Vaccine Backsliding Will Ripple Around The Globe | Health Affairs

One of the most distressing trends in US public health has been the backsliding in vaccine rates. In 2024, the Centers for Disease Control and Prevention found that 92.7 percent of kindergarteners had received all required state vaccines in the 2023–24 school year (down from 95.2 percent in 2019–20), leaving some 280,000 children unvaccinated and unprotected against measles. This spring’s nationwide measles outbreak, and the first US deaths from measles in a decade, were a tragic, unnecessary result.

Now, as measles threatens to become endemic in the US, the National Institutes of Health has terminated dozens of research grants that seek to understand vaccine hesitancy and how to improve vaccination rates.

Such decisions will have a major toll on US public health. But their global impact may be enormous.

For example, in March, it was reported that the US intended to terminate its $2.6 billion commitment to Gavi, the Vaccine Alliance, which had been pledged through 2030. Since its founding twenty-five years ago, Gavi has helped vaccinate more than 1.1 billion children worldwide, with the US underwriting about 13 percent of its budget.

This public-private partnership, which supplies vaccines to more than half the world’s children, is a resounding global health success that has won bipartisan support in Congress for two decades. As Gavi’s chief executive officer, Sania Nishtar, outlined in an interview with TIME, the US is not just a funder, but a vital technical partner that mobilizes vaccines to the front lines of public health emergencies such as mpox and Ebola before they reach our shores.

The numbers alone are tragic. According to Nishtar, pulling this funding would mean that more than seventy-five million children would not get vaccinated, and more than a million would die. It would have an immediate impact on the ability to control deadly outbreaks of measles, meningococcal disease, mpox, cholera, and more.

It would also make it more difficult to get new, lifesaving vaccines into communities—vaccines that could prevent the spread of severe malaria and the virus that causes cervical cancer, which are breakthroughs that could transform global health.

As Austin Demby, the health minister of Sierra Leone, put it in an interview with the New York Times, “There are children’s lives at stake, global health security will be at stake.”

This is not just a health issue, but also a security issue. Global health is US health. The world is too interconnected to think that we can isolate ourselves—and measles offers a clear example. Many of the children in this spring’s US outbreak caught the disease overseas, including children from Maryland, California, Texas, and Hawaii, where the infection was state’s first new case in two years. In our interconnected world, a disease is always just one flight away.

For our own safety, and the world’s, the US must stick to its commitments to global vaccine production and distribution. The spread of vaccine-preventable diseases is not inevitable. We can regain these losses and restore confidence in public health.

Vaccines are not something to shy away from; they’re something to be immensely proud of. There’s a reason United Nations Secretary-General António Guterres has called them “the most important public health intervention in history,” and there are more reasons than ever to commit to them.

This article was originally posted on healthaffairs.org