‘Utterly devastating': Global health groups left reeling as European countries slash foreign aid
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Some of Europe's biggest global health funders are slashing their aid budgets, which health groups fear could spell catastrophe for countries reliant on foreign cash to combat malaria, HIV, tuberculosis, andemerging threats.
Global health groups still don't know exactly which programmes are on the chopping block. But they say the recent European cuts are painful given the US has taken an axe to its own foreign assistance in the six weeks since President Donald Trump took office.
In the United Kingdom, for example, Prime Minister Sir Keir Starmer said last week that he would shave the foreign aid budget from 0.5 percent of gross national income (GNI) to 0.3 percent in 2027 in order to prop up defence spending, prompting the international development minister to quit in protest.
Meanwhile the Dutch government laid out plans to cut aid by 2029 as it prioritises the 'interests of the Netherlands'.
Belgium has also trimmed development cooperation funding by 25 per cent.
France slashed its aid budget by 35 per cent and will launch a review of its existing programmes. And Switzerland will shut down development initiatives in Albania, Bangladesh, and Zambia by late 2028.
The cuts mean global health programmes – which received around 10 per cent of all foreign aid in 2023 – are competing for a shrinking pot of money as Europeans turn their attention to defence and other domestic priorities.
'The door is just closing on aid everywhere we look,' Dr Michael Adekunle Charles, chief executive of RBM Partnership to End Malaria, a major anti-malaria initiative, told Euronews Health.
The US supplied about half of the group's budget before those grants were terminated, Charles said.
A recent UK grant for £5 million (€6 million) to tackle the mosquito-borne disease in Cameroon, Nigeria, Tanzania, and Uganda does not appear to be at risk, he said, but he doesn't expect additional funding from the UK – and other European countries are not stepping up to fill the gap.
That's already forcing difficult decisions about whether to spend money on insecticide-treated bed nets, which help prevent mosquito bites and infections, or case management for malaria patients, who can die if they miss even a day of treatment.
'Many lives are at stake,' Charles said, describing the situation as 'quite dire' in African countries where malaria is endemic.
'Snowball effect' of US and European cuts
In 2022, the US was the biggest global health donor (€15.1 billion), followed by Germany (€4.2 billion), Japan (€3.1 billion), the UK (€2 billion), and France (€1.9 billion), according to a tracker run by SEEK Development.
The recent European cuts are not exactly the same as those from the US, which were swift and brutal, eliminating tens of billions of dollars for HIV treatment, polio vaccination efforts, health worker employment, and more in lower-income countries.
European governments are giving more time to wind down their projects, and several have said they will not renege on existing contracts. Meanwhile cuts from countries like Germany and Sweden were already in motion.
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Chart shows global health spending by country.
Even so, the new cuts are causing concern among global health experts in Belgium, the UK, and the Netherlands, who had hoped Europeans would step up amid the US retreat – and have been left disappointed.
'Something we've never seen, I think in the history of international cooperation, is such a massive cut, not from one donor, but from multiple,' Jean Van Wetter, head of the Belgian development agency Enabel, told Euronews Health.
'You have a kind of snowball effect, which is very negative'.
The Netherlands, for example, usually earmarks a large share of its development aid for sexual and reproductive health issues, and when Trump slashed these programmes in his first term, the country led a fundraising effort to fill some of that gap.
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But while sexual and reproductive health remains a priority under the new development policy plan, health groups shouldn't expect a repeat performance, according to Paul van den Berg, a political advisor at the Dutch non-profit Cordaid.
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'It's a bit lower on the priority list, but it's still there,' van den Berg told Euronews Health, though another fundraising campaign 'will definitely not happen'.
What European health aid cuts could mean
The UK is trimming its aid budget by the same margin as it did in 2021, offering some clues on where the recent cuts could fall.
According to an analysis by the UK-based umbrella group Action for Global Health, money was eliminated to train health workers in countries like Nepal and Myanmar, ambulances transporting patients to hospitals in Sierra Leone ran out of fuel, and bilateral projects for clean water and sanitation lost 80 per cent of their funding.
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'It was incredibly challenging for those programmes and those essential health services to continue when essentially, the plug was pulled on them,' Katie Husselby, the group's director, told Euronews Health.
She described the latest round of cuts as 'utterly devastating' and a 'double whammy' given the US funding freezes.
The UK has already committed funding to multilateral groups like the Global Fund to Fight AIDS, Tuberculosis, and Malaria, as well as climate change-related initiatives.
These pledges leave little, if anything, left over for direct health partnerships between the UK and other countries, according to an analysis from the Center for Global Development.
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Ultimately, the cuts from the US and Europe could reshape the global aid system, according to Jesper Sundewall, an associate professor of global health systems at Lund University in Sweden.
He said that while the abrupt US exit has been 'irresponsible' and 'immoral,' developing countries should take a bigger role in funding their health services directly, and that global health collaborations could be approached differently to appeal to shifting political priorities.
'The view on aid is getting outdated,' Sundewall told Euronews Health.
As development budgets shrink, he said, global health programmes could be spread across the government.
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Van Wetter from Belgium, however, warned that the magnitude of the recent cuts could cripple global health initiatives in ways that will be challenging to recover from.
'When you work on a long-term health system strengthening programme, it takes time to build, to get results… so if you stop and then decide to reinvest later, it's difficult,' Van Wetter said.
In the meantime, he added, 'we are worried that the system can collapse'.
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