Threats to International Public Health

International public health stands to look much different in the coming years. The 2025 closure of the U.S. Agency for International Development (USAID) — which in 2024 managed over $35 billion in humanitarian aid — may result in up to 14 million preventable deaths by 2030. USAID assisted 130 countries, with health being one of the highest-priority sectors for funding. The end of USAID resulted in immediate cuts to the research and treatment of diseases such as malaria, HIV/AIDS, and polio, as well as nutrition and sanitation programs that provided food and clean water globally.

The U.S. withdrawal of funding and support from the World Health Organization (WHO) further threatens the prognosis for continued gains in disease prevention and treatment, preparedness for future pandemics, and international collaboration on public health issues. A 2025 study found that health inequalities, COVID-19 disruption, and rising levels of misinformation and hesitancy are reducing vaccination rates around the world, potentially enabling the reemergence of diseases once thought largely eradicated, such as polio. This could further threaten global collaboration and governance on public health.

Research cuts pose additional challenges. Altogether, the U.S. has paused or ended more than $1 billion in funding from the National Institutes of Health (NIH), affecting more than 2,000 grants for chronic diseases, global health, cancer research, and other health-related projects. In August 2025, the Department of Health and Human Services cancelled nearly $500 million in funding for mRNA vaccine development. In a December 2025 report, the Gates Foundation warned that global public health funding from the U.S. and some EU countries was down almost 27 percent from last year, but suggested that focusing efforts on certain solutions could still improve future health outcomes. Restructuring the global health research infrastructure to adapt to new funding sources will happen, but it might take some time. This loss of funding and declining health outcomes may require planners to proactively design for these changing dynamics.