U.S. withdrawal from WHO and aid programs: implications and opportunities for Africa’s global health security

The United States has long played a central role in global health through its engagement with the World Health Organization (WHO) and through major bilateral programs, including the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the U.S. Agency for International Development (USAID). These investments have contributed to health infrastructure development, disease surveillance, and the expansion of treatment and prevention programs across Africa. The recent U.S. withdrawal from WHO and the freezing of USAID funding raise concerns for infectious disease control, healthcare delivery, and global health security, particularly in settings with high dependence on external financing. This commentary argues that the U.S. withdrawal, while disruptive, should not be understood solely as a setback, but as an opportunity for African governments to assume greater ownership of their health systems and exercise leadership through deliberate political and policy choices. These include increased domestic health financing, stronger institutional governance, and enhanced regional coordination. The paper outlines pathways for sustaining donor-built infrastructure, expanding local pharmaceutical and diagnostic manufacturing, and aligning public–private partnerships with national health priorities. By strengthening domestic capacity and regional cooperation, African governments can reduce vulnerability to external funding shocks, improve outbreak preparedness, and play a more active role in shaping global health security agendas.