$1.3bn in US health funds left unspent by Trump ‘could lead to 150,000 preventable deaths’

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More than $1.3 billion (£975 million) in US funding for tuberculosis, malaria, HIV and maternal healthcare could go unspent within two weeks because it has not yet been released by the Trump administration, potentially resulting in tens of thousands of preventable deaths.

An analyses of US global health spending by international health non-profit Partners in Health found that the money, which had been approved by Congress, is being withheld by the Office of Management and Budget.

The funding authority expires on 30 September, at the end of the US federal financial year.

“The result will be deadly consequences for patients, the incapacitation of history’s most successful global health programme, and the fuelling of a flourishing new HIV pandemic,” the organisation said.

The analysis predicts the cost to global health programs will result in an estimated 121,000 deaths from tuberculosis, with $150m of the funding for programmes targeting the disease, 47,600 deaths from malaria and the loss of lifesaving nutrition products for 22.9 million children.

Of the finds at risk, $250m for bilateral malaria programmes, $320m for maternal and child health and $330m for HIV programmes, according to Partners in Health.

The money could be transferred to the State Department or otherwise the period in which it can be used could be extended, said Vincent Lin, an associate director of health policy and advocacy at Partners in Health.

Yet unless the money is actually released to programmes and countries, it would not help people in need.

Last year, hundreds of millions of dollars for nutrition programmes and neglected tropical diseases were held and “it took them a year to even think about how to start programming the funds”, Mr Lim said.

The warning comes as separate analysis by the organisation found that the US has spent $2.3bn less on its flagship HIV programme, the President’s Emergency Plan for AIDS Relief (PEPFAR), than it had at the same point two years ago.

PEPFAR has supported HIV treatment and prevention programmes since 2003 and has saved more than 26 million lives, according to figures cited by Partners in Health.

US government data showed that about two million people were removed from PEPFAR-supported treatment programmes following cuts in 2025, while mother-to-child transmission of HIV was increasing.

“The result will be deadly consequences for patients, the incapacitation of history’s most successful global health program, and the fueling of a flourishing new HIV pandemic,” said.

The warning comes ahead of the first anniversary of the Trump administration’s America First Global Health Strategy, which has reshaped how the US distributes international health aid. The organisation said the reductions were likely to deepen as the strategy is implemented through new agreements with individual countries.

An analysis of 18 bilateral agreements obtained through a Freedom of Information Act lawsuit found planned cuts in US health spending over the next five years in countries including Sierra Leone, Burundi and Malawi, Mr Lin said.

While advocates have long called for reforms to the global health funding system to ensure sustainability and uphold human rights, the America First strategy has made US global health policy more “transactional, exploitative and short-sighted”, advocacy organisation Physicians for Human Rights said to mark the anniversary.

“Data from PHR and other independent groups clearly show that services are weaker than they were a year ago,” said Emily Bass, an expert consultant with PHR.

Dr Alain Casséus, head of infectious diseases at Zanmi Lasante, a Haitian organisation affiliated with Partners in Health, said the consequences of funding cuts would not necessarily arrive as a single dramatic event.

“There will be no major announcement, but there will be signs,” Dr Casséus said.

“Ordering windows will pass quietly, regions will run out before drugs, and diagnosis will lack.”

Patients could lose access to viral-load monitoring and remain on ineffective drug regimens without knowing that their treatment had failed, increasing the risk of drug resistance.

The Independent has contacted the White House for comment.

This article has been produced as part of The Independent’s Rethinking Global Aid project