Top officials from Africa Centres for Disease Control and Prevention (Africa CDC) met with US government officials and members of Congress yesterday to discuss recent cuts to global health funding, the same day officials learned of new US cuts that will affect Gavi, a program that helps provide and distribute vaccines to low- and middle-income countries.
The eroding support of health initiatives in Africa comes as countries in the region continue to battle several outbreaks, including a large mpox event that continues to evolve, with Sierra Leone emerging as a new regional hot spot and exported cases continue to be reported outside of Africa.
US cuts to Gavi intensify shrinking health support for Africa
Yesterday the New York Times reported that the United States has terminated a $2.6 billion grant to Gavi that was slated to run through 2030. The cut to Gavi was contained in a spreadsheet that USAID sent to Congress this week, seen by the New York Times, that detailed the foreign aid projects it plans to continue and the ones facing termination.
Sania Nishtar, MD, PhD, Gavi’s chief executive officer, said on X today that the United States has been one of Gavi’s oldest and strongest partners. “Together we have helped cut child mortality in half, immunised a whole generation of children, helped keep our world safe. In addition to our contribution to global health.” She added that the collaborations have showed the world how to do development well. “Contributing to broader economic growth, societal cohesion and—importantly—helping countries get to a stage when they no longer need our help.”
Gavi said United States support is vital, with the earlier funding poised to save more than 8 million lives over the next 5 years and give millions more a better chance at a healthier more prosperous future.
At a regular Africa CDC weekly briefing today, Ngashi Ngongo, MD, PhD, MPH, who leads Africa CDC's mpox incident management team, said the United States contributions make up 15% of Gavi’s funding. “That’s a lot,” he added. Africa CDC officials are still gathering information to understand how far the decision goes, as meetings between US and Africa CDC representatives continue in Washington, DC, this week.
In meetings with US officials, Ngongo said African officials made the point clear that global health security starts with what happens outside of the United States. He said the US administration shared its perspective, which views health more as a business rather than something that happens on the ground.
Ngashi said the business perspective resonates with African health officials, given efforts already underway in the African region to produce vaccines and other health supplies locally. He also said the group’s plans for health sector digitization also dovetail with greater private sector investment.
He also said the group continues to meet with other nations and outside support groups to make sure the region is “spreading our net wide enough.”
Sierra Leone launches mpox vaccination amid rising cases
In mpox outbreak developments, cases are still trending upward, with Uganda, Burundi, and the Democratic Republic of the Congo (DRC) reporting the most cases over the past week, Ngongo said. He added the Central Africa Republic (CAR) reported its first case, after going 6 weeks with no new cases.
In a positive development, the region saw the case-fatality rate drop a bit, from 1.8% to 1.5%, which he said is due to better care-seeking and improved quality of case management.
Cases are accelerating in Sierra Leone, which reported its first cases in January. Ngongo said the country today launched its mpox vaccination campaign, lifting the number of countries in Africa immunizing against the disease to seven. He added that the country has received 58,300 vaccine doses, which will target people in Western Area Urban and Western Area Rural districts, focusing on healthcare workers, contacts, sex workers, and other frontline workers.
In a weekly health emergencies update, the World Health Organization (WHO) African regional office said Sierra Leone’s rapid rise in cases is concerning, due to the concentration of cases in Freetown, the country’s capital, with most cases among young adults, students, and business people. It said high mobility, social interactions, and closed environments such as schools are driving the spread of the virus, which has been identified as the global clade 2 strain.
Africa CDC said 113 cases have been confirmed so far, 2 of them fatal, with underlying health conditions reported in both people who died from their infections.
Africa CDC launches second phase of response plan
In other developments, Ngongo detailed the plan for the next phase of the region’s outbreak response, which will cover the next 6 months. He said the goal is to halve the mpox burden in endemic areas and strengthen the health systems in affected and at-risk countries.
Part of the plan included enhanced contact tracing, with a goal of identifying at least 20 primary contacts for each patient and 200 secondary contacts.
A vigorous vaccine push is also part of the strategy, with a goal of immunizing 6.4 million more people over the next 6 months, he said, adding that the region needs $224 million in new support for the next phase of the response.
