Among the many people baffled and dismayed by this second Trump administration’s dramatic funding cuts are those involved in science and biomedical research. The cuts — billions already enacted, with billions more proposed — are threatening many avenues of global health and research. And in these last several months, a question that has been permeating the philanthrosphere is to what extent private funding can replace disappearing federal dollars for research and valuable programs. It’s a discussion that Inside Philanthropy has been addressing throughout the year.
This past spring, for example, the U.S. government announced it would withdraw funding for Gavi, the Vaccine Alliance — a successful global public-private partnership that has provided vaccines to more than 1 billion children in developing countries, saving an estimated 19 million lives. The U.S. had been contributing 13% of Gavi’s budget, until the Trump administration earlier this year canceled $2.6 billion in funding intended to run through 2030.
Following cancellation of the Gavi support, the Gates Foundation last month announced a new commitment of $1.6 billion over five years to maintain Gavi’s operations, re-upping a previous commitment. Gates, of course, is unusual in the scale of its giving and the depth of its financial assets, and has long been focused on vaccinations, among other global health causes.
“For the first time in decades, the number of kids dying around the world will likely go up this year instead of down because of massive cuts to foreign aid,” Bill Gates said in a statement. “That is a tragedy. Fully funding Gavi is the single most powerful step we can take to stop it.”
While the size of Gates’ commitment is, of course, an outlier, other philanthropies have been making similar moves to shore up defunded infectious disease infrastructure, at least until government can step back in — if it ever does.
The WHO Foundation and ELMA step up to preserve global measles monitoring
The move to defund Gavi was no huge surprise given the vocal antivaccine activism of Trump’s HHS secretary Robert F. Kennedy, Jr. But it comes at a time when growing vaccine misinformation and distrust are already resulting in a spike in measles cases in the U.S. Measles is a serious and exceptionally contagious disease that had been declared eliminated in this country 25 years ago — because of vaccines. But as of July, the U.S. has reported the highest number of measles cases since 2000 — 1,274 this year, nearly all among unvaccinated people. A few have resulted in death. Again, this is a disease that had been virtually eliminated in this country.
The defunding of Gavi coincided with a related blow to global health when the Trump administration pulled U.S. support from the World Health Organization, citing dissatisfaction with the organization’s management of the COVID-19 pandemic. Loss of U.S. funding threatens the survival of numerous WHO health initiatives around the world, including disease surveillance and response to disease outbreaks.
One of those initiatives is a program called the Global Measles and Rubella Laboratory Network (GMRLN). The program involves more than 700 laboratories operating in 191 countries and is the world’s largest tracker of outbreaks and the spread of measles and rubella. In addition to monitoring those serious diseases, GMRLN has also become a global backbone of infectious disease surveillance more generally, providing health authorities with the data needed to guide response and containment of other threats, such as yellow fever and dengue. GMRLN was already in danger following a 2023 reduction in support from the U.S. Centers for Disease Control and Prevention, which has historically been its primary backer, and the U.S. withdrawal from WHO left the GMRLN network under imminent threat of collapse.
Here’s where the private funding comes in. Two philanthropies teamed up this year to prevent the loss of GMRLN’s valuable disease surveillance infrastructure: the WHO Foundation, the independent grantmaking nonprofit launched as a direct philanthropic supporter of the World Health Organization proper, and ELMA Philanthropies. ELMA is an Africa-focused family of foundations that fund a broad range of needs across the continent. Earlier this year, ELMA partnered with the Gates Foundation and other backers to launch the maternal-and-infant-mortality-focused Beginnings Fund. ELMA’s funding also ranges across economics, crisis response and relief, the arts — and vaccines and immunizations.
To keep GMRLN in operation, the WHO Foundation recently launched a $3.6 million emergency fundraising campaign — with the ELMA Vaccines & Immunization Foundation, one of the group of grantmakers under the ELMA umbrella, driving the effort by matching every contribution up to $2 million.
Loss of the GMRLN global monitoring network would accelerate the already worsening threat of measles and other infectious diseases. “The United States, for example, has had the greatest number of cases of measles this year than we’ve seen in the last 25 years,” said Anil Soni, CEO of the WHO Foundation. “Surveillance labs are what we need to make sure that we can detect measles and rubella when they happen and respond as quickly as possible.”
In addition to the cost to human health, the funding cuts will also take an economic toll. Sickness costs a lot more than health; treating illness costs more than preventative care. According to Soni, economic models show a $60 return for every dollar invested in a vaccination.
And it’s not just a matter of helping people in far-off nations. Measles is one of the most contagious diseases in the world, and it is a swift traveler that crosses borders with every plane flight. The only reasonable approach to controlling the virus is to battle it on a global basis. “Globally, measles vaccine rates are approximately 83%, which sounds high, but it’s actually quite low relative to the last 25 years,” Soni said. “That means there’s a large population of unvaccinated persons, and as a consequence of that, measles can spread rapidly.” Last year, there were 300,000 cases of measles globally, with most of them in low-income countries, many in Africa and Asia, which don’t have as much routine vaccination as the U.S. and other higher-income countries. About a third of the cases were in Europe.
Philanthropy can fill global health gaps, even if it can’t “replace” government
In the very early weeks of the Trump administration, WHO Foundation leaders understood drastic U.S. funding cuts were a near certainty and started making plans to adapt.
“We suspected this was coming, and so we immediately asked philanthropies and companies, anyone who cares about global health, to come join us for a call and listen to leaders of WHO tell you what this means in practice,” Soni said. “We had more than 300 organizations show up for that call.” A WHO vaccine scientist described the threat to GMRLN and the importance of maintaining the network.
ELMA was one of participants on that call, and recognized the particular threat to Africa, its primary region of investment and expertise. “Within week one of this administration, ELMA was on the case and started the ball rolling in terms of learning about the impacts of the cuts and making the determination to make a [financial] gift — and to make it a matching gift — to encourage others to give, as well,” Soni said. Contributions, including from the Skoll Foundation and other global health funders, are continuing to flow to the emergency fundraising campaign.
But in the coming years, and perhaps beyond this current administration in Washington, philanthropic funders will have to continue to address changes to the U.S. government’s support of science and health, Soni said. “We can’t expect nor ask philanthropy to fill the role of government — whether it’s the governments of low-income countries or high-income countries who have generous aid programs — regardless, the numbers are too large for philanthropy.”
As we have been reporting here in Inside Philanthropy, private giving can help and can evolve to better meet global needs as U.S. funding pulls back, but, still, we shouldn’t expect it to replace the entirety of U.S. federal funding. Ultimately, what philanthropy has done, and can continue to do, is to move quickly, take risks and drive innovation, Soni observed. In the case of the GMRLN program, “We’re not asking [philanthropists] to replace the CDC.” Instead, while philanthropic support will be vital to maintaining GMRLN for now, WHO will need to bring more governments and countries to fund the program for the long term.
That said, private funders can, and are, filling some gaps left by the federal government. The Gates Foundation, for example, has the financial resources to keep Gavi and other programs functioning. The WHO’s GMRLN program is also notable in that it provides vital disease monitoring for a relatively modest amount of money — about $9 million per year — that returns many times its cost in terms of illness prevention, lives saved and the speedy collection of data about emergent disease outbreaks.
The WHO Foundation and ELMA’s support is one case where a philanthropic solution may well enable a vital program to keep operating — and it’s not the only one. But as Soni and others have noted, in the end, philanthropy alone won’t be able to take over all of the tasks — and costs — of global health and research.
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