By Genevie Fernandes
The cover image shows a visibly disconcerted German Chancellor Angela Merkel reacting to an unmindful remark made by the U.S President Donald Trump during her recent visit to the White House. Chancellor Merkel’s facial expression captures quite well the global reaction to the budget blueprint released by the Trump Administration, specifically its drastic cuts in foreign aid.
Trump’s budget plan to make ‘America Great Again’ has proposed sweeping cuts across government departments including a steep reduction of 28 percent or $10.1 billion from Department of State, the U.S. Agency for International Development (USAID). While global health programs like PEPFAR, GAVI and the Global Fund for AIDS, Tuberculosis and Malaria have escaped any cuts, the National Institutes of Health’s Fogarty International Centre which is its only program devoted to global health research and training for curbing the spread of infectious diseases, is listed for shutdown. This document also calls for a cut in funding to multilateral development banks, including the World Bank, by approximately $650 million over three years. This step could seriously jeopardise the World Bank’s capital replenishment for health programs in developing countries, as the U.S is the Bank’s biggest and most influential shareholder.
If actioned, this budget will also radically slash U.S funding to the United Nations (UN) and its affiliated agencies. Currently, the United States contributes around $10 billion or 22 percent of the UN’s total budget each year. Such abrupt cuts could make it extremely difficult for a single country or even a group of nations to make up for the shortfall in funding for the whole range of UN programs, and may lead to a breakdown of this international humanitarian system.
Take the case of one UN agency - United Nations Population Fund (UNFPA), which is the largest provider of reproductive health services to women in the world and currently operates in more than 46 countries. At present, the U.S is one of the major donors to UNFPA’s core budget. It also supports a total of 27 short-term UNFPA projects worth $23 million. In 2016, U.S core contributions to UNFPA prevented an estimated 320,000 unintended pregnancies, 100,000 unsafe abortions and 10,000 maternal deaths or cases of long-term disability. The proposed cuts in U.S foreign aid coupled with the recently re-imposed Global Gag Rule could put the lives of thousands of women and young girls at risk, especially those fleeing from violence and war.
In Syria alone, UNFPA budget cuts could result in the closure of 119 mobile clinics and health centres that have allowed 48,000 women to give birth safely, and offered family planning services to an estimated 58,000 women, and 64 women’s centres and safe spaces for women who have experienced sexual violence. UNFPA projects in Lebanon, Jordan, Turkey, Somalia, Ethiopia, Yemen, Afghanistan and north-east Nigeria may also be forced to shut down. The UNFPA is one among the many international agencies working for women, children and vulnerable populations, that stands to get affected by the withdrawal of foreign aid from the U.S.
While the final budget will need approval from the U.S Congress and may look different from the proposed plan, this blueprint reveals a lot about the Trump Administration’s views on foreign aid and its commitment to global health. It reflects a perspective that foreign aid and international cooperation are dispensable in the grand vision of putting America First. This outlook is dangerous and could stimulate more of such drastic U.S foreign policy measures in the near future that would affect global health and security.
Consequently, within this rapidly changing political landscape where the role of the U.S as the most influential donor for global health will keep shifting, countries will have to work together, not only to fill the funding gaps, but to also lead the way in reforming global health institutions, strengthening national health systems, galvanizing partnerships with non-governmental and civil society stakeholders, and supporting innovative and sustainable health financing mechanisms such as domestic resource mobilization and widening the net of donors.