Pandemic Center

David Baltimore explained to Mr Mandela, in a language so precise as only he could, that there was no vaccine for Aids and that an aggressive rollout of antiretrovirals, tough management of needlestick use and a high visibility public campaign for safe sex were key.

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A primary driver of the monumental endeavour to develop the yellow fever vaccine was a shared sense of responsibility that America, having the means and knowledge, should use its resources for the good of all. That sense of responsibility is now waning.

Max Theiler is the first of 13 South Africans to receive a Nobel Prize (1951, physiology and medicine) for developing what became known as an attenuated vaccine for yellow fever. His discovery changed the course of medicine as it treated, cured and prevented the deaths of thousands upon thousands of people. His Swiss-born father, Sir Arnold Theiler, was the inaugural director of the Onderstepoort Veterinary Research Institute outside Pretoria.

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In December 2024, a group of scientists did something rare: published a warning against building a technology that some of them had spent years working toward. Even more eye-popping, this came at least a decade before the tech is even possible.

The warning concerned mirror bacteria: hypothetical synthetic organisms built from mirror-image forms of the proteins, amino acids, DNA, and other biomolecules used by life on earth.

In an analysis published in Science, we and 36 colleagues—including two Nobel Laureates and 16 members of national academies from around the world—argued that such organisms could be built within the next 10 to 30 years and could pose an extraordinary threat if they were.
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While the immediate effects of the US cuts in health aid are being felt primarily by the Global South, the associated risks extend worldwide.
Last week, global leaders gathered for the World Health Assembly in Geneva to address the reality that the global health landscape is being reshaped by dramatic shifts in funding, priorities, and leadership.

Chief among these is the United States’ decision to slash foreign aid and withdraw from the World Health Organization (WHO). Despite spending only 0.24% of its gross national income on foreign aid, the United States has been the largest donor to global health programmes, providing one-third of the international assistance in global health. This is not just a US issue – other countries have also signalled reductions in foreign health aid, and Argentina also recently announced it will withdraw from the WHO.

These dramatic shifts have forced the WHO to plan a reduction in staff by nearly 50%, triggering massive restructuring. Non-government organisations (NGOs) are laying off large numbers of staff worldwide. While other donors and philanthropies are stepping in, they cannot fill the void alone.

Meanwhile, the shock to the system is already resulting in lives lost. According to the WHO, countries such as Haiti, Kenya, Lesotho, South Sudan, Burkina Faso and Nigeria may run out of HIV antiretroviral medications within months.

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The vacuum left by the US threatens irreparable damage to global health institutions, with the WHO bearing a disproportionate burden. The organisation must view this crisis as an opportunity to develop into an entity that is leaner with greater agency to carry out its most essential, life-saving tasks.

The World Health Organization (WHO) is in a moment of crisis. The decision by the US to withdraw from the organisation leaves the WHO with a deficit of about 15% of its total funding through the end of 2025 and 45% projected for 2026-27.