In a recent interview,Dr.Seth Berkley, a professor at Brown University School of Public Health and former CEO of Gavi, the Vaccine Alliance, voiced serious concerns about the global impact of abrupt funding cuts to key international health organizations. Berkley, who co-founded Covax during the COVID-19 pandemic to ensure equitable vaccine access, warns that these cuts will have devastating consequences, particularly for the world’s most vulnerable populations.

Impact on the World Health Institution (WHO)

While acknowledging the need for reforms and increased efficiency within the WHO, Berkley emphasized that defunding the organization is counterproductive, undermining both U.S. interests and global health security. Withdrawal does not serve the interests of the US or those of the world as it will reduce its ability to do critical work. The sudden cessation of funding, he argues, will disrupt essential programs in many countries, leading to:

• Loss of lives due to the shutdown of long-standing programs.
• Spread of infectious diseases.
• Lack of epidemic control.
• Further spread of antimicrobial resistance.

Berkley notes that the abrupt nature of these changes makes it challenging for programs to sustain their activities, especially in the poorest countries. He also points out that broader geopolitical shifts are limiting the ability of other nations to step in and mitigate the effects.

Gavi,the Vaccine Alliance: A Critical Lifeline at Risk

Berkley highlighted Gavi’s critical role in providing vaccine support to roughly half the world’s children in the poorest countries,and vaccinating more than 1.1 billion additional children in the last 25 years. He emphasized Gavi’s effectiveness as a public-private partnership. It has been an incredibly prosperous public-private partnership, driving down the cost of vaccines by more than 90%, introducing more than 700 new vaccines and reducing vaccine preventable disease deaths by 70%. He added that for every dollar invested in Gavi, there is a $54 return when considering broader societal benefits. However, the potential cancellation of a billion-dollar grant poses a significant threat.

According to Berkley,the U.S. currently provides about 13% of Gavi’s funding. If this support were to cease, an estimated 75 million children could go without vaccines, leading to increased deaths, disabilities, and outbreaks. Furthermore, the introduction of new vaccines, such as those for malaria and meningitis, could be jeopardized. Gavi also manages global stockpiles for Ebola, yellow fever, cholera, and meningococcal meningitis, vital resources for rapid epidemic response. The potential impact on global health security is substantial.

The Looming Threat of Polyepidemics

Berkley also addressed the increasing threat of polyepidemics, driven by climate change, human encroachment on wildlife areas, and antimicrobial resistance. Climate change will have a very large impact on epidemic events. He explained that the movement of people due to climate emergencies, changing disease patterns, and the increasing ranges of insect and animal vectors will lead to new infectious diseases, with approximately 70% of new pathogens originating from animal sources. The misuse of antibiotics further exacerbates the risk of antimicrobial resistance during outbreaks. Therefore,increased investment in outbreak identification,mitigation,and medical countermeasures is crucial.

Malaria Vaccine Rollout and Indian Pharma’s Role

Berkley, as an advisor to the Serum Institute of India (SII), praised the malaria vaccine rollout as a potential game-changer.Malaria remains a leading cause of death for young children in Africa, accounting for 94% of malaria deaths globally.The introduction of malaria vaccines, alongside other effective interventions, offers the possibility of dramatically reducing these deaths.He stated that for every 200 children vaccinated in high-incidence communities, one life could be saved. The SII vaccine, being 60% cheaper and producible in large quantities, has the possibility to be a game changer, but only if it is introduced and used. however, adequate funding is essential for its successful implementation.

He also commented on Indian pharma’s efforts towards self-reliance in vaccine production,noting that while India has historically been a major vaccine producer,the sudden halt of exports during the COVID-19 crisis eroded trust in Indian manufacturers. This led many countries to pursue local production, which, while promoting self-sufficiency, may be less cost-effective and reliable. Berkley emphasized the importance of maintaining a focus on quality and ensuring multiple producers of critical vaccines.

The Devastating Impact of Abrupt Program Closures

Berkley further highlighted the detrimental effects of abruptly closing down essential health programs, citing the recent closure of India’s first transgender health clinic and the halting of the U.S.’s PEPFAR project, which provides assistance and care to HIV patients.It is difficult to make option plans when programs are defunded suddenly. In particular, he warned that stopping HIV treatment can quickly lead to drug resistance and a resurgence of immunosuppression.