“This isn’t fiscal responsibility. It’s a political decision to let preventable diseases spread – to ignore science, lend legitimacy to anti-vaccine extremism, and dismantle the infrastructure that protects us all.”

Public health experts and other critics have condemned the Trump administration’s decision to cut off funding to the global vaccine alliance Gavi, which the organisation estimates could result in the deaths of over a million children.

“Abhorrent. Evil. Indefensible,” Atlantic staff writer Clint Smith said on social media in response to exclusive reporting from The New York Times, which obtained documents including a 281-page spreadsheet that “the skeletal remains” of the United States Agency for International Development sent to Congress on Monday.

The leaked materials detail 898 awards that the Trump administration plans to continue and 5341 it intends to end. A spokesperson for the US State Department, which runs the gutted USAID, confirmed the list is accurate and said that “each award terminated was reviewed individually for alignment with agency and administration priorities”.

The US contributes 13% of Gavi’s budget and the terminated grant was worth US$2.6 billion through 2030, according to the Times. Citing the alliance, the newspaper noted that cutting off US funds “may mean 75 million children do not receive routine vaccinations in the next five years, with more than 1.2 million children dying as a result”.

Responding to the Trump administration’s move in a social media thread, Gavi said US support for the alliance “is vital” and with it, “we can save over eight million lives over the next five years and give millions of children a better chance at a healthy, prosperous future”.

“But investing in Gavi brings other benefits for our world and the American people. Here’s why: By maintaining global stockpiles of vaccines against deadly diseases like Ebola, mpox, and yellow fever, we help keep America safe. These diseases do not respect borders, they can cross continents in hours and cost billions of dollars,” Gavi continued.

The alliance explained that “aside from national security, investing in Gavi means smart economics too. Every dollar we invest in lower income countries generates a return of $54. This helps countries develop and communities thrive, taking away pressure to migrate in search of a better life elsewhere”.

“The countries Gavi supports, too, see the benefit in our model: Every year they pay more towards the cost of their own immunisation program, bringing forward the day when they transition from our support completely,” the group noted. “Our goal is to ultimately put ourselves out of business.”

“For 25 years, the US and Gavi have had the strongest of partnerships,” the alliance concluded. “Without its help, we could not have halved child mortality, saved 18 million lives or helped 19 countries transition from our support (some becoming donors themselves). We hope this partnership can continue.”

Many other opponents of the decision also weighed in on social media. Eric Reinhart, a political anthropologist, social psychiatrist, and psychoanalytic clinician in the US, said, “A sick country insists on a sick world.”

Dr Heather Berlin, an American neuroscientist and clinical psychologist, sarcastically said: “Oh yes, this will surely end well. Good thing the US has an invisible shield around it to protect us from ‘foreign’ diseases.”

Some Times readers also praised the reporting. Dr Jonathan Marro — a paediatric oncologist, bioethicist, health services researcher, and educator in Massachusetts — called the article “excellent but appalling,” while Patrick Gaspard, a distinguished senior fellow at the Centre for American Progress and its action fund, said that it was “crushing to read this important story”.

The newspaper noted that “the memo to Congress presented the plan for foreign assistance as a unilateral decision. However because spending on individual health programs such as HIV or vaccination is congressionally allocated, it is not clear that the administration has legal power to end those programs. This issue is currently being litigated in multiple court challenges”.

Liza Barrie, Public Citizen’s campaign director for global vaccines access, also highlighted that point in a statement. She said that “the Trump administration’s decision to end US funding for Gavi will cost more than a million children’s lives, make America less secure. It abandons 25 years of bipartisan commitment to global immunisation and undermines the very systems that help prevent deadly outbreaks from reaching our own doorsteps”.

“Vaccines are the most cost-effective public health tool ever developed,” Barrie continued. “This isn’t fiscal responsibility. It’s a political decision to let preventable diseases spread – to ignore science, lend legitimacy to anti-vaccine extremism, and dismantle the infrastructure that protects us all. In their shocking incompetence, the Trump administration will do it all without saving more than a rounding error in the budget, if that.

“Congress has authority over foreign assistance funding,” she stressed. “The administration’s attempt to unilaterally walk away from its Gavi commitment raises serious legal questions and should be challenged. Lawmakers must stand up for the rule of law, and for the belief that the value of a child’s life is not determined by geography.”

Republished from Common Dreams, March 16, 2025