Dr. Cheikh Mbacké Faye, Regional Director of APHRC West Africa and Director of the Countdown to 2030 initiative, has published a new commentary in The Lancet Global Health.
The commentary responds to a new modelling study that examined the far-reaching effects of abrupt reductions in US foreign assistance on HIV, tuberculosis, family planning, and maternal and child health outcomes. These effects extend far beyond individual programs, exposing how decades of external support have shaped fragile health systems..
In his commentary, Dr. Faye underscores two key insights:
- First, donor disinvestment should be seen not merely as budgetary tightening, but as a structural threat to health system stability. Gains in HIV, TB, family planning, and maternal and child health are deeply interlinked, meaning cuts in one area risk ripple effects across others.
- Second, countries must build stronger adaptive capacity, including mobilizing domestic financing, forging innovative partnerships, and enhancing resilience in the face of global fiscal shocks.
He also notes important gaps in the modelling, such as the absence of malaria, a disease still claiming nearly 600,000 lives annually, mostly in sub-Saharan Africa where US funding plays a critical role. Including malaria in future analyses will be essential to understanding the true scale of risk.
At a time when multiple donors are reducing aid, the commentary calls for renewed global solidarity, ethical responsibility, and stronger multilateral collaboration to ensure that the world’s poorest women, children, and communities living with chronic diseases are not left behind. Protecting health gains, Dr. Faye stresses, requires shared responsibility, innovative domestic financing mechanisms such as health taxes and debt swaps, and strengthened governance and accountability.
The commentary is a timely reminder that resilience must be measured not only in dollars spent but in systems sustained.
📖 Read the full commentary here: Rethinking global health resilience amid donor funding cuts