GENEVA/JOHANNESBURG: Urgent action is required to address a growing global crisis in financing vital health systems, as countries grapple with towering debt and plummeting aid, the World Health Organisation said on Monday.

The UN agency launched guidance for countries on how to counter the immediate and long-term effects of the sudden and severe cuts to external funding, which have dramatically disrupted essential health services in many places.

“The world is now facing a global health financing emergency that demands urgent, coordinated action,” WHO chief Tedros Adhanom Ghebreyesus told a meeting of African Union member states in Geneva.

Under President Donald Trump, the United States — traditionally the world’s top donor — has heavily slashed foreign aid, causing havoc across the globe, while other major international aid donors have been tightening their belts.

New UN report tackles ‘inequality-pandemic cycle’

This has taken a dire toll in poorer countries in Africa and beyond, which have relied heavily on foreign assistance to cover basic healthcare needs. The WHO said that in 2025, external health aid was projected to be down by more than 30 per cent compared to 2023. Data from March showed immediate disruptions in health services in around 70pc of low- and middle-income countries.

‘Critical shortage’

“These sudden cuts are already causing widespread disruption to health systems and services. One third of countries now report critical shortages of essential medicines and health programmes,” Tedros said.

He stressed, though, that even before the sudden cuts, “health financing was off track”, with debt soaring during the Covid-19 pandemic, worsening longstanding public underfunding of the sector.

The current crisis, he said, thereby presents “an opportunity to leave behind the era of aid dependency and embrace a new era of sovereignty, self-reliance and solidarity”.

Peter Sands, head of the Global Fund to fight AIDS, Tuberculosis and Malaria, agreed and said it was now “all the more important that African states accelerate their progress towards self-reliance”.

High inequality

“High levels of inequality, within and between countries, are making the world more vulnerable to pandemics, making pandemics more economically disruptive and deadly, and making them last longer,” a report by the UNAIDS-convened Global Council on Inequality, AIDS and Pandemics and published ahead of meetings of G20 leaders in South Africa this month said.

“Pandemics in turn increase inequality, driving the cyclical, self-reinforcing relationship,” it said.

The council that produced the report was led by experts, including Nobel laureate economist Joseph Stiglitz, former Namibia First Lady Monica Geingos, and renowned epidemiologist Sir Michael Marmot.

“Failure to tackle key inequalities and social determinants since Covid-19 has left the world extremely vulnerable to, and unprepared for, the next pandemic,” it said.

The Covid-19 pandemic “pushed 165 million people into poverty while the world’s richest people increased their wealth by more than a quarter”, they said.

Breaking the cycle

Inequality “is a political choice, and a dangerous one that threatens everyone’s health”, Geingos said in a press release. The report called on world leaders to increase pandemic preparedness by investing in “social protection mechanisms” within their countries while also tackling global inequality, including through debt restructuring for developing countries.

“Pandemics are not only health crises; they are economic crises that can deepen inequality if leaders make the wrong policy choices,” Stiglitz said.

“When efforts to stabilise pandemic-hit economies are paid for through high-interest on debts and through austerity measures, they starve health, education and social protection systems,” he said.

This made societies less resilient and more vulnerable to disease outbreaks.

“Breaking this cycle requires enabling all countries to have the fiscal space to invest in health security,” Stiglitz said.

Published in Dawn, November 4th, 2025