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Think Global Health

Defunding Gavi and China's Health Influence

April 4, 2025

 

Editors' Note

Myanmar continues to pick through the rubble after a pair of earthquakes struck a week ago, killing more than 3,000 people as of Thursday. The disaster arrived the same day the White House informed Congress of its intentions to eliminate any remaining staff not mandated by law from the U.S. Agency for International Development (USAID). Onlookers noted how USAID's dismantling allowed China to dominate relief efforts in Myanmar.  

Updates from the tragedy, plus the burgeoning trade war, quickly eclipsed another pivotal development in global health: the U.S. decision to pull funding from Gavi, a global initiative that has vaccinated more than 1 billion children since its launch in 2000. CFR Global Health Senior Fellow Prashant Yadav and Research Associate Chloe Searchinger detail how the funding cut could leave Gavi with three options to downsize its operations—and invite China to grow its strategic influence in low- or middle-income countries. 

Next, Michelle D. Gavin, CFR's senior fellow for Africa policy, probes why many African politicians have remained quiet on the U.S. realignment of foreign aid, stating, "No one wishes to turn the eye of Sauron their way." 

Pivoting to U.S. domestic policy, Columbia University Population and Family Health Professor Thoai D. Ngo delves into the Make America Healthy Again (MAHA) Commission and its mission to remedy the nation's high levels of chronic disease. To accomplish that, Ngo urges policymakers to address the root causes of income inequality. 

This week's edition culminates with dating apps—namely an examination led by global health practitioner Tegan Mosugu of how the digital platforms could unlock at-home HIV testing for underserved populations.  

If you want to stay on top of the latest trends in global health, Think Global Health is now on BlueSky! 

Until next week!—Nsikan Akpan, Managing Editor 

 

This Week's Highlights

GOVERNANCE

Image

Africa's Quiet Response to U.S. Realignment of Foreign Aid 

by Michelle D. Gavin

Characterizing the end of U.S. aid as a catalyst allows African politicians to emphasize their readiness for a new era 

Read this story

 

POVERTY

Image

How the MAHA Commission Can Improve U.S. Life Expectancy 

by Thoai D. Ngo 

To help Americans live healthier, policymakers should address what researchers call the causes of causes for ill health

Read this story

 

Figure of the Week

Of the 54 countries eligible for Gavi's vaccine cofinancing, 11 qualify for the accelerated transition phase—a five-year period where the country boosts its vaccine spending until it is fully self-financed.

Those countries face the biggest fallout from the U.S. decision to stop funding for Gavi, and they are already within the strategic focus of China's broader foreign influence strategy. Since 2000, China has provided more than $89 billion in cumulative development assistance to those nations—all of which are members of the Belt and Road Initiative. 

A line chart showing large life expectancy disparities between different groups in the U.S. with steep declines during the pandemic.
 

Recommended Feature

GENDER

Image

How Dating Apps Could Unlock At-Home HIV Testing

by Tegan Mosugu, Jen Hecht, and Steph Niaupari  

A consortium is working with dating apps to support HIV and sexually transmitted infection prevention online and at home  

Read this story

 

What We're Reading

UN Urges Aid to Myanmar Quake Survivors Before Monsoons Hit (Reuters) 

Latest Wastewater Data From 128 European Cities: More Stimulants but Less Cannabis Found (European Union Drug Agency) 

  

Trump Signs Orders Imposing 10% Minimum Tariff, Broader Reciprocal Tariffs—but Exemptions for Pharma (Fierce Healthcare) 

Dozens of Free Measles Vaccine Clinics Close in Texas as Federal Funding is Cut (NBC News) 

This Is Why My Texas Town Lost Trust in Public Health (New York Times) 
 
The USAID List of Terminated Global Health Awards—What Does it Tell Us? (KFF)

"This Is About Children's Lives": Gavi's CEO Makes the Case for Funding the Global Vaccine Alliance (TIME)

 

 

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