Flagship Gavi vaccine projects face axe if US funding stops, CEO warns

Yahoo

31-03-2025

Some of Gavi's flagship vaccine programmes will have to be cut if the United States goes through with a plan to stop funding the global partnership, its CEO has warned.
Among the projects under threat are plans to begin building emergency stockpiles of new mpox and tuberculosis vaccines, the distribution of badly needed malaria jabs, as well as a billion dollar programme to boost vaccine production in Africa.
Dr Sania Nishtar, who took over as CEO of the organisation in March last year, said the Gavi board would have to decide 'what gets shelved' in the event American funding dries up.
'If we take a 15 per cent cut, and if this comes on the top of the cuts that the traditional donors may make, we have to go to the drawing board on what gets dropped, what gets scaled down,' she told The Telegraph.
'We've just introduced the malaria vaccine and then, of course, the tuberculosis vaccine is on the anvil,' she said. 'There is already a commitment to maintain a new stockpile for the mpox vaccine. So all these things will be up for debate, as would be the African Vaccine Manufacturing accelerator.'
The Trump administration's decision to end support for Gavi, which helps purchase vaccines for the world's poorest countries and has been credited with saving the lives of 19 million children, was revealed in a spreadsheet sent to Congress last week.
The US has been one of the organisation's biggest donors since it was set up at the turn of the millennium, and Dr Nishtar said she was optimistic that Washington can be persuaded to continue its support.
'I must emphasise that we have not received a termination notice,' she said. 'We think that the situation will be remedied and we will not have to live with this funding shortfall.
'There's a 25-year history of partnership and, for that reason, I'm optimistic that the US will reconsider its decision.'
Compared to some major aid groups and international humanitarian organisations, Gavi operates with minimal overheads, making it particularly vulnerable to sudden changes to its funding.
Gavi says that 97 cents out of every dollar raised for the organisation goes towards its immunisation programmes.
So if the Trump administration does end US support for its operations, the impact will be calamitous, Dr Nishtar said.
As a result of the end of US support, 75 million children will miss out on regular vaccinations, leading to 1.3 million preventable deaths in the next five years, according to Gavi's estimates.
'If the US pulls out … inevitably, there will have to be trade-offs and a scale back of our existing operations, which will be tragic,' she said.
But the end of US funding for Gavi could have ramifications that are felt well beyond its frontline vaccine programmes.
Dr Nishtar said the US decision could create a cascading 'domino effect,' forcing cuts to flagship programmes but also disrupting the research community and global pharmaceutical industry that underpins them.
'If you start reducing the volume of routine vaccines, that impacts price, that impacts the ability of countries to access those vaccines,' she said. 'It's an ecosystem we've built.'
The US had committed to give Gavi $2.6 billion (£2 bn) in a grant that was meant to last until 2030.
Gavi has survived funding shortfalls before, but grappling with such a big cut to its funding at the same time as other major backers in Europe are also cutting back their donations, is an unprecedented challenge.
'This is a very unique situation,' said Dr Nishtar.
Not even the support of countries like India and Indonesia, which were once recipients of Gavi's vaccines but now contribute to its budget, will be enough to offset America's departure.
As a result, for the first time, Gavi will not have the money to be able to buy the latest vaccines and risks falling behind the curve of scientific development, she said.
'This is the first time where we have a funding crunch and science going way ahead of us.'
While some of the impact of the looming US withdrawal will be felt within its borders – Dr Nishtar pointed out that America and Britain both get more back from Gavi through vaccine sales than they put in – it is in Africa where the worst effects will manifest.
After years of steady progress, malaria rates have plateaued, with devastating consequences for those at risk.
'I don't know if you have ever seen a child convulse with malaria,' she said. 'It's a horrific scene for parents to see and to know that this was entirely preventable, to know that a vaccine exists today and is in a programme, with every African head of state screaming for it.'
The US decision to stop funding Gavi has rattled many in the global health sector, even if they could see it coming after President Donald Trump froze almost all foreign aid when he took office.
But despite the gloom surrounding the dramatic scaling back of foreign aid around the world, Dr Nishtar remains optimistic that leaders in Washington and Europe will see sense.
'I remain optimistic because our donors understand the value of Gavi,' she said. 'I remain optimistic that the world's moral compass is still there, and that there will be a turnaround, and that we will come out with a fully funded Gavi.'
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