U.S. exit risks Africa's health cooperation

Africa's health systems could face heightened strain following the United States' full withdrawal from the World Health Organization on Jan 22, with African experts and policymakers warning that the move could weaken disease surveillance, disrupt frontline care in conflict-affected regions, and deepen inequalities in access to essential medicines across the continent.

The U.S. exit is expected to leave a significant funding and coordination gap at a time when many African countries remain vulnerable to infectious disease outbreaks, humanitarian emergencies, and under-resourced primary healthcare systems. Many African countries rely heavily on international organizations such as the WHO for disease prevention and control.

The WHO has expressed its regret over the U.S. announcement, highlighting the organization's crucial role in protecting the health of the world's people, with WHO Director-General Tedros Adhanom Ghebreyesus stating that the withdrawal is a loss for the U.S. and the world.

Melha Rout Biel, executive director of the Institute for Strategic and Policy Studies in South Sudan, described the withdrawal as a retreat from the internationally agreed multilateral order, with potentially fatal consequences for vulnerable populations.

"The U.S. withdrawal is indeed a very unfortunate action geared toward leaving internationally agreed systems and order," Biel said. "Many people in Africa and elsewhere who are badly in need of medicine, including for HIV and other infectious diseases, will face death. Medical staff will lose jobs and will not be able to support their families."

Biel said African institutions now face a "wake-up call" to shoulder greater responsibility, urging Africa and the broader Global South to mobilize resources to sustain the WHO's work.

While the funding gap left by Washington is substantial, he added that coordinated support from developing countries could help mitigate the risks. "The world still needs the WHO," Biel said. "Standing by it is for a good cause."

Carlos Lopes, a professor at the Nelson Mandela School of Public Governance at the University of Cape Town, said the U.S. withdrawal would be far more than a budgetary shock, describing it instead as confirmation of a deeper retreat from multilateralism with destabilizing consequences for Africa.

"In low-income and conflict-affected settings, WHO coordination underpins disease surveillance, outbreak response, vaccination campaigns, and health workforce support," Lopes said. "The sudden loss of U.S. funding and political backing would weaken early-warning systems, slow emergency responses, and exacerbate existing inequalities in access to care."

Lopes cautioned that partners from the Global South cannot simply replace the U.S. role overnight.

"This transition requires predictable long-term funding, stronger governance arrangements, and genuine respect for multilateral rather than purely transactional cooperation," he said, warning that the withdrawal of a major power risks turning global public goods into arenas of geopolitical competition.

Acute impact

In Nigeria, the impact is expected to be particularly acute. Olusoji Ajao, founder of Afrocentric Masterclass, a cultural company that focuses on African voices, said WHO support has been critical in sustaining healthcare delivery in conflict-affected regions where state capacity is limited.

"The WHO was central to sustaining frontline health responders and humanitarian healthcare delivery in some areas of Nigeria where local authorities could not cope. When that support is withdrawn, it is not bureaucracy that collapses — it is care on the frontline," Ajao said.

Ajao said Nigeria's conflict-affected regions are likely to feel the humanitarian consequences first, arguing that global health leadership should be measured by responsibility to the most vulnerable rather than political decisions taken far from crisis zones.

Experts agreed that the U.S. exit may accelerate Africa's push toward greater health sovereignty, including local vaccine manufacturing, regional stockpiles, and improved emergency preparedness.

"Partnerships should teach and equip, not just give," he said.

Ajao said sustainable cooperation should focus on capacity-building, shared responsibility, and local ownership, particularly in resource-rich but institutionally fragile countries.