In a list of thousands of terminated USAID awards that was sent to Congress this week is a devastating cut suggesting the Trump administration might be planning to end funding to Gavi, the global initiative that helps provide life-saving vaccines for children in the poorest countries in the world. This decision will not only lead to an uptick in disease and deaths but could pose security risks to the United States. Members of Congress who have long championed US support to Gavi should urgently call on the administration to reverse course.
Global immunization efforts over the past 50 years have helped reduce infant deaths by a staggering 40 percent worldwide—and 52 percent in Africa alone. That is many tens of millions of lives saved. Gavi helps increase access to immunization in the lowest income countries by funding and supporting vaccine distribution and infrastructure, which is central to the global effort to increase immunization rates, especially for new and underused vaccines.
Gavi has helped to vaccinate over 1 billion children globally since its creation in 2000. According to one estimate, Gavi-supported vaccine programs saved about 1.5 million lives from 2000 to 2019. In addition to health effects, Gavi’s support in some of the poorest countries in the world also has important knock-on effects on the wider economy. A 2020 study estimates that every $1 invested in Gavi yields $54 in economic returns.
This investment also protects Americans. President Trump himself made the case for backing global immunization efforts through Gavi in 2020, noting that when it came to infectious disease, “there are no borders.” That means underimmunization anywhere can have consequences everywhere. And Gavi’s maintenance of global stockpiles of key vaccines is critical to stopping disease outbreaks before they reach US borders. Gavi’s mission to “increase equitable and sustainable use of vaccines” is more important than ever as the world confronts new outbreaks and seeks to roll out new, effective vaccines that could help turn the tide against deadly diseases like malaria.
This is exactly why Gavi has long enjoyed strong bipartisan support in Congress. Just last year, lawmakers in both chambers introduced resolutions (House; Senate) affirming the US support for Gavi. And it is why the US is Gavi’s third largest contributor. But the award termination is a worrying sign that the administration may be turning away from that commitment.
In early 2020, toward the end of the first Trump term, the administration pledged $1.16 billion to Gavi—a slight bump up from the previous US pledge. In June 2024, the Biden administration pledged at least $1.58 billion to Gavi’s most recent replenishment round covering the next five years.
In recent years, the appropriated sums for Gavi have been at least $290 million. The 2024 pledge should have required the annual budgeted amount for Gavi to increase to around $316 billion in FY2025, but the recent continuing resolution extended funding levels from FY2024. (Note that these figures do not include $4 billion in emergency supplemental funding to Gavi to support COVID vaccine purchases under COVAX in 2021, which has been reported as fully disbursed).
US contributions to Gavi are funded through USAID’s Global Health account, specifically under the “maternal and newborn child health” budget line. The USAID award system doesn’t align with Gavi’s five-year pledging cycle, but the terminated award in the system is for $2.6 billion, running between September 2022 and December 2030. Of that amount, $880 had been obligated by January of this year, and (in a change from two weeks ago), it appears all of that obligated sum has been disbursed, give or take, the amount that should be expected given 2020 pledges and budgeting for FY22 through FY24, but below the level that would be expected given the pledge made last year. Without an urgently revived or recreated award sufficient to ensure over $300 million in annual funding, the US will rapidly enter into arrears on its payments to Gavi.
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The apparent decision to cut future funding comes at a particularly concerning time, as other major donors are also slashing aid budgets. Reports suggest the UK could potentially cut its contribution to Gavi as well. This could turn back years of hard-won progress, with devastating impacts. Back-of-the-envelope estimates suggest that terminating US support for Gavi alongside bilateral funding for global vaccine efforts could result in between 20,000 to 500,000 more people dying from vaccine-preventable infections each year (Gavi’s own estimate is 240,000). And it will put Americans at risk: stymying efforts to stop the global spread of infectious disease outbreaks. The United States and the world will be worse for it.
With thanks to Erin Collinson and Justin Hurley for feedback on an earlier draft.
