JENÉE FARRELL
IN JANUARY, a pivotal shift in global health governance sent shock waves around the world. With an executive order setting the stage for the US to exit the World Health Organization by January 2026 – and with USAID now dismantled – the Caribbean finds itself at a critical crossroads.
For decades, US funding and expertise powered essential programmes across our region, from HIV/AIDS prevention to hurricane disaster response. Today, Caribbean nations must reimagine public health security by embracing regional innovation and South-South collaboration. For a region already vulnerable to climate change, infectious diseases, and economic instability, this shift is not just a challenge – it is an opportunity to build a healthier, more self-reliant future.
Rethinking health security
The implications of the US withdrawal are profound. Without nearly US$1 billion in annual US contributions to WHO’s budget, essential initiatives – from vaccine procurement to disease surveillance and emergency response – face significant funding gaps.
Smaller island developing states, which have historically relied on external support to bolster their health systems, are especially vulnerable to these disruptions. For example, US funding has been instrumental in programmes like the President’s Emergency Plan for AIDS Relief (PEPFAR), Caribbean Regional Programme (CRP), which has helped reduce HIV/AIDS prevalence in the Caribbean, and in disaster response efforts following hurricanes like Beryl and Dorian.
In response, Antigua and Barbuda is leading a proactive initiative to strengthen regional public health security. According to the Antigua Observer, the nation’s cabinet has approved plans to present a draft Caribbean Community (Caricom) resolution that would enable member states to set aside dedicated funds for vaccine procurement – operating independently of traditional international frameworks.
As chief of staff ambassador Lionel Hurst noted, “We are preparing ourselves, utilising a mechanism that could be very helpful whenever and if ever there is a pandemic in the future.”
This move not only promises to protect Caribbean nations from potential disruptions, but also offers a blueprint for others striving for healthcare autonomy.
Strengthening regional health systems through Carpha
In this new era of diminished external support, the Caribbean Public Health Agency (Carpha) – the region’s sole dedicated public health body – remains essential to safeguarding our shared future. Carpha’s co-ordination of regional health responses, enhancement of disease surveillance, and provision of technical expertise have proven vital, as demonstrated during the covid19 pandemic when it ensured equitable vaccine distribution and shared real-time infection data.
By fostering collaboration among member states, harnessing innovative solutions, and advocating sustainable health financing, Carpha can support a resilient public health infrastructure. However, achieving this will require greater investment from Caribbean gover
