Africa's reliance on World Health Organization support faces a critical test after Donald Trump withdrew the United States – and the considerable funding it contributes – from the global body. The move could have serious consequences across the continent, but one senior African health official told RFI it could also push African nations to take greater control of their health systems.
Between 2022 and 2023, Washington contributed $1.28 billion to the World Health Organization (WHO) – more than any other country.
But hours after taking office on Monday, Donald Trump signed an executive order announcing that the United States was leaving the WHO and taking its funding with it, citing dissatisfaction over its handling of the Covid-19 pandemic and the inequality of contributions.
“China, with a population of 1.4 billion, has 300 percent of the population of the United States, yet contributes nearly 90 percent less to the WHO," the order read.
The move has raised concerns on the African continent about how the loss of finance could impact the fight against HIV-Aids, and the growing mpox epidemic – which the African Union's health watchdog (Africa CDC) has declared a public health emergency.
On Wednesday, the African Union expressed dismay over the withdrawal, urging the Trump administration to reconsider.
RFI spoke to Professor Yap Boum II, deputy coordinator of the CDC's mpox response unit.
RFI: What are your thoughts on the decision announced by the new American president?
Professor Yap Boum II: The decision was anticipated, it had been in the air. Dr Tedros Ghebreyesus, director-general of the World Health Organization, addressed it this week, so it’s not surprising.
However, it will have a significant impact. For instance, in responding to the mpox epidemic the WHO and Africa CDC are coordinating efforts, and out of the projected funding of $1 billion, the US contributes $500 million – half of the total. This withdrawal could have substantial consequences. We need to consider what the US's exit from the WHO signifies. Does it imply a reduction in US support for global health? These are distinct issues. It’s crucial to understand the practical implications so that we can all adapt accordingly.
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RFI: Historically, the US has been a significant contributor to public health emergency appeals.
YB: Yes. For instance, the US is the largest contributor to the fight against HIV-Aids in Africa and globally. In response to major epidemics like Covid-19 and now mpox, the US has provided half of the funding. The impact will be considerable, depending on how the situation unfolds.
Is the WHO all there is to health? That’s the key question. Could this open the door for other agencies, such as USAID or various organisations, to receive the funds. And, couldn’t this also be an opportunity for African philanthropists for example to contribute more to the Africa CDC? Couldn’t this lead to a reorganisation of the global health landscape? We’ll get more clarity on this in the coming weeks and months.
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RFI: So you’re not dismissing the possibility of other players stepping in?
YB: Absolutely not. As the saying goes, nature abhors a vacuum. If there are crises – and there will be – needs will continue to grow. We’ll need individuals, institutions and even nations to fill that gap. The current Davos summit presents an opportunity to discuss how certain philanthropists can take on the funding that the US might give up. I’m currently in Kinshasa, Democratic Republic of Congo, focusing on how African entities, countries and member states can invest more in the health of their communities in response to mpox.
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RFI: Have you observed African governments being willing to increase their contributions to financing African structures, especially Africa CDC?
YB: Absolutely. To kickstart the response to the mpox epidemic, member states were the first to invest. Here in the DRC, the government was quick to release funds to support the response efforts. There’s a strong desire for sovereignty that allows us to respond to epidemics.
However, we currently lack the critical mass to do this alone. So in some respects the pressure [stemming from the US’s withdrawal from the WHO] could act as a catalyst for member states, as well as for philanthropists and investors. We’ve never had so many African billionaires. Now is the time to invest more seriously to ensure national and even continental sovereignty.
This interview, adapted from the original in French, has been lightly edited for clarity.
