In a health clinic in Uganda, a doctor recounts that five babies have been born HIV positive among the 20 deliveries at the facility between mid-January and mid-April, a devastating change after years of virtually eliminating mother-to-child transmission of HIV. The head of another Ugandan facility that provides HIV treatment and prevention services described his feeling of helplessness at seeing babies who required treatment for a condition that was likely preventable: “It’s like a mother seeing the children dying of hunger and yet you don’t have anything to feed them,” he said. “You see someone who [is] declining slowly-by-slowly, really. Something should be done.”
This new reality for families in Uganda is a direct result of President Donald Trump’s actions from the early days of his administration to freeze U.S. foreign aid and eliminate crucial global health programs that had been running for decades. Both of these Ugandan health organizations had been able to achieve profound improvements in prevention and treatment of HIV due to support from the President’s Emergency Plan for AIDS Relief (PEPFAR), a flagship U.S. global health initiative recognized to have saved 26 million lives and enabled 7.8 million babies to be born without HIV infection.
The drastic aid reductions came as a total shock. As in Uganda, the suddenness of the cuts left governments, health care professionals, and humanitarians in countries around the world ill-equipped to immediately mobilize new resources or solutions. The cuts have already unleashed catastrophic human consequences. Modelling by a researcher at the Boston University School of Public Health estimates more than 317,704 preventable deaths — 103 deaths per hour — have already occurred from tuberculosis, malaria, HIV and other diseases since the U.S. halt in funding, deaths that would not have occurred had the funding continued. Such evidence indicates the Trump administration’s decisions have put millions of lives in peril.
Following the convening of the World Health Assembly last month in Geneva and looking to the current session of the U.N. Human Rights Council that began June 16, leaders in global health and human rights have a critical opportunity to come together to ensure a coordinated international response to address the large-scale deprivation of human rights triggered in January 2025.
A Health-Funding Crisis is a Human Rights Crisis
While the tallies of the impact of these cuts are crucial, the losses and the risks of more deaths and suffering must also be recognized as part of a profound global regression in the realization of human rights caused by the termination of health programs globally. States are obligated to take action under human rights law to prevent and remedy these violations. The rollback of U.S. funding has upended the mechanisms that enabled aid-recipient States to fulfill the human rights of their people, often impacting the most vulnerable populations across dozens of countries, as health-care delivery systems fracture, with no clear solution in sight.
At Physicians for Human Rights, where I work, we are hearing from medical and humanitarian partners around the globe that the funding freeze has caused deaths, devastated health-care delivery systems, and deprived individuals of access to essential medicines and services that are guaranteed under United Nations treaties governing the rights to life and health, such as the International Covenant on Civil and Political Rights (ICCPR) and the International Covenant on Economic, Social, and Cultural Rights (ICESCR). The ICCPR, which the U.S. and 174 other countries have signed and ratified, recognizes that ensuring the right to life requires providing services to avoid preventable deaths, including pregnancy-related deaths. In jurisprudence, the U.N. Human Rights Committee, which monitors compliance with the ICCPR, has established that the right to life includes being free from acts or omissions that are intended or expected to cause unnatural or premature death. The committee has recognized this includes measures to protect lives of women against the health risks associated with pregnancy, including by providing prenatal care.
But Ethiopian health professionals told PHR about what they have been facing in caring for patients in the conflict-devastated Tigray region since U.S. funding was paused or in some instances terminated in January. PHR’s new brief, “Shuttered Clinics, Preventable Deaths: The Impact of U.S. Global Health Funding Cuts in Ethiopia,” describes thousands of health workers having been laid off, plans to reconstruct three desperately-needed health facilities cancelled, and mobile health centers closed that had served thousands of people who’d been forced from their homes by violence in other parts of the country.
An Ethiopian clinician shared the anguish of a fellow health worker witnessing multiple women dying from pregnancy-related complications that they had been able to prevent before the funding freeze. Another health worker described heartbreaking cases of survivors of conflict-related sexual violence being cut off from crucial medical supplies to support healing, including reproductive health care and mental health services and medications. These cuts are particularly impacting individuals living in camps for internally displaced persons, where mobile health delivery services can no longer provide life-saving care, including maternal health care.
Humanitarian Aid and Political Whims
U.S. cuts to health services also send a damaging global message about the role of humanitarian aid, suggesting that it is simply a foreign policy tool that can be held hostage to political whims, rather than a human rights obligation that States must work together to uphold. Indeed, international human rights law recognizes States’ obligations to ensure the rights of individuals to have access to essential medicines, vaccines, and other health care to avoid preventable loss of life and harms to their health.
For example, the U.N. Committee on Economic, Social and Cultural Rights in General Comment 14 on the right to health specifically called upon States to take steps “individually and through international assistance and co-operation” to fully realize economic, social, and cultural rights, noting that wealthier States should help facilitate access to essential health services in other countries and “provide the necessary aid when required.” The committee notes that this obligation stems from the recognition that “the existing gross inequality in the health status of the people particularly between developed and developing countries, as well as within countries, is politically, socially and economically unacceptable and is, therefore, of common concern to all countries.”
In addition to the ICESCR, treaties such as the Convention on the Rights of the Child and the Convention on the Rights of Persons with Disabilities also establish that States parties must take steps through international cooperation and assistance to achieve the full recognition of those rights.
Despite thousands of lives at stake each day, the international community has yet to step forward by meaningfully ensuring international assistance to address this sudden regression in the rights to life and health, in line with their human rights obligations. The Trump administration’s rollback on aid is not projected to be alleviated soon – the proposed fiscal 2026 discretionary budget that Trump sent to Congress for the year starting Oct. 1 contains a 60 percent reduction from the current appropriated level of global health funding (much of which is among the funding that has been suspended). Rather than increasing aid, other once-generous donor governments such as those in Belgium, France, the Netherlands, Sweden, Switzerland, and the United Kingdom also have dramatically pulled back overseas development aid.
In doing so, these governments often cite the need to allocate resources to military spending in the interests of national safety and security. This response belies the reality that global health funding cuts will endanger us all, regardless of where we live. The world faces an escalating threat of infectious-disease outbreaks due to halted vaccination programs and poor management of drug-resistant infections. Recent estimates published in The Lancet medical journal show that a complete cessation of U.S. funding without replacement by other sources would lead to at least an additional 25.3 million deaths worldwide between 2025 and 2040. These estimates represent deadly and far-reaching risks that borders and militaries will not be able to contain.
Lessons from the COVID Response
The U.S. funding cuts have spurred a massive global health and human rights crisis that requires a global solution. The COVID-19 epidemic provides one critical example of an integrated health and human rights response, where the World Health Organization and the U.N. Office of the High Commissioner for Human Rights came together to outline States’ obligations to ensure health services and other humanitarian aid during the pandemic, promote innovative measures to address resource gaps, and ensure specific measures to prioritize care for vulnerable populations, including those in conflict and those living with infectious diseases such as HIV or tuberculosis.
The COVID-19 pandemic revealed serious gaps in the global health delivery framework that left millions, particularly vulnerable populations, exposed to severe violations of their human rights. States’ responses to COVID led to severe violations of human rights, including through criminalization of movement and failure to adequately respond to the needs of marginalized populations who face intersecting discrimination. U.N. efforts to emphasize a human-rights based approach to pandemic response helped counter some of these trends by promoting non-discriminatory and inclusive response, mobilizing international cooperation, and challenging overly restrictive emergency measures including those that harmed human rights defenders and vulnerable groups.
As U.N. member States convene at the Human Rights Council during this session, a commitment to undertake a similar high-level dialogue on health and human rights must be prioritized. First, the U.N. must lead in articulating that the global health funding cuts are not only a public health crisis but also a human rights crisis. Within weeks of countries shutting down during COVID-19, the U.N. understood the intersecting health- and human rights crises that were occurring as a result, and released a report articulating how human rights can and must guide the COVID-19 response and recovery. While COVID-19 did undoubtedly still lead to serious human rights abuses, the clear recognition of the human rights dimensions provided governments, advocates, and communities important tools to mitigate harm.
Today, too, there is an urgent need to recognize the human rights dimensions of the destruction of the global health infrastructure resulting from the funding cuts. PHR’s partners in Uganda, Ethiopia, and beyond have underscored that it is not yet too late to prevent further violations of rights that result in needless suffering and death. It can be done by restoring individuals’ access to basic health care. Indeed, experts have noted that the end of U.S. dominance in global health financing may also present opportunities for stronger health programming that advances compliance with human rights standards — for example, by freeing countries from adhering to sweeping policies that limited sexual and reproductive health services internationally.
The U.N., through the World Health Organization and the Office of the High Commissioner for Human Rights, has an important role to play in raising awareness of the human rights impacts of the funding cuts, including on the scale and severity of violations occurring and the disproportionate impact on vulnerable populations. These agencies also must create a platform for States to coordinate to ensure sustainable financing of global health to respond to this crisis in line with the human rights obligation to provide “international assistance and co-operation.” Now is the time for coordinated, decisive action from the international community — to save lives today and to secure human rights and dignity for the future.
