The West African nation of Ghana has seen significant improvements in childhood vaccination rates over the past decade, with coverage for diseases such as measles, polio, and diphtheria rising to over 90% in many districts. However, recent cuts to U.S. foreign assistance—a major contributor to the country's health budget—have created a funding gap that experts warn could reverse these advances.
The $78.2 million shortfall primarily affects the procurement of vaccines, cold chain logistics for storage and transport, and the salaries of community health workers who administer immunizations in remote areas. The United States, through agencies such as USAID and the Centers for Disease Control and Prevention, has historically been a leading donor for Ghana's Expanded Programme on Immunization.
Dr. Kwame Asante, a public health specialist at the University of Ghana, described the situation as "a critical juncture." He noted that while Ghana has made strides in reducing child mortality, the gains are fragile. "If we cannot maintain the cold chain or pay health workers, the coverage will drop, and we will see outbreaks of diseases we thought were under control," he said.
The Ghana Health Service has confirmed that it is reviewing its immunization budget and seeking alternative funding sources, including from the Global Alliance for Vaccines and Immunization (GAVI) and other bilateral partners. However, officials acknowledge that replacing the U.S. contribution will be challenging, especially given competing demands for health resources amid other aid reductions.
The cuts are part of broader reductions in U.S. foreign aid under the current administration, which has prioritized domestic spending and questioned the effectiveness of certain international programs. Proponents of the cuts argue that aid can create dependency and that countries like Ghana should increase their own health spending.
Local health workers on the ground report that some vaccine supplies are already being rationed and that outreach campaigns in rural areas have been scaled back. "We used to go to villages every month for immunizations. Now it's every two or three months, and many children are missing their doses," said Mercy Adjei, a nurse in the Northern Region.
The World Health Organization has warned that any decline in immunization coverage could lead to significant outbreaks, especially of measles, which is highly contagious and requires very high coverage rates to prevent spread. The organization has urged donor countries to maintain funding for essential health programs.
Ghana's government has pledged to increase its domestic health budget, but with a struggling economy and high inflation, the timeline for such increases remains uncertain. In the meantime, health advocates are calling on the international community to bridge the gap to prevent a public health crisis.