa, and Uganda have also allocated additional budget funds or outlined clear policy agendas to sustain service delivery despite reduced external assistance. These examples demonstrate that while the crisis is severe, strategic planning and domestic resource mobilization can help protect the most vulnerable populations and maintain essential services.