The Trump administration intends to end US financial support for Gavi, an organization that has helped buy important vaccines for children in developing countries, save millions of lives over the past quarter century and significantly expand its support in efforts to combat malaria, one of the world's biggest killers.
The administration has decided to continue its major drug subsidies to treat HIV and tuberculosis, and to continue food aid to countries facing civil wars and natural disasters.
These decisions are included in a 281-page spreadsheet sent to Congress on Monday night by the U.S. International Development Agency, and lists foreign aid projects that are expected to be closed ongoing. The New York Times have obtained copies of spreadsheets and other documents describing the plan.
The document presents the US as a compassionate ally, providing an overview of the extraordinary scale of the resignation from half-century efforts, and provides an overview to lead the fight against infectious diseases that kill millions of people each year.
The cover letter details the relics of the USAID skeleton after the cut, with the majority of its funds being eliminated, with only 869 of the over 6,000 employees.
Overall, the administration has decided to continue its 898 USAID awards and end 5,341, the letter says. The rest of the programs are said to be worth up to $78 billion. However, only $8.3 billion of that is unbligrigable and still paid out. That amount covers awards that will continue in years, so the figure suggests a massive $40 billion cut that USAID spent each year.
A State Department spokesman currently running the rest of USAID confirmed that the list was termination accurate, saying, “Each award that was terminated was reviewed individually for coordination with agency and management priorities, and if Rubio Secretary deemed to be inconsistent with national interests or institutional policy priorities, the termination was carried out.”
The memo to Congress presents a plan of foreign aid as a one-sided decision. However, it is not clear that the administration has legal authority to terminate these programs, as spending on individual health programs, such as HIV and vaccinations, is allocated to Congress. The issue is currently being litigated on multiple court issues.
Among the finished programs are funding for the UN Food and Agriculture Organization, which monitors diseases that can infect humans, including avian influenza in 49 countries. Several major programs have also been completed to track and fight malaria, one of the world's top killers.
Sierra Leone's health minister, Dr. Austin Denbye said he relied on Gabi's support to help buy the vaccine, and warned that the effects would be “shocked and perturbed” by the decision to terminate US funding, and that the effects would be felt around the world.
“This is not just a bureaucratic decision, it is a crisis in children's lives and global health security is at risk,” he said. “Supporting Gabi in Sierra Leone isn't just a matter of Sierra Leone, it's something that benefits the region and the world.”
In addition to trying to reach all children with routine vaccinations, Sierra Leone is currently battling the outbreak of MPOX. Gabi offers both vaccines and important support to provide them.
“We hope that the US government will remain the global leader it has been. Putting money on Gavi is not an expense, it's an investment,” Dr. Demby said.
Since its establishment 25 years ago, Gavi is estimated to have saved the lives of 19 million children. The US donates 13% of its budget.
The termination grant to Gavi was worth $2.6 billion until 2030. Gavi relied on the pledges that President Joseph R. Biden Jr. made during his next fundraising cycle last year.
The new vaccine, which promises to save millions of lives in low-income countries, has recently become available to protect children from severe malaria and teenage girls from viruses that cause cervical cancer, and Gavi has expanded its portfolio of support that can be provided to those countries.
Loss of US funding will retreat the organization's ability to continue to provide basic services, such as measles and polio vaccinations, to the growth of child populations in the poorest countries.
Gavi's own estimates suggest that the loss of US support could mean that 75 million children have not been routinely vaccinated over the next five years, resulting in over 1.2 million children being dying.
The United States has been one of the top donors to the organization since its creation, and is the biggest amid the Covid-19 pandemic. European countries have historically provided large amounts of funding, but many are working on changes to US policy on Ukraine, reducing foreign aid spending and the US demanding increased defense spending. Another major gavidner, Japan, suffers from depreciation currency.
Gavi's chief executive, Dr. Sania Nishter, said he hopes the Trump administration will reconsider its decision to end its support. Gavi's work keeps people safe, including Americans, she said. In addition to protecting individual children, vaccinations reduce the chances of major outbreaks. The organization maintains a global stockpile of vaccines against diseases such as Ebola and cholera, and deploys them in a rapid response effort for the outbreak.
Gavi's structure requires the country to pay a portion of the vaccine's costs, and shares are increasing as revenue levels rise. Middle-income countries are separated from support.
According to the memo, 869 USAID staff had worked as of last Friday, but 3,848 people were on administrative leave and 1,602 people were fired. Of the 300 probation employees initially fired, 270 have returned to work following a court order banning dismissal.
