As Western governments slash billions in foreign aid budgets, women and children in the world's most vulnerable communities face a grim reality: The fragile health systems they depend on are crumbling. These cuts aren't merely financial adjustments — they represent potential death sentences for millions who rely on donor-funded health care programs.
The global health community now confronts its most significant challenge in decades: How to sustain critical health services amid dwindling international support and growing political opposition to gender equality and reproductive rights. This isn't just about finding new money — it's about fundamentally transforming how we finance, deliver, and advocate for women’s, children’s, and adolescents’ health, or WCAH, worldwide.
In low- and middle-income countries, a troubling imbalance has emerged — external aid per capita for health ($12.8 in 2022) exceeds domestic spending ($8.8 in 2022). Meanwhile, African nations are diverting $163 billion annually just to service mounting debts.
About the authors
Helen Clark
Helen Clark was the prime minister of New Zealand for three successive terms from 1999 to 2008, after an extensive parliamentary and ministerial career. In April 2009, Clark became administrator of the United Nations Development Programme. She was the first woman to lead the organization and served two terms. In July 2020, she was appointed by the director-general of the World Health Organization as a co-chair of the Independent Panel for Pandemic Preparedness and Response.
Rajat Khosla
Rajat Khosla has been the executive director of Partnership for Maternal, Newborn and Child Health since May 2024. He previously directed the International Institute on Global Health and worked at the World Health Organization and UN Human Rights on global health, rights, and inequalities. Rajat has advised major United Nations agencies, published widely, and holds affiliations with the University of Southern California Institute on Inequalities in Global Health and the University of Essex Human Rights Centre.
