USAID cuts halt Yale-led efforts to build global health infrastructure

Daniel Zhao

Following an abrupt notification from the U.S. Agency for International Development, Yale researchers lost support for a project establishing Chad’s first National Institute of Public Health and a $15 million award for health education initiatives in Liberia. 

The first round of grant terminations revoked funding for five global health projects at Yale, according to an internal survey from the Yale Institute for Global Health in February. The News spoke with two researchers whose projects were suddenly terminated. Some other researchers declined to comment. 

Building public health infrastructure in Chad

Amy Bei, an associate professor at the School of Public Health, had been leading two global health initiatives reliant on USAID funding: a program to build Chad’s first National Institute of Public Health and establish a national genomic surveillance system and a separate malaria vaccine project conducted across multiple African countries.

Bei’s work came to a halt after she received a stop-work order from USAID in January. The letter did not mention Bei’s research specifically and stated that the stop-work order was effective immediately. 

However, the letter noted that the “Secretary of State has approved waivers of the pause under the Executive Order, subject to further review, with respect to emergency food assistance, salaries and related administrative expenses for all personal services contractors and legitimate expenses incurred prior to January 24th,” among other exceptions.

Unlike wealthier nations, Chad lacks the resources to independently track disease outbreaks. Bei’s program sought to change that by training epidemiologists and laboratory specialists to monitor malaria, dengue, antimicrobial resistance and vaccine efficacy through cutting-edge genomic tools. This investment, Bei explained, was critical for empowering Chad to identify and respond to public health threats without waiting for external help.

“The whole goal is to strategically build up these platforms and build up the training of people with self sufficiency in mind,” Bei said.

Having local genomic surveillance capacity, which is the ability to continuously monitor pathogens to track how they evolve and spread, is about speed, accuracy and survival. During past outbreaks, including COVID-19, countries without in-country genomic surveillance often had to ship biological samples abroad and wait weeks or months for data. 

“When we think about public health surveillance, it really has to be ongoing, routine, with quick turnaround times from identification and sequence of the pathogen into actionable information. Otherwise, it’s kind of like historical research,” Bei said.

Bei’s work had already achieved several firsts for Chad. During a dengue outbreak, her team successfully trained local health workers to sequence virus samples in-country, which is much more efficient than sending samples overseas. 

When Bei received the stop-work order, plans were underway to extend genomic surveillance to malaria, which would have included drug resistance monitoring and vaccine response tracking.

“We have trained over 200 medical and public health care practitioners through the program, most of whom have participated in deep and repeated training,” she said. 

Meanwhile, Bei’s second project, a next-generation malaria vaccine consortium, led by African partner sites, involving Institut Pasteur de Dakar, Yale, Oxford and several African institutions, was also impacted. 

Although the consortium itself is primarily funded by the European Developing Countries Clinical Trials Partnership, its foundational clinical trials were funded through USAID. The sudden halt to those trials has slowed the overall progress of malaria vaccine development efforts in the region.

A Decade of Progress in Liberia at Risk

On Feb. 24, Kristina Talbert-Slagle GRD ’07 ’10, an assistant professor at the Yale School of Medicine, received a similar grant termination notice from USAID. 

Her project focused on long-term investments in Liberia’s health education, hospital management and workforce training, including a goal to transform education at the country’s only medical school. She started the project when the Ebola epidemic ended in 2015, aiming to rebuild a healthcare system that had been shattered by the crisis.

“Liberia is still a post-war, resource-constrained country, and we have more work to do in rebuilding its still-fragile health system,” wrote Talbert-Slagle. “We can’t put the brakes on health systems that work like this and expect to keep the next global health security threat at bay.” 

Talbert-Slagle explained that her team’s efforts had already achieved milestones, including the establishment of a Center for Teaching, Learning, and Innovation at the University of Liberia College of Health Sciences and an evidence-based health policy training course for national officials. They have also built infrastructure in Liberia that is necessary for distributing funding and managing research grants. 

The halt of funding has already stymied support to faculty training, leaving doctors without resources to take on faculty roles and infectious disease control in Liberia. It has also shuttered the country’s only high-fidelity simulation facility used for life-saving clinical education.

“To freeze funding overnight with no warning is extremely disruptive to individuals and systems; even resilient systems cannot respond this quickly to such drastic removal of resources,” wrote Talbert-Slagle.

Beyond local consequences, Talbert-Slagle warned of broader risks to global health security. 

She emphasized that dismantling health systems support in fragile countries could leave the world more vulnerable to future outbreaks.

“We can’t put the brakes on health systems that work like this and expect to keep the next global health security threat at bay,” Talbert-Slagle wrote.

Talbert-Slagle said that the School of Medicine has offered the possibility of additional funding. She said that she has applied for these funds to support her team at Yale and a few part-time team members in Liberia for the next year.

A broader collapse of trust

Both Talbert-Slagle and Bei’s experiences reflect what Yale Institute for Global Health interim director Michael Cappello described as a wider crisis. Cappello said that the USAID grant suspensions will not only disrupt immediate program outcomes but will also cause long-term damage to international partnerships painstakingly built over years.

Not only do international collaborative efforts rely on USAID funding, Cappello said, but it is also important to continue to give resources to people who have spent decades cultivating relationships and trust with international institutions, governments and universities. 

He warned that the consequences could extend far beyond individual programs or universities.

“The consequences are going to echo for decades in terms of the loss of trust, the loss of scientific progress and the loss of lives saved,” Cappello said.

USAID was founded on Nov. 3, 1961.