Health Limited

We write in the midst of an existential crisis. Both for Health Poverty Action and hundreds of thousands of people around the world. As a result of the 90% cut in USAID contracts announced in January 2025 – followed swiftly by cuts from the UK, France, Germany, the Netherlands, and Switzerland – vaccination programmes have halted, vital food aid ceased, and over the course of a few months tens of thousands of people died.1 Some of the world’s poorest economies have been plunged into catastrophe with currency devaluations and plummeting GDP,2 causing budget deficits, layoffs of health workers and increased borrowing and debt. Even the UN has been affected, most particularly The World Health Organisation (WHO), cutting budgets and being forced to restructure. The scale of the cuts and impact mean that 2025 may mark not only the end of the so-called ‘aid’ system, but of norms that defined the post-World War era. The impact on our own work has been drastic. With budget cuts forcing us to shrink programmes, halt work, and cut staff, increasing pressure on those remaining. In the midst of this we have responded flexibly, adapted operations, done even more with less and attempted to fill the gaps as government services collapse. Whilst being forced to scale back in some areas, we have seized new opportunities that arise. Specifically, in Zimbabwe, where we embarked on a new partnership with the TRURO Trust to conduct research to understand how migration, gendered violence, and mental health intersect in order to produce actionable, locally relevant responses to the intertwined challenges of violence and mental distress. Our own hope is for the possibility that a more equitable system can emerge from the demise of the current one. A more honest and just alternative that recognises that the wealth of the Minority World is built on their exploitation and impoverishment of the Majority World. One that takes steps to halt exploitation and demand the redistribution of global wealth to those most impacted. This could include looking for other ways to fund global redistributive finance. Among the options that require immediate exploration are legalising, regulating and taxing the illicit drugs trade, and taxes on wealth. Cancelling debts, many offered under unjust conditions, is also an essential and urgent component. Health Poverty Action will be part of these debates, advocating for a fairer alternative and a fairer world. With thanks as always to all our hard-working staff and volunteers, and of course to you, our supporters and collaborators for your unwavering commitment in these difficult times.