Since 2000, Gavi, the Vaccine Alliance, has helped lower-income countries buy and deliver vaccines against diseases such as measles, pneumonia, rotavirus and HPV. The organization says it has helped vaccinate more than half the world's children, and in 2024 alone, Gavi-supported programs saved at least 1.7 million lives, its highest annual total on record [1]. Now, facing a funding shortfall driven in large part by the loss of U.S. support, Gavi is making cuts that its own leaders say will cost lives.
The funding gap
Gavi raises money in five-year cycles. For 2026 through 2030, it set a target of $11.9 billion. At a pledging summit in June 2025, it fell billions of dollars short [2]. The Trump administration reaffirmed its decision to end future U.S. funding for Gavi, and Health and Human Services Secretary Robert F. Kennedy Jr. cited vaccine safety concerns, a claim made without supporting evidence, according to Agence France-Presse [2][3]. The United States pulled support worth about $1.58 billion [3].
Historically, four donors, the United Kingdom, the United States, Norway and the Gates
Foundation, provided 65% of Gavi's funding [2]. Other donors also gave less: the United Kingdom's pledge fell nearly 25%, from £1.6 billion to £1.25 billion [2]. By late 2025, Gavi had raised about $9.5 billion and said it was confident of reaching $10 billion [1]. As of April 2026, Gavi CEO Sania Nishtar said the alliance remained about $1.9 billion short of its original target [3].
"Gavi Leap": a smaller, restructured alliance
In December 2025, Gavi's board approved a pared-down strategy called the "Gavi Leap," with a budget of about $10 billion over five years [1]. Its key changes include [1]: • Cutting Gavi's staff by about one-third, from 643 to 440 people across its offices in Geneva, Washington and New York.
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Reducing support to its main partners, the World Health Organization and UNICEF, by roughly 30% for 2026-2030.
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Sending about 90% of the vaccine budget directly to countries through "country vaccine budgets," giving governments more control over priorities.
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Focusing on the lowest-income countries with the highest child death rates, with over a third of country funding aimed at the 25% most vulnerable children.
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Increasing support for fragile and humanitarian settings by 15%, while cutting support for lower-middle-income countries. Gavi says the new approach is designed to protect the children at greatest risk even with less money. Core childhood vaccines, including polio, pneumococcal, measles-rubella, HPV, rotavirus and yellow fever vaccines, are to be maintained, but new vaccines and campaigns will be added more slowly [1]. "Through the Gavi Leap, we are putting in place an ambitious programme of reforms that will enable countries to have increased agency and ownership," Nishtar said [1].
The malaria vaccine takes the biggest hit
The deepest cuts have fallen on Gavi's malaria program. Malaria kills about 600,000 people a year in Africa, most of them young children. After decades of research, the first malaria vaccines were approved, and Gavi supports their use in 25 African countries [3]. Because of the funding gap, Gavi lowered its goal of reaching 85% vaccine coverage in target countries by 2030 to 70% [3]. Gavi had projected that its malaria vaccine rollout would prevent 180,000 deaths. Nishtar told AFP in April 2026 that the impact of the cuts "will likely be tens of thousands of children's lives lost," calling the situation "hugely disappointing" [3]. A "silver lining"? Nishtar has been careful not to criticize Washington directly, and she has said she hopes the United States will rejoin the alliance [3]. She also pointed to what she called a "silver lining": African governments are investing more in health. African countries provided about $300 million in co-financing in 2025 [3]. Gavi has also tried to support vaccine manufacturing in Africa through a $1 billion subsidy program announced in 2024, though, as of April, no manufacturer had yet drawn on it [3]. Nishtar planned to propose extra upfront financing for African vaccine makers to Gavi's board in July 2026 [3]. Lower vaccine prices could also help stretch the budget. Manufacturers GSK and Bharat Biotech have announced plans to cut the price of their malaria vaccine to below $5 per dose by 2028 [2].
The debate
The U.S. decision reflects broader skepticism within the administration toward multilateral health organizations, along with Kennedy's long-standing criticism of vaccines. Supporters of the decision argue that U.S. taxpayers should not fund organizations they believe lack accountability, and that wealthier recipient countries should pay more of their own costs. Public health experts and many governments counter that Gavi is one of the most cost-effective investments in global health, buying vaccines in bulk at low prices and preventing diseases that can spread across borders. They note that measles, polio and other vaccine-preventable diseases are resurging in several parts of the world, including the United States.
Countries take more control
One of the biggest changes under the Gavi Leap is how money reaches countries. Instead of applying for separate grants for each vaccine, countries will receive a vaccine budget and decide their own priorities beyond core childhood vaccines, based on national strategies [1]. Gavi is also ending rolling applications so that all countries compete for funding on the same terms, and it has kept support for the hepatitis B birth dose [1]. Supporters say this gives governments more ownership. Critics worry that, with less money overall, countries will be forced to choose between vaccines that all save lives.
Why it matters
Vaccines are among the most effective public health tools ever developed, and Gavi is the main channel through which children in the poorest countries receive them. The alliance's choices over the next five years, which vaccines to protect, which countries to prioritize and which programs to slow, will be felt most by families who have little say in them. Whether other donors and recipient governments can fill the gap left by the United States will determine how many of those cuts become permanent.
Sources
- 1. Elaine Ruth Fletcher, "Gavi Cuts Staff and Support to WHO and UNICEF, Gives More Freedom to Countries to Decide Vaccine Priorities," Health Policy Watch, December 5, 2025 (updated December 8, 2025). https:/ /healthpolicy-watch.news/gavi-cuts-staff-and-support-to-who-and-unicef-gives-more-freedom-to-countries-t o-decide-vaccine-priorities/
- 2. Janeen Madan Keller and Rosie Eldridge, "Mind the Gap: Recapping Gavi's Pledging Summit," Center for Global Development, July 3, 2025. https://www.cgdev.org/node/3134929
- 3. "Children's lives at risk from US funding cuts to vaccine alliance: CEO," AFP via Arab News, April 24, 2026. https://www.arabnews.pk/node/2641193 Information in this article is current as of October 10, 2026. Bracketed numbers refer to the sources listed above.