Britain helped drive back the world's deadliest diseases. Now it is abandoning the fight
4 min read
The current Ebola outbreak is back on the front pages with the news that a British aid worker recently returned from DRC is being monitored at a London hospital after displaying possible symptoms.
Those of us who work in public health are not surprised. Infectious diseases do not respect borders. The current Ebola outbreak is now the fastest-growing on record, outpacing even the 2013-16 West Africa epidemic, with more than 2,000 confirmed cases and 750 deaths by mid-July.
An estimated 63,000 pregnant women are due to give birth in the outbreak zone, in a country that already has one of the world's highest maternal mortality rates. Those rates are expected to rise even higher as women are too scared to go to hospital to give birth in case they contract Ebola.
The World Health Organisation (WHO) has warned that countries neighbouring the DRC are at high risk, and that the outbreak is still expanding into new areas. Diseases do not stop at borders.
Yet this week, in the middle of that outbreak, the Foreign Office published its annual report. Buried in its annexes are three years of planned cuts to bilateral aid, country by country. The DRC will receive £34 million less this year, a 29 per cent cut. UK bilateral aid to Africa as a whole is falling by £733 million this financial year compared with 2024-25, and by £875 million, more than half, by 2029. It is the largest cut facing any region in the world.
Over the last two decades, we have shown again and again that major infectious disease threats can be contained, driven back, and in some cases defeated.
HIV is no longer the death sentence it once was for millions of people. Malaria deaths have been reduced substantially. Polio has been pushed almost to the brink of eradication. Previous Ebola outbreaks have been brought under control. And smallpox has been removed from the face of the earth.
None of this happened by chance. It happened through hard work, science, partnership and money.
You would not know it from the annual report. A year ago, the same document set out the UK's global health work in detail, naming Gavi and the Global Fund and pointing to Britain's role in helping vaccinate over half the world's children. This year's report contains none of that. The words malaria, HIV, tuberculosis and maternal health do not appear anywhere in its 264 pages.
The countries where British aid helped drive down deaths from these diseases, including Kenya, Malawi, Mozambique and Rwanda, will have their bilateral programmes all but ended, reduced to an influencing budget of £5 million a year.
Also, in recent months, the UK Government has cut critical global health funding for vaccines, for tackling AIDS, tuberculosis and malaria, for pandemic preparedness, and for reducing our defences against the risk of antimicrobial resistance. The Government's own equality impact assessment states that its multilateral global health investments will fall by roughly a quarter.
UNAIDS estimates that the loss of previously US-supported HIV programmes could lead to an additional six million infections and four million deaths between now and 2029, including 300,000 children. The UK cuts continue to bite deeper.
Supporting health beyond our own shores as part of UK overseas aid is in our own interests. Think of it this way. Wouldn't you want your next-door neighbours to have working smoke alarms? In the same way, we need our global partners to have strong and effective health systems and healthy populations.
Investing in global health is not a 'forever project'. The past decades of successful international partnerships mean that most health services in low- and middle-income countries are now funded by those countries themselves. That has meant that the resources the UK provides are more focused on where it is most needed, where the risks are greatest, and where cuts and sudden policy changes do the most damage.
The right response to President Trump's widespread USAID cuts would have been for the UK to step up: to help fill the gaps, smooth the transition, and act as a counterweight for countries negotiating new agreements with the United States.
Instead, in some areas, the UK has compounded the damage by cutting our own funding. This retreat is an abdication of responsibility by the current Government. The consequences were predictable, and they are already becoming apparent.
It is not too late to reverse these damaging cuts. Andy Burnham inherits this decision, but he is not bound by it. There could be no better moment for our new Prime Minister to show that the UK still understands that its own health security begins beyond its own borders.
Professor Timothy Hallett is Professor of Global Health in the School of Public Health at Imperial College London and an Affiliate Professor at the Department of Global Health, University of Washington, Seattle.
