Childhood vaccines are one of the most efficient means of improving the lot of the world’s poorest people, according to the Copenhagen Consensus Center.Marvellous Durowaiye/Reuters
David Morley is a member of the Order of Canada and the co-chair of the Stephen Lewis Foundation.
In the past 35 years, the world has seen a child survival revolution. In 1990, 13 million children under the age of five died of preventable causes; the most recent figures show that today, that number is closer to 5 million. That is still far too many, but that huge decline is far greater than any other moment in human history.
The American government and its far-reaching foreign aid programs have been key to this success. Support from the U.S. (and other wealthy countries, most notably Canada and its Muskoka Initiative for Maternal and Child Health) has been a foundation for this success.
A key to this achievement has been vaccines. The Copenhagen Consensus Center, a globally recognized economic think tank, ranks childhood vaccines as one of the most efficient means of improving the lot of the world’s poorest people.
In the words of its president, Bjorn Lomborg, “Vaccines are one of the true wonders of humanity having saved more lives than any other medical invention. Where they’ve been widely embraced, vaccines have essentially eliminated the spread of diseases that once ran rampant.” He points out that “increased spending on childhood vaccinations can save half a million lives each year and is one of the best investments for the world.”
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The Canadian government agrees. “Vaccination is one of the most cost-effective investments in global health,” Global Affairs Canada declares on its website. “The estimated return on investment is $54 for every $1 spent on vaccines due to people living longer and healthier lives.”
But now, this positive revolution in child survival and human health is under threat. Last Wednesday, America’s Health and Human Services Secretary, Robert F. Kennedy Jr., announced that the U.S. would withdraw its support to GAVI, the global vaccine initiative, to purchase vaccines for children in the poorest countries in the world.
Basing this decision on a widely discredited 2017 report on a diphtheria vaccine, the United States has decided to take its ideological anti-vaccination crusade global – and it’s the world’s poorest people who will suffer.
The decision to pull funding from global vaccine efforts weakens the foundation of children’s health. This means more children will die from preventable causes and more parents will have to suffer the unbearable pain of losing a child.
The American retreat from the remarkably successful global vaccination initiative is forcing a reconsideration of the world’s humanitarian system. In some cases, newcomers to foreign aid – countries such as India and Indonesia, which once were beneficiaries of international development programs – are making donations to the global vaccine efforts. Other more traditional donors, including Canada and Australia, have said they will increase their support for vaccines. But all of this cannot fill a USAID-sized hole in the global health system.
It is easy to see in hindsight that the world grew too reliant on American foreign aid and to say that the UN and global NGOs should have been better prepared. But the shifts in American foreign policy in 2025 have caught every country in the world by surprise. And while most people felt reform was necessary, until a new international development regime comes about, the chaos and reduction of today will simply cause more hardship and suffering.
There are signs of hope, of course. Community groups are showing their strength and solidarity as they come together in mutual support. Local governments will increase their own funding of vaccines – the government of Ghana, for example, with a vaccine coverage rate of 97 per cent, plans to pay for all its own vaccines by 2030.
These are paths that others will have to follow. But right now, seeing the United States use flimsy, unsubstantiated arguments to threaten the greatest revolution for good the world has ever seen is a reminder of what the end of American leadership means for the world – and for the children who will needlessly die.