The new document on Health cooperation after USAID's reduction

The Trump Administration's decision to drastically reduce USAID funding for development assistance raises dramatic concerns for health and welfare in the most vulnerable countries. Estimates suggest that USAID's reduction for the next fiscal year could reach 10 billion, with potential further cuts of 30-40 billion over the next three to five years. Entire essential health care programs are thus at risk, where there are already devastating effects. Studies predict a dramatic increase in mortality in the years ahead, with millions of deaths related to diseases such as AIDS and tuberculosis, as well as a significant increase in child malnutrition. For instance, current estimates indicate that the total cancellation of US financial support would result in 25 million avoidable deaths between 2025-2040. USA provide 15% of the budget of the Global Alliance for Vaccines and Immunizations (GAVI) and its cancellation would result in 75 millions of children missing essential vaccines and over 1 million deaths. The cancellation of US programs highlights the need for active intervention by Europe and Italy to support the poorest countries. Italy is the world's eighth largest donor, with $5.5 billion in 2023, but its share of GNI (Gross National Income) devoted to Official Development Assistance (ODA) is only 0.27 percent, lower than those of countries such as Germany and France. Compared to its total ODA, the component dedicated to health care is estimated to be 7 percent. The Mattei Plan for Africa can strengthen the Italian commitment, but it has limited initial resources and no strong priority for the health sector. A rapid turnaround by Europe and Italy is essential to fill the gap left by the United States and enhance their role as global donors, particularly in the health sector. No less important in this general perspective is, in addition to addressing the current emergency, to conduct a long-term effort of capacity building and the promotion of ownership by recipients, enabling low-income countries to assume leadership over their health systems with the general vision of making low-income communities less dependent on international aid.