The U.S. federal government has cut funds for international health research and global health aid, withdrawn from the World Health Organization. With this retreat from commitments to international health work compounded by cuts from the European Union, many leaders in global health are examining the obstacles for global health research and care delivery with fresh eyes.
Even in the face of these obstacles, this is a moment of great possibility, with novel medications like lenacapavir promising to transform the treatment and prevention of HIV; shorter, less toxic, and more affordable treatments for drug-resistant tuberculosis; and remarkable efforts to build global capacity to deliver surgical, chronic disease, and cancer care.
Drawing on two decades of experience delivering medicine in challenging circumstances — including the world’s first cholera vaccination program in the midst of an outbreak — and researching how to get care where it’s most needed, Louise Ivers discussed her vision of the road ahead with Harvard Medicine News.
Ivers is professor of global health and social medicine in the Blavatnik Institute at HMS, HMS professor of medicine at Massachusetts General Hospital, and director of the Harvard Global Health Institute at Harvard University.
Harvard Medicine News: What does the future of global health research and care delivery look like in the context of the massive international funding cuts we’re seeing?
Louise Ivers: The thing to say first and loudest is, we must persist, and we will persist.
The global community of people who work in solidarity to achieve health for all is not going to be dissuaded of the moral imperative to do this work.
I think it’s also vitally important that we communicate more with the people who don’t see the value in our lifesaving work. Millions of people around the world who were receiving medicines funded by the U.S. federal government are likely to lose their lives since those programs have been cut, and hundreds of thousands have already died, but there are many Americans who are glad that those programs are gone. Some of that is our fault for thinking we had everyone alongside us when instead we have neglected to properly engage with everyone and explain the impact and importance of what we do.
Telling the stories of our successes and the challenges that we face working in global health is an important part of the work.
HMNews: How does this moment compare to other challenging times you’ve seen?
Ivers: If you look back to the HIV epidemic at its height, it often didn’t seem there was a clear path forward. Even when we had powerful new medicines, it was very difficult to get them to the people who needed them and couldn’t afford to pay. For too long it looked like the international community of wealthy countries wasn’t going to get on board with contributing to supporting that work.
We’re at a similar moment now. We have amazing new drugs that have the potential to change the face of HIV, yet many of the sources of funding that would have helped provide these lifesaving drugs have dried up.
But there are always moments of great progress and hope. For example, the creation of the Global Fund for AIDS, TB, and Malaria in 2002 offered hope among uncertainty, and in 2003 President George W. Bush became a leader in providing financial resources to fight HIV. That support fueled huge progress.
We have a moral responsibility to find ways to make sure that this kind of lifesaving care is available to everyone who needs it.
HMNews: What inspires your determination to carry on?
Ivers: The situation in Haiti, where I’ve worked for 20 years, is very, very difficult right now from a humanitarian perspective. There’s food insecurity; violent gangs that make it difficult just to move from place to place; and local, regional, and global political obstacles that make it challenging to solve these problems.
And yet, my Haitian colleagues keep putting one foot in front of the other, caring for patients the best they can every single day.
Knowing that helps me keep things in perspective.
HMNews: What is the role of an academic institution like Harvard in building global health in 2026?
Ivers: I think global health work exemplifies the ideals of what a university can be, generating new knowledge and educating people across disciplines, all connected to the goal of the betterment of humanity.
Harvard has an incredible capacity to bring people together from across disciplines and from around the world to work on complex issues. We’re also leaders at intertwining biological discovery, biomedical innovation, and the social sciences.
That’s key, because global health problems can’t be solved in isolation.
HMNews: What are some key insights from the work you’ve done that could be particularly helpful in this moment?
Ivers: One key to the successes that global health researchers and clinicians have had at Harvard, largely inspired by leaders like our dearly missed colleague Paul Farmer, is working closely with people who live with the problems you’re aiming to solve and centering their experiences and inputs. That proximity is essential to collective action in overcoming global challenges.
Many faculty members across the university have highly impactful relationships with academic medical centers and health care delivery organizations around the world that are based in communities that face tremendous health challenges and are doing remarkable work to address them. Just to name two examples, the Department of Global Health and Social Medicine at HMS works with the University of Global Health Equity in Rwanda through the Paul Farmer Collaborative, and the Harvard T.H. Chan School of Public Health has been working for nearly three decades with the Botswana Harvard Partnership.
The people who are closest to the problems are the ones who understand the problems the best, and they are also usually the ones with the solutions. As educators, researchers, and clinicians, we have skills that, working collectively with our partners, can help transform ideas for a solution into a reality and to help prepare the next generation of leaders to carry that work forward. That works in both directions, because our community at Harvard is deeply enriched by our global collaborations and our global faculty and student body.
HMNews: How can the Harvard Global Health Institute help future-proof global health efforts?
Ivers: Our mission is to bring together people from across the University’s many faculties who are already working on global health issues. So, for example, we have a call for applications for small grants to convene scholarly working groups from at least two schools each. We also run an internship program for undergraduates, matching them to service and research opportunities in global health.
The philanthropic support our faculty receive for this kind of interdisciplinary global health research is crucial, because even in the best of times many traditional research funders often don’t support these kinds of creative, foundational projects that can provide a transformative spark.
One of our most important jobs is finding ways to nurture that spark and keep it growing brighter and brighter.
HMNews: Can you give me an example of how bringing people together helps spark solutions?
Ivers: Megan Murray [the Ronda Stryker and William Johnston Professor of Global Health at HMS] convened a scholarly working group that brought together people from communities around the world that are confronting serious health problems related to climate change. They were rural and urban, arctic and tropical, labor organizers and Indigenous leaders. At the meeting, they made surprising, exciting connections between their common challenges and shared insights on solutions that they were exploring. Now they’re continuing to work with one another and with Harvard researchers and clinicians to find and deploy solutions.
As educators, researchers, and clinicians, we have skills that can help transform an idea for a solution into a reality and to help prepare the next generation of leaders to carry that work forward.
This interview was edited for length and clarity.
