Presented by Munich Security Conference
On the one hand, U.S. President Donald Trump has clearly signaled he intends to keep money flowing for global health — including for HIV/AIDS. On the other hand, the abrupt way the U.S. slashed funds last year, and the constraints it’s put on HIV treatments since, have cost people dearly.
Also in today’s edition: The Trump administration makes no bones about the fact that it doesn’t intend to pay a dime of what it owes to the World Health Organization.
+ Join us on Jan. 28 for a Devex Career Briefing that will unpack how the recruitment landscape across Africa is evolving in 2026 and what that means for your career. Save your spot now.
As the signing of health compacts with African nations shows, the Trump administration hasn’t turned its back on global health. But for many in Africa, they already feel abandoned — and fear the worst is yet to come.
When news of the U.S. aid cuts shook the world last year, local Ugandan radio stations blared warnings that HIV services would shut down for 90 days. Juma Bwanika, who had maintained a strict pill regimen for 13 years to suppress his HIV infection, began rationing his pills.
But Uganda was able to maintain basic HIV services. The U.S. cuts did, however, sever the community outreach that would’ve informed Bwanika that those services were still available. By the time he learned that, the damage was done: Tests show the virus has rebounded.
“Ever since this order from Trump, I am seeing death near me,” he tells Devex contributing reporter Andrew Green.
Andrew chronicled stories like Bwanika’s that illustrate the insidious — but difficult to measure — ways that the cuts have stripped away HIV gains in Africa.
Many countries, in fact, still do not know the full impact because the cuts also terminated critical data collection. “We’re actually not going to have a good grasp of the real impact for many years to come,” says Leora Pillay of Frontline AIDS.
There’s hope national governments can step up — something David Kamkwamba of the Network of Journalists Living with HIV in Malawi says that should have happened a long time ago. “What Trump did was just to bring home that message to say we need to start living within our means,” he says.
Still, Kamkwamba disdains the sudden nature of the cuts, which some say has eroded trust regardless of what happens next.
Kenneth Mwehonge of Uganda’s Coalition for Health Promotion and Social Development says people now wonder why they should bother using services that could disappear overnight. As people lose faith in the system, he says, “they will definitely stay on the ground and die.”
Read: One year after US aid freeze, HIV care in Africa is in retreat
+ This story is part of The Aid Report, a Gates Foundation-funded, editorially independent initiative to track and document the on-the-ground impacts of the U.S. aid cuts. You can also go to https://www.theaidreport.us for more information.
The United States is expanding a policy that will lead to tighter health restrictions. Vice President JD Vance announced Friday a “historic expansion” of the Mexico City Policy, which blocks U.S. federal funding to international nongovernmental organizations that either provide abortions or information about them, even if other donors fund those specific services.
“We’re going to start blocking every international NGO that performs or promotes abortion abroad from receiving $1 of U.S. money,” he said. U.S. law already prevents any U.S. funding from supporting abortion care.
Vance also said the administration would place restrictions related to gender ideology and diversity, equity, and inclusion on foreign assistance spending, which reproductive health advocates say would be unprecedented, sow confusion, and put lives at risk.
Devex Senior Reporter Adva Saldinger is tracking the unfolding story and will bring you more this week.
Background reading: Trump reinstates Mexico City Policy, further limiting abortion care
$260 million
—That’s how much the World Health Organization says the U.S. owes in dues — which it says must be paid now that the Trump administration has officially withdrawn from the world body.
The administration’s reply? I’ll sum it up: Not a chance.
But can it do that? When the U.S. joined WHO, Congress stipulated that the country must pay what’s owed to the agency for the current fiscal year in order to withdraw. For Lawrence Gostin, founding director of the O’Neill Institute for National and Global Health Law, that means Trump is breaking federal law.
“I believe that since Congress enabled the U.S. to join WHO, it should be Congress who decides whether to withdraw,” he adds.
But Gostin — who tried but failed to bring a lawsuit over the withdrawal — is clear-eyed and blunt about what’s next, saying that “Trump will get away with his lawless and reckless action because it has not been challenged either in Congress or the courts.”
“There is almost no chance that Congress will push back,” he says. “The Democrats would have pushed for it, and still would, but they would never get the Republicans on board.”
Secretary of State Marco Rubio and Secretary of Health and Human Services Robert F. Kennedy were equally blunt in a statement declaring that all funding to WHO has ceased.
They also said WHO wouldn’t give back the American flag flying outside the organization’s headquarters in Geneva.
“We will get our flag back for the Americans who died alone in nursing homes, the small businesses devastated by WHO-driven restrictions, and the American lives shattered by this organization’s inactivity,” they stated. But reports now say that the flag has been taken down.
WHO published a statement rejecting the Trump administration’s accusations. It noted that it didn’t recommend lockdowns or mask and vaccine mandates in response to the COVID-19 pandemic, but supported governments to make their own decisions, writes Devex Senior Reporter Sara Jerving.
Read: The Trump administration says it won't pay what it owes WHO
Also: Can the US formally withdraw from WHO without paying its debts? (Pro)
+ Start your 15-day free Devex Pro trial today and gain immediate access to in-depth analyses, insider intelligence, crucial funding data, exclusive event access, and much more. Discover the advantage of having Devex Pro.
WHO has been very vocal about the dangers of noncommunicable diseases, a subject that was raised during the World Economic Forum in Davos last week — for good reason: NCDs are estimated to cost the global economy more than $2 trillion per year and kill more than 43 million people yearly.
But experts say they are not treated like the global emergency that they are, and that health care systems globally — including the U.S. — plow large amounts of money into critical care instead of prevention.
At Davos, panelists said it’s time for a rethink. How? By changing the narrative and framing the NCD fight as a business opportunity, not just a policy matter.
Shamsheer Vayalil, founder and chair of Burjeel Holdings, a leading private provider of health care services in the United Arab Emirates and Oman, had a particularly interesting take: “I think it’s time for disruptions. Probably it’s the time to build the next Amazon or Facebook in combating NCD, that could be one of the top 10 most valued companies in the world.”
+ For more content like this, sign up to Devex CheckUp — our free weekly newsletter that provides front-line and behind-the-scenes reporting on global health.
Davos is done and dusted, though you should still check out my colleague Elissa Miolene’s coverage for the development highlights. She summed up the mood: On edge ahead of Trump’s appearance, and filled with relief afterward, because the U.S. president backed off his threats to take Greenland by force.
Trump’s headline-grabbing presence was just one of the many ways Davos seemed to regain its mojo this year after perennial questions about its relevance. Indeed, while many still knock Davos as an Alpine party for the elite, people of all stripes work hard all week to move the needle on global progress.
So some downtime is a must. To that end, every year, Devex convenes a small, off-the-record gathering of humanitarians to connect and reflect amid the intensity of Davos.
Cohosted with our long-time partners at Circle, this year’s evening featured singer Wyclef Jean, who I’m sure livened up a tired crowd with his hits. But even amid the reverie and relaxation, the more serious nature of Davos is never far away.
Jean reflected on growing up in Haiti, the deeply personal origins of his humanitarian and philanthropic work, and why sustained commitment to the country remains essential. He also traced his development roots back to remittances — recognizing their power to keep families afloat and communities resilient — and how that insight sparked a lifelong engagement in the inclusive finance space. The night closed with an intimate performance — a reminder that culture, creativity, and joy remain central to sustaining impact, long after the Swiss Alps go quiet.
ICYMI: Davos Dispatch — a blizzard of development news in the Alps
+ Devex is officially on Telegram and WhatsApp! Join our channels to receive updates on the latest globaldev news directly to your mobile device.
The World Bank Group opened its first office in Doha, Qatar, on Sunday, which will also serve as a regional hub. [Euronews]
A U.N. aid convoy has reached Ain al-Arab in northern Syria after a humanitarian corridor opened amid a fragile ceasefire between Syrian government forces and Kurdish fighters. [France 24]
The U.N. Development Programme seeks more funding from the private sector as government aid budgets shrink and public money becomes more limited, according to the agency’s chief, Alexander De Croo. [Financial Times]
Sign up to Newswire for an inside look at the biggest stories in global development.