What Matters in Global Health

A Global Health Catastrophe: The U.S. Pulls Funding for Thousands of Life-Saving Programs

In a sweeping and unprecedented move, the U.S. government has terminated nearly 10,000 global health grants, cutting vital programs that have long been at the frontline of the fight against HIV, tuberculosis (TB), and malaria. The decision has sent shockwaves through global health networks, leaving millions at risk and prompting widespread condemnation from experts, activists, and affected communities.

The terminations affect 5,800 grants administered by the U.S. Agency for International Development ( USAID ) and 4,100 grants managed directly by the State Department. Many of these programs had been granted temporary waivers due to their critical role in saving lives. Among those impacted are HIV services that reach some of the world’s most vulnerable populations, as well as food and nutrition programs supporting malnourished children and displaced communities.

“All malaria supplies protecting 53 million people, mostly children—including bed nets, diagnostics, preventive drugs, and treatments—terminated,” said Dr. Atul Gawande, former USAID assistant administrator under the Biden administration. The decision has also led to the abrupt closure of food kitchens in war-torn regions and the halting of all global TB programs, dealing a significant blow to efforts to control these diseases.

In South Africa, where over eight million people live with HIV, the impact is particularly devastating. Kathy Rees of Anova Health Institute Health Institute, which provides HIV services to marginalised communities, described the decision as catastrophic. “Tomorrow, we are letting go 2,800 people who are mainly peer educators and data capturers,” she said. Professor Linda-Gail Bekker , CEO of the Desmond Tutu Health Foundation , warned that the funding cuts would result in 500,000 additional deaths and around half a million new infections over the next decade.

The sweeping terminations have been met with anger and despair. “As an activist, as a person living openly with HIV, I’m very hurt,” said Sibongile Tshabalala, chairperson of the Treatment Action Campaign (TAC) in South Africa. “How am I going to survive? Will the public health care system be able to cater for us? Will it be able to cover all the gaps that we are facing?”

In Uganda, the BAYLOR COLLEGE OF MEDICINE CHILDREN'S FOUNDATION UGANDA saw its HIV and TB programs shuttered overnight, leaving district health systems scrambling to fill the void. The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) was forced to close its programs in Lesotho, Eswatini, and Tanzania, which collectively provide HIV treatment to 350,000 people, including nearly 10,000 children.

The terminations have devastated health programs and raised legal and political concerns. Mitchell Warren , head of the U.S.-based HIV advocacy organisation AVAC , called the move “unlawful.” His organisation has taken legal action to prevent further cuts. “The U.S. Congress approved the funds, and that is what has been stopped. It’s an illegal grab. It’s not following due process,” said Fatima Hassan of the Justice Health Initiative, Inc.

The consequences of these cuts will ripple far beyond the immediate closures. With PEPFAR funding comprising up to 89% of the HIV response in some African nations, the loss of U.S. support could lead to a resurgence of preventable deaths and infections. As activists and global health leaders scramble to find alternative funding sources, the fate of millions remains uncertain.

Measles Outbreak in Texas Reaches 146 Cases, Claims Life of a Child

Texas is facing its worst measles outbreak in nearly 30 years, with confirmed cases rising to 146 across nine counties. The surge has led to the tragic death of an unvaccinated school-aged child, marking the first U.S. measles fatality since 2015. Health officials are calling for urgent action as the outbreak continues to grow.

The Texas Department of State Health Services reported that the hardest-hit area is Gaines County, where nearly 100 cases have been recorded. The outbreak has also led to 20 hospitalisations. “We’re here to say quite simply: Measles can kill, ignorance can kill, and vaccine denial definitely kills,” said U.S. Representative Lloyd Doggett , as officials urged unvaccinated residents to get immunised.

The outbreak is concentrated in rural West Texas, particularly in a close-knit, under-vaccinated Mennonite community. Lara Anton, a spokesperson for the state health department, said low vaccination rates have exacerbated the spread. Texas law allows exemptions from school vaccines for religious or personal beliefs, and Gaines County has one of the highest rates of vaccine opt-outs in the state, with nearly 14% of school-aged children missing at least one required dose last year. The true number of unvaccinated children may be even higher due to unreported cases among homeschooled students.

Robert F. Kennedy Jr., the U.S. Secretary of U.S. Department of Health and Human Services (HHS) and a known vaccine sceptic, initially downplayed the outbreak, calling it “not unusual.” However, he later acknowledged the severity of the situation, stating that his agency remains committed to funding Texas’ immunisation program and making outbreak containment a “top priority.”

Health officials stress that measles is one of the most contagious diseases, capable of lingering in the air for up to two hours after an infected person coughs or sneezes. The measles, mumps, and rubella (#MMR) vaccine is highly effective, with two doses providing 97% protection. “Most children recover, but measles can cause serious complications, including pneumonia, brain swelling, and even death,” warned Dr. Desmar Walkes of the Austin-Travis County Health Authority.

While Texas remains the focal point, cases have also been reported in eastern New Mexico, though officials say the outbreaks are unrelated. In Austin, an unvaccinated infant recently contracted measles while travelling overseas, reinforcing concerns that declining vaccination rates could lead to further spread.

Public health officials continue to emphasise the importance of vaccination, warning that unless immunisation rates improve, more preventable illnesses and deaths could follow.

Fighting Health Misinformation: A Call for Action

As misinformation continues to spread at an alarming rate, health experts warn that its impact on public health is more dangerous than ever. Professor Liam Smeeth, Director of the London School of Hygiene and Tropical Medicine , believes 2025 must be the year to push back against the rising tide of falsehoods contributing to vaccine hesitancy, fear, and confusion. “People aren’t always trying to spread fake news deliberately,” he explains. “They often share information that aligns with what they believe to be true—it just feels right to them.”

With the rapid evolution of artificial intelligence and social media algorithms, misleading claims gain traction quickly, reinforcing existing biases and deepening public distrust in science. “What we see is people circulating information that fits their narrative,” Smeeth notes. “The challenge is that once misinformation takes hold, it becomes incredibly difficult to correct.”

One of the most damaging misconceptions has been around vaccines, particularly during the COVID-19 pandemic. Many falsely believed that mRNA vaccines could alter human DNA, an idea widely debunked by scientists. Smeeth acknowledges that the scientific community could have done more to prevent these myths from taking hold. “There’s a real need to communicate simply,” he says. “For example, with the flu vaccine, we once ran a campaign that simply stated: ‘The flu vaccine cannot give you flu because there isn’t any flu virus in it.’ Sometimes, that level of clarity is what people need.”

Rebuilding trust in public health institutions is another pressing concern. The pandemic saw governments and health organisations struggle to maintain credibility as policies changed and uncertainty persisted. “Unfortunately, some politicians completely broke the public’s trust,” Smeeth admits. “Rather than focusing on who to blame, we should ask what we can learn and how we can do better.”

Smeeth emphasises the need for empathy when countering misinformation. Instead of condemning those who share false claims, he advocates for a more constructive approach. “Most people spreading misinformation are doing so out of fear or concern, not malice,” he says. “If we engage with empathy and provide clear, accessible information, we stand a much better chance of making an impact.”

Looking ahead, Smeeth and his colleagues are working on new strategies to combat misinformation, including efforts to create a coordinated response network. “One strong, clear message is always more effective than thousands of smaller ones,” he stresses. “If we come together, we can push back against the misinformation epidemic and restore trust in science.”