Quote: “Health diplomacy is not just about aid; it is about power, influence, and the ability to shape global health narratives.” – Chatham House Global Health Report.
Introduction
Trumpism, characterized by nationalism, populism, and a transactional approach to international relations, has significantly influenced global health diplomacy. The impact of former U.S. President Donald Trump’s policies on global health was profound, and his return to office in 2025 has once again shifted international health priorities.
Nowhere is this shift more evident than in Africa, where U.S. funding and policies have historically shaped healthcare initiatives.
This article examines the influence of Trumpism on global health diplomacy, focusing on Africa and Nigeria’s response to these evolving challenges.
Understanding Trumpism in Global Health Diplomacy Trumpisms approach to global health is marked by three major characteristics:
1. America First Doctrine: Prioritization of domestic interests over international commitments.
2. Skepticism Toward Multilateralism: Distrust in organizations like the World Health Organization (WHO).
3. Cuts to Foreign Aid: Reduction in funding for global health programmes, impacting HIV/AIDS, TB, and malaria initiatives.
These policies contrast sharply with previous U.S. administrations that championed global health investments as a diplomatic tool.
Key Impacts on Global Health in Africa Under the Trump administration, several policy shifts significantly impacted African health programmes:
1. Reduction in Foreign Aid and Health Programme Funding
The administration implemented drastic cuts to the U.S. Agency for International Development (USAID), leading to the cancellation of thousands of aid contracts and the suspension of life-saving programmes.
Funding for the President’s Emergency Plan for AIDS Relief (PEPFAR) was halted, jeopardizing treatment and prevention programmes for HIV/AIDS in Nigeria.
Support for Gavi, the Vaccine Alliance, which provides vaccines to children in developing countries, including Nigeria, was discontinued.
2. Withdrawal from the WHO
The U.S. officially withdrew from the WHO, citing concerns over its handling of global health crises.
This move created uncertainty in funding and coordination for health initiatives in Africa, particularly during pandemic responses.
3. Reinstatement of the Global Gag Rule
The administration reinstated the Global Gag Rule, restricting U.S. funding to foreign organizations that provide or promote abortion services, impacting reproductive health services in Nigeria.
Nigeria’s Response to the Shifting Landscape In light of these developments, Nigeria has taken several steps to mitigate the impact:
1. Increased Domestic Health Funding
The Federal Executive Council approved an additional $200 million for the health sector to offset the shortfall from U.S. aid cuts.
₦4.8 billion was allocated for HIV/AIDS treatment, and a multi-ministerial committee was formed to sustain health programmes affected by U.S. policy shifts.
2. Local Production of Health Commodities
Plans are underway to begin domestic production of HIV commodities, including test kits and antiretroviral drugs, aiming for self-sufficiency in healthcare resources.
3. Legislative Actions
Nigerian lawmakers have urged the government to bridge the funding gap left by the suspension of U.S. aid, emphasizing the need to protect citizens reliant on these health programmes.
Challenges and the Future of Health Diplomacy Despite proactive measures, Nigeria and other African nations face significant challenges:
Resource Constraints: The sudden withdrawal of substantial U.S. funding poses difficulties in maintaining the scale and quality of existing health programmes.
Capacity Building: Developing infrastructure and expertise for domestic production of medical commodities requires time and investment.
International Partnerships: The shift in U.S. policy necessitates the exploration of new international partnerships and funding sources to sustain health initiatives.
Chatham House and Global Health Diplomacy The Chatham House, a leading policy institute, has been instrumental in shaping global health diplomacy. It provides a platform for high-level discussions on health security and governance. The Chatham House Rule, which ensures open dialogue without attribution, allows policymakers and experts to discuss sensitive health diplomacy issues candidly.
Example: During a Chatham House discussion on Africa’s response to declining foreign aid, Nigerian health officials, under the Rule, shared unfiltered insights on domestic health funding gaps and challenges without fear of diplomatic repercussions.
Conclusion
Trumpism’s approach to global health diplomacy has reshaped Africa’s health landscape, with Nigeria at the forefront of adapting to these changes. The nation’s shift towards increased domestic funding, local production, and strategic international partnerships reflects resilience in the face of evolving U.S. policies. As the global health order continues to change, African nations must strengthen their health systems through self-reliance and collaborative regional initiatives.
References
1. Chatham House. (2024). Global Health Governance and Diplomacy Report. Chatham House
2. USAID. (2023). Impact of U.S. Foreign Aid Cuts on Global Health Programmes. USAID
3. World Health Organization. (2024). The Role of Multilateralism in Global Health. WHO
4. Nigerian Ministry of Health. (2025). Annual Health Sector Review Report. Federal Ministry of Health, Nigeria
5. Gavi, The Vaccine Alliance. (2023). Immunization Efforts in Africa Amid Changing U.S. Policies. Gavi
6. The Lancet. (2024). Global Health Challenges in the Wake of Nationalist Policies. The Lancet Global Health
Felix Ukam writes from Calabar, he is the Executive Director, Centre for Healthworks, Development and Research Initiative, CHEDRES, a nongovernmental organization based in Cross River State, Nigeria.
NB: Opinions expressed in this article are strictly attributable to the author, Felix Ukam, and do not represent the opinion of TheInvestigator or any other organization the author works for/with.