As countries mark World Health Day today, fresh concerns have been raised about the sustainability and funding of the World Health Organisation’s (WHO) global health interventions.
Of particular concern is the estimated $1.9 billion shortfall in the 2026-27 budget of the global health body since the United States’ withdrawal in January 2026, ending its 78-year financial support of the body.
The withdrawal followed an executive order signed in January 2025 by President Donald Trump that initiated the legally required one-year exit process. U.S. contributions have ranged from $163 million to $816 million yearly over the last decade.
Following the withdrawal, which created a significant funding gap of nearly 18 per cent, countries like Switzerland, Sweden, and Qatar, along with private entities such as the Novo Nordisk Foundation, have contributed additional funds, though they have not fully bridged the shortfall.
Notably, China has become the world’s largest funder of the WHO, having upscaled its contribution from $39 million to a $500 million pledge in 2025.
In responding to the U.S. exit, the WHO has been forced to restructure, cutting its executive management team and reducing departments from 76 to 34 to manage the loss of nearly 18 per cent of its funding. It also shrunk its two-year budget for 2026-2027 from $5.3 billion to $4.2 billion.
But even after the dramatic scaling back, it remains $1.9 billion short towards that budget, according to Health Policy Watch.
Given that Nigeria is not exempt from the ripple effects of the funding shortfall, stakeholders said that the country needs to recalibrate its health financing model and build a more resilient system capable of withstanding external shocks while ensuring equitable access to care.
Nigeria has historically depended on external funding to sustain major public health programmes, particularly in the fight against HIV, tuberculosis and malaria.
However, recent global funding trends point to increasing pressure on traditional donors, raising concerns about the future of such support.
The federal government recently approved the release of N200 billion to mitigate the impact of the financial squeeze on AIDS, Tuberculosis, and Malaria (ATM) responses.
In an interview with The Guardian, a renowned Virologist and the Chairman of the Board of Biovaccines Nigeria Limited (BVNL), Prof. Olawale Tomori, warned that the withdrawal of the U.S. from the WHO would have catastrophic consequences for an unprepared world, disrupting numerous health programmes worldwide, which depend on the WHO coordination and funding.
Tomori noted that the U.S. is historically the largest donor to the WHO, contributing 22 per cent of its $6.8b budget for 2024-2025, and added that the U.S. gave the WHO nearly $1 billion in fixed and voluntary contributions in 2022-23.
He said: “The consequences are dire; the implications frightening. The entire world, including the U.S. itself, will feel the impact of this withdrawal from the WHO. First, let us remember that this is not sudden. In 2016, during his first term, he withdrew the U.S. from participation in WHO activities, and Biden reversed the situation in 2020. When he was re-elected, it was a surprise that the world (and WHO in particular) was not better prepared for Trump’s return.”
The Virologist added that the first thing we need to do to escape from our “shameless dependency on foreign aid, is to truly know what we are, who we are, and how endowed we are.
“The world describes us as resource-limited, resource-constrained, and without thinking, we accept such name-calling. We are not resource-limited or resource-handicapped. We are resource-wasteful and resource-squandering.
“We are not resource-constrained; we are corruption-constrained. Until we know who and what we are, we will never find the solution to our problems.
“On the issue of disease prevention and control, our acceptance of the tag ‘resource-limited’ drives us to beg for assistance even in areas of our highest capability, capacity, and competence and where we have highly trained human resources.”
Also speaking, the Executive Secretary of the Country Coordinating Mechanism (CCM) of the Global Fund, Tajudeen Ibrahim, told The Guardian that considering the role of WHO as a global health policy regulator and in detecting, monitoring and responding to evolving health threats, epidemics, the consequences of the U.S. withdrawal from WHO are huge.
He added that the withdrawal would be incredibly costly for both the American people and the global community. “This is not just in the pure economic terms of the U.S. contributions to WHO; the regulatory roles will be negatively impacted. The already-established reputation in global diplomacy will be affected.
“Director General Dr Tedros Adhanom Ghebreyesus, at the February 2025 Executive Board meeting, announced the cut to the global health agency’s 2026-27 budget to $4.2 billion, but funds still fall dramatically short. The budget crisis is bigger than previously thought. The deficit faced by the global health organisation is around $1.9 billion to deliver on its roles. The 2025 budget alone has a deficit of about $600 million.
The ability of those who support humanitarian services and other important activities that support health security would be largely affected. The possible impact includes providing technical assistance to governments and partners around the world to help them respond to health challenges. The U.S. plays a very important role in providing this technical assistance.”
On his part, a Public health expert at Eko University of Medicine and Medical Sciences, Godswill Iboma, also said that the decline in donor support has had direct consequences on healthcare delivery in affected countries, including Nigeria, particularly in the fight against neglected tropical diseases.
Iboma explained that many of these diseases are treated not only with medication but also require sustained investment in social infrastructure, such as water, sanitation, and hygiene (WASH) systems.
With reduced funding for such interventions, he said, efforts to control diseases like schistosomiasis have been weakened, leading to a resurgence in some communities.
Drawing on field observations from his research in parts of Abuja, Iboma said schistosomiasis prevalence rates vary with the availability of basic sanitation infrastructure.
He noted that communities with access to clean water and proper sanitation recorded little to no cases, while areas lacking such facilities experienced higher infection rates. He added that earlier successes in controlling such diseases, partly supported by donor-funded donations, are now being threatened by the decline in sustained external assistance.
According to him, the situation underscores the importance of maintaining not just treatment programmes but also preventive measures that address environmental and behavioural factors.
He stressed that without consistent funding for both medical interventions and infrastructure, gains in reducing disease prevalence could be reversed over time.
Iboma also cautioned that the current funding gap has limited health systems’ ability to reach vulnerable populations effectively.
To address these challenges, Iboma advocated for a shift towards greater domestic responsibility and self-reliance. He urged the country to adopt inward-looking strategies by prioritising local funding and reducing overdependence on foreign aid.
He argued that governments must strengthen their capacity to provide essential healthcare services, invest in infrastructure, and support local production of basic medical supplies such as needles, syringes, and other consumables.
He maintained that combining domestic resource mobilisation with strategic partnerships involving the private sector and diaspora communities would position countries like Nigeria to better withstand fluctuations in external donor support while strengthening long-term health system resilience.
