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A growing wave of nationalism is sweeping across the West and demanding a sharper focus on domestic issues and lesser engagement abroad. For global health investments in Africa, which have been heavily supported by international funding, these happenings call for increased domestic investments in health and other areas of development.

The rise of nationalism sentiments have been wide ranging – from Austria, to France and the Netherlands. However, two recent developments – the victory by the Brexiters in the UK in June 2016 and the election of President Trump in the U.S. less than five months later – are certainly the most momentous. The two events are the best exemplifications of the global politics of the times. More and more countries seem to be looking inward, not outward. In his inaugural speech as the President of the United States, Donald Trump vowed: “From this day forward, it’s going to be only America first, America first. Every decision on trade, on taxes, on immigration, on foreign affairs will be made to benefit American workers and American families.”

While it is still early to know what effect the Trump administration’s policies will have on global development, The New York Times has reported that the administration is “preparing executive orders that would clear the way to drastically reduce the United States’ role in the United Nations and other international organizations.” The orders would kick off the process of reviewing and potentially repealing certain forms of multilateral treaties, the Times reported.

For years now, advocates across Africa have been calling on African governments to step up their investments in global health.  Africa bears a disproportionate burden of diseases. It is estimated that sub-Saharan Africa has 11 percent of the world’s population but 24 percent of disease burden. Despite the tremendous progress made against the big three infectious diseases – HIV, TB and malaria – numerous African’s continue to die of these diseases every year. To end these diseases and others that continue to kill many on the continent, advocates have called on African governments to find ways to invest more of their own money towards this cause.

Progress against major infectious diseases in the last two decades has been unequivocal. For instance, an estimated 790 000 people died in the African Region from HIV-related causes in 2014, according to WHO. That was a 48 percent drop in number of deaths from the disease compared to 1.5 million people in 2004. That progress was achieved through strong investments by international development funders and African governments. To end HIV, TB and other diseases as epidemics, advocates have called on international funders and African governments to do more.

With the growing wave of nationalism, and the possibility that contributions by international funders can decline, African countries have a bigger duty to ensure that this progress does not stall.  If funding levels from the U.S. – the single biggest investor in international funding for global health – falls, the dream of ending HIV, tuberculosis and malaria as epidemics by 2030 may not be realized. We hope that the U.S. and other big donor governments will safeguard and advance this work, completing the wonderful job they started. This is especially crucial, as we get closer than ever to ending major diseases as epidemics.

We call on African countries to step up their investments in global health to fill any gaps that may be left by a possible decline in international funding.

If it turns out that the growing anti-globalization sentiments will not result to reduced investments in global health, then that sustained funding and stronger investments by African governments can help us to press forward faster with the goals of ending HIV, TB and malaria as epidemics by 2030 as well as build stronger health systems to tackle other diseases. This would be a landmark victory for all in the world, which would save millions and millions of lives, revitalize communities, create stronger economies and spawn greater benefits for all people in all corners of the world.

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