US Withdrawal from WHO Declared 'Public Health Emergency of International Concern'

In January 2025, US President Donald Trump announced an immediate freeze on all international health aid, prompting health experts to declare the withdrawal a public health emergency of international concern (PHEIC) in an unprecedented move. The funding cuts halted PEPFAR HIV/AIDS treatment services, imposed USAID stop-work orders, and ended US support for UN Women and the UN Population Fund, threatening services in over 150 countries. UNAIDS estimates the withdrawal could cause six million HIV-related deaths and nine million new infections by 2030—a tenfold increase from 2023 mortality—with millions more deaths expected from reduced malaria and tuberculosis funding. Health experts argue the PHEIC declaration, though never before used for a single country's political actions, could mobilize international collaboration and enable countries to override pharmaceutical patents to maintain access to essential medicines.

US withdrawal of international health funding and immediate impacts

• ▪Ceasing US funding for UN Women and the UN Population Fund threatens to end services that support sexual rights and reproductive health in more than 150 countries
• ▪US President Donald Trump announced an immediate freezing of all international health aid shortly after assuming power in January 2025
• ▪The United States ceased funding for United Nations agencies including UN Women and the UN Population Fund
• ▪Stop-work orders imposed on the US Agency for International Development (USAID) immediately reduced HIV testing and treatment
• ▪The Trump administration's funding freeze on the US President's Emergency Plan for AIDS Relief (PEPFAR) resulted in the sudden closure of treatment services for thousands of people with HIV/AIDS

Projected mortality and disease burden from funding cuts

• ▪UNAIDS estimates that if US aid is not resumed, there could be nine million new HIV infections by 2030
• ▪If the Trump administration halts funding for Gavi, the Vaccine Alliance, vaccine preventable diseases and deaths are likely to resurge both in the US and abroad
• ▪UNAIDS estimates that if US aid is not resumed, there could be six million HIV-related deaths by 2030, a 10-fold increase on 2023 mortality
• ▪Multiple estimates predict reduced US funding will lead to millions of deaths by 2030

Proposal to declare a Public Health Emergency of International Concern

• ▪According to the World Health Organization's International Health Regulations, a PHEIC is an extraordinary event which is determined to constitute a public health risk to other states through the international spread of disease and to potentially require a coordinated international response
• ▪Fatima Hassan is director of Health Justice Initiative in South Africa
• ▪Andrew Hill is a visiting research fellow at the University of Liverpool in the UK
• ▪Professor Roojin Habibi is from Ottawa University
• ▪Professor Matthew Herder is from Dalhousie University's school of law in Canada
• ▪Professor Matthew Herder and colleagues wrote in the BMJ that the rapid withdrawal of international health aid by the United States constitutes a public health emergency of international concern (PHEIC)

Perspective of Health experts (Professor Matthew Herder, Professor Roojin Habibi, Fatima Hassan, Andrew Hill)

• ▪Professor Matthew Herder and colleagues argue that the US withdrawal of international health aid meets the WHO's criteria for a public health emergency of international concern

Perspective of Trump administration

• ▪The Trump administration imposed stop-work orders on USAID that halted ongoing HIV testing and treatment programs

Perspective of UN agencies (UN Women, UN Population Fund, UNAIDS)

• ▪UN agencies emphasize that US funding cessation threatens sexual rights and reproductive health services operating in over 150 countries
• ▪UNAIDS warns that without resumed US aid, HIV-related deaths could increase tenfold from 2023 levels by 2030

Perspective of Gavi, the Vaccine Alliance

• ▪Gavi, the Vaccine Alliance warns that halted US funding would likely cause vaccine-preventable diseases to resurge in both the United States and internationally