The West is slashing global health programmes. Could that be a good thing?

Despite efforts to increase domestic investment, there are still substantial funding gaps. Many African countries struggle to meet the Abuja Declaration target of allocating 15% of their national budgets to health. In April 2025, the Africa Centres for Disease Control and Prevention published a guide on how to transform health financing in the continent. The novel financing ideas include solidarity levies on airline tickets, alcohol and mobile services; and the guide explores how Africa’s $95 billion in annual diaspora remittances can support national health priorities.

Similarly, the Association of Southeast Asian Nations (ASEAN) has strengthened its health policy coordination. Faced with rising concerns over zoonotic diseases and cross-border health threats, in 2022 ASEAN launched a regional Centre for Public Health Emergencies and Emerging Diseases, which integrates surveillance, research and rapid response across member states. These steps are encouraging, with Japan committing USD $50 million of financial support. This shift ensures that health strategies fit regional needs rather than being influenced by external donors.

Climate change and health diplomacy

Another key driver of evolving health policy is the intersection of climate change and public health. Rising temperatures, extreme weather events and changing disease patterns are pushing health and environmental policy closer together.

Middle Eastern nations are pioneering heat-health adaptation strategies, as prolonged heatwaves threaten urban populations. The region is the world’s most water-stressed area and is home to some of the hottest locations on the planet. It is estimated that, on average, 2.1 per 100,000 deaths per year in the Middle East and North Africa region are heat related.

Countries including Saudi Arabia are funding research into cooling technologies, hydration solutions, and urban design that mitigates the health risks associated with rising temperatures. This marks a significant shift in health policy leadership, towards regions that historically have been less involved in public health governance.

A less centralised and more inclusive health future

These changes indicate a broader movement towards a multipolar global health governance structure, where decision-making is increasingly decentralised. No longer dominated by a handful of high-income nations, global health policy is becoming more representative of the diverse needs of populations.

Nevertheless, nations striving for self-sufficiency in healthcare still face significant challenges, including funding gaps, infrastructure deficiencies, political instability and epidemiological transitions. Disparities in wealth and a historical dependency on external aid complicate efforts further.

Yet shifting leadership in global health is not just a challenge – it is also an opportunity. As traditional donors pull back, emerging powers, regional alliances and technological pioneers are reshaping the future of healthcare. This evolution has the potential to reduce dependency, enhance regional autonomy and create more responsive and sustainable health policies. The key to harnessing these opportunities lies in embracing collaborative governance, investing in innovation and ensuring that health equity remains at the core of this transformation.

The opinions expressed in this blog are those of the author and do not necessarily represent the views of The Health Policy Partnership.