• Women wait to have the malaria vaccine R21/Matrix-M administered to their children at the comprehensive Health Centre in Agudama-Epie, in Yenagoa, Nigeria, on Monday, December 9, 2024. (AP)

The Trump administration plans to terminate US financial support for Gavi, the global vaccine alliance that has played a critical role in immunizing children in developing nations, saving millions of lives over the past 25 years, The New York Times reported on Wednesday.

Additionally, the administration intends to significantly reduce funding for malaria eradication efforts, despite the disease being one of the world's leading causes of death.

However, the Trump administration has opted to continue certain key grants, including funding for medications to treat HIV and tuberculosis, as well as food aid for countries affected by civil wars and natural disasters.

These decisions are outlined in a 281-page spreadsheet sent by the US Agency for International Development (USAID) to Congress on Monday night, detailing which foreign aid programs will be continued or terminated, according to the NYT.

The documents provide a sweeping overview of the administration’s significant retreat from a five-decade effort to position the US as a global leader in humanitarian aid and the fight against infectious diseases.

Extent of USAID cuts

A cover letter accompanying the spreadsheet underscores the extent of the cuts, revealing that most of USAID’s funding has been eliminated, leaving only 869 of its more than 6,000 employees still on active duty.

In total, the administration has decided to sustain 898 USAID awards while terminating 5,341, according to the letter. The remaining programs are valued at up to $78 billion, though only $8.3 billion of that consists of unobligated funds—money still available for disbursement. Since this amount covers multi-year awards, it signals a drastic reduction from the $40 billion USAID previously spent annually.

A State Department spokesperson, whose agency now oversees the remnants of USAID, confirmed the accuracy of the termination list. The spokesperson stated that each award was individually reviewed for alignment with agency and administration priorities, and terminations were carried out based on Secretary Rubio’s determination that they were inconsistent with national interests or agency policy goals.

While the administration has presented its foreign aid strategy as a unilateral decision, it remains unclear whether it has the legal authority to terminate congressionally allocated programs, such as those supporting HIV treatment and vaccination efforts. This issue is currently being contested in multiple court cases.

Impact on global health programs

Among the terminated programs is US funding for the United Nations Food and Agriculture Organization, which monitors zoonotic diseases—those that can be transmitted from animals to humans, including avian flu—in 49 countries.

Additionally, several major malaria surveillance and eradication initiatives have been discontinued, despite malaria being one of the deadliest diseases for children worldwide.

Dr. Austin Demby, Sierra Leone’s health minister, expressed deep concern over the decision to end US contributions to Gavi, which provides critical vaccine support to his country.

“This is not just a bureaucratic decision, there are children’s lives at stake, global health security will be at stake,” he warned.

“Supporting Gavi in Sierra Leone is not just a Sierra Leone issue, it’s something the region, the world, benefits from.”

In addition to routine immunization programs, Sierra Leone is currently battling an mpox outbreak, for which Gavi has provided both vaccines and logistical support.

“We hope the U.S. government will continue to be the global leader it always been — putting money in Gavi is not an expenditure, it’s an investment,” Demby said.

Since its establishment 25 years ago, Gavi has been credited with saving an estimated 19 million children’s lives. The United States has historically contributed 13% of its budget.

The now-canceled US grant to Gavi was valued at $2.6 billion through 2030 and was based on a funding pledge made by former President Joe Biden last year.

Read more: 'Brutal funding cuts' for aid threaten millions of lives: UN

Threat to new vaccines and immunization programs

New vaccines with the potential to save millions of lives, including one for severe malaria in children and another to protect teenage girls from cervical cancer, have recently become available and Gavi had planned to expand its support to make these vaccines accessible to low-income countries.

However, the loss of US funding will not only hinder the organization’s ability to expand but could also undermine its core immunization efforts for diseases such as measles and polio in the world’s poorest regions.

According to Gavi’s own projections, without US support, 75 million children could miss routine vaccinations over the next five years, potentially resulting in over 1.2 million deaths.

The United States has been among Gavi’s top donors since its inception and became its largest contributor during the COVID-19 pandemic. While European nations have traditionally provided substantial funding, many are now scaling back foreign aid in response to shifting US policies on Ukraine and increased pressure to boost defense spending. Meanwhile, Japan, another key Gavi donor, is grappling with currency depreciation.

Gavi CEO Dr. Sania Nishtar expressed hope that the Trump administration would reconsider its decision. The work Gavi does keeps people everywhere—including Americans—safe, she said.

In addition to protecting individual children, vaccinations help prevent large-scale outbreaks. The organization also maintains emergency vaccine stockpiles for diseases such as Ebola and cholera, deploying them in rapid response efforts.

Gavi operates on a co-financing model, requiring recipient countries to contribute to vaccine costs, with their share increasing as their economies grow.

The memo further reveals that as of last Friday, only 869 USAID employees remained active, while 3,848 were on administrative leave and 1,602 were in the process of being laid off. Of 300 probationary employees who had been initially dismissed, 270 have since been reinstated following a court order blocking their termination.

Read more: Funding cuts drying up aid for malnourished children, UN says