One of the first Executive Orders signed by President Donald Trump upon assuming office was the decision to withdraw the United States from the World Health Organization (WHO). However, this measure will not take immediate effect; it is set to be implemented on 21 January 2026.
This development is particularly unfortunate, as the WHO has been instrumental in supporting Tanzania’s efforts in HIV/AIDS management, tuberculosis control, emergency response to disease outbreaks, and health system strengthening. In the current year alone, WHO had committed a programme budget of approximately $39 million. When the withdrawal takes effect, the agency will suffer a significant financial blow, given that the United States contributes between 16% and 18% of WHO’s overall budget.
In addition, Trump has signed an Executive Order on re-evaluating and realigning U.S. foreign aid, resulting in a 90-day freeze on all disbursed aid by the United States Agency for International Development (USAID). This pause is intended to assess and determine whether such assistance aligns with U.S. interests.
In Tanzania, USAID has played a crucial role in implementing the President’s Emergency Plan for AIDS Relief (PEPFAR) by funding local health organisations, strengthening healthcare systems, and supporting HIV prevention, treatment, and care services. Since its inception in 2003, PEPFAR has been a vital component of Tanzania’s HIV/AIDS response. Due to its life-saving impact, PEPFAR has been granted a temporary waiver to continue implementing urgent HIV treatment services.
The Key Issues at Stake
Two key issues arise from these developments.
First, once the U.S. withdrawal from WHO takes effect, a substantial financing gap will emerge. The European Union is unlikely to fill this void, as it has also indicated a shift in its approach to development aid, prioritising national interests—a stance similar to that of the U.S.
Second, even after the 90-day pause, the level of USAID’s support is expected to decline significantly.
As a country, we must recognise the gravity of this situation and determine the best course of action. Healthcare is a fundamental necessity in any society, and a nation that fails to care for its sick citizens cannot be considered responsible. As Mahatma Gandhi once said: “It is health that is real wealth and not pieces of gold or silver.”
Let us be honest with ourselves—our budget is entirely inadequate to compensate for these funding cuts.
I have heard some dismissing the severity of the problem with statements like “tumejiandaa” (we are prepared). I wish that were true, but the financial requirements are enormous. To put things into perspective, PEPFAR alone has injected $2.3 billion into Tanzania’s healthcare system since its inception.
What Must Be Done?
Therefore, we must take decisive action.
- We need to realign our national priorities. Incidentally, the 2025/26 budget is currently under preparation and is expected to be tabled in Parliament in April. The government must cut wasteful spending and increase the healthcare budget from its current 5% of total expenditure to at least 8%-10%.
- We must leverage multilateral diplomacy by working alongside other African nations affected by these aid cuts. A collective approach in negotiating with the U.S. government could be more effective in mitigating the impact of reduced foreign assistance.
The urgency of the situation cannot be overstated. Failure to act swiftly and strategically will put the health of millions of Tanzanians at risk.
Elly Manjale is an economic, business, and management consultant based in Arusha who writes on economic, business, social, and political issues.
📞 Contact: +255 37 1521
📧 Email: emanjale@gmail.com
