The War on Global Health | Diagnosing the Impact of Aid Cuts with Lisa Hilmi

DevelopmentAid Dialogues

As foreign aid cuts ripple across donor nations, global health systems are beginning to fracture. In the 25th episode of the DevelopmentAid Dialogues podcast, host Hisham Allam sat down with Lisa M. Hilmi, Executive Director of CORE Group, to discuss the very real and immediate consequences of this funding vacuum. Hilmi, a seasoned public health leader, has spent decades working across Africa, South Asia, and beyond, shaping frontline programs in partnership with governments and grassroots networks.

Hilmi swiftly refuted the notion that recent aid reductions have had no human cost. “Children have tragically died from malnutrition due to the closure of feeding centers,” she said, adding that community health workers, many of whom are women and primary caregivers, are facing desperate circumstances: “Some are unable to afford school fees for their children or access life-saving medications for themselves. Several have even lost their lives to suicide after losing their jobs.”

She said that the cuts were not just one-time budget decisions, but a planned breakdown of important infrastructure. "We're not getting the leadership or money we need from donor governments." The cuts came quickly and without warning; this was a planned attack on global health and humanitarian aid. “I think right now we're seeing a targeted war upon global health in the way that these cuts were implemented.”, added Hilmi.

The ripple effects, she warned, are already apparent. “Polio eradication efforts have been suspended in some areas due to halted surveillance and vaccination campaigns,” Hilmi said. On malaria, she noted, “We’ve had reports from health workers and governments about shortages of diagnostic kits, insecticide-treated nets, and reduced educational outreach.”

Hilmi pointed out that while the United States led the wave of withdrawals, others followed closely. “It’s not just the U.S.—the UK, France, and Germany have also reduced their commitments,” she said. While countries like Canada and Saudi Arabia have stepped up, she emphasized that these efforts are not yet sufficient to compensate for the scale of the cuts.

On zoonotic diseases, the consequences are deeply concerning. “In the Horn of Africa alone, we anticipate a 20% to 25%-rise in anthrax cases among animals and humans, with up to 400 human deaths annually. Rabies infections could rise by as much as 40%, potentially causing around 2,000 additional deaths,” she said.

When asked whether institutions like the World Health Organization (WHO) could provide support in the face of donor retrenchment, Hilmi was direct: “The WHO itself is struggling. They're laying off staff and scaling back programs. The very institutions that countries might rely on in a crisis are being gutted.”

Despite the bleak assessment, Hilmi concluded with cautious optimism. “There are committed individuals and resilient communities ready to act. I believe we will find new ways forward—through solidarity, innovation, and accountability.”

For the full conversation with Lisa M. Hilmi, listen to the latest episode of DevelopmentAid Dialogues podcast. Follow us for more grounded, urgent conversations on the future of development cooperation.

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