Recent developments in the U.S. government have put global health funding, particularly for malaria, at dire risk. With shifts in foreign aid priorities and budget cuts to the U.S. President's Malaria Initiative (PMI), the continued progress in malaria control and elimination is uncertain. Malaria remains the deadliest parasitic disease, claiming nearly 600,000 lives annually, with young African children disproportionately affected. Historically, the United States has played a leading role in financing global malaria control efforts. The current retreat by the US government puts progress at risk and raises serious questions about the mutual benefits resulting from these investments.

How are malaria programs currently funded?
Malaria programs are supported with domestic funds from endemic countries and international funding. Domestic funds covered 37% of the 4.0 billion annual target in 2023, this is quite significant when put into perspective as the collective share of the global GDP from Sub-Saharan Africa is 2.5%. International funds are mostly funneled through The Global Fund to Fight AIDS, Tuberculosis and Malaria, a dedicated global partnership that aims at raising and investing US$ 5 billion a year in programs against these diseases.

For malaria, the global fund channeled another 37% of all international financing for malaria in 2023, which resulted in 227 million protective mosquito nets distributed over 300 million malaria tests and 171 million treatments. Approximately one third of the Global Fund contributions come from the US and one third from the European commission and EU member states.

The rest of the international support is channeled through bilateral funds with the US as clear leader with 800 million invested through PMI in 2023. The UK is the second largest bilateral donor, the rest is covered by smaller amounts from the World Bank and countries members of the Development Assistance Committee. There is no equivalent to this malaria-specific bilateral initiative in Europe. The gap in the target investment for malaria control in 2023 was of US$ 5 billion.

The Economic Case for Investment
The evidence is clear: malaria eradication is a high-return investment. The Roll Back Malaria partnership estimated in US$ 41.6 billion the cost of reducing by 90% the global malaria burden by 2030 according to the goals set by WHO. If this price tag seems high, perhaps a reference could help, this is approximately the cost of Brexit settlement to the UK taxpayer as estimated by the House of commons. In contrast with Brexit however, the outcome of reducing malaria by 90% would be of undebatable humanitarian benefits, with estimated 1.3 billion cases averted and 4.5 million lives saved. Yet too little is discussed about the expected economic output of this investment, which is estimated at US$ 4.1 trillion, or a return on investment of up to 60 to one in the African continent over 15 years. This is mostly due to increased productivity and greater household prosperity. In comparison, NVIDIA promises up to 7 to one over 4 years on GPU doing AI inference work.

Modelling work conducted eight years ago estimated that averting one Disability Adjusted Life Year (DALY) - a measure of overall disease burden that represents the total years of healthy life lost due to illness, disability, or premature death- costs US$ 94 for PMI-funded interventions or 99.6% cheaper than the US$ 25,000 per DALY averted by colorectal cancer screening..

Europe stands to gain significantly from a healthier and more stable African neighbor. The US retreat indicates either a gross miscalculation of the human and economic losses associated with these cuts or that their assessment of the strategic and economic value of malaria control or elimination is lower than it used to be. A European-led malaria initiative could strengthen trade relations, support local economies, and reduce migration pressures driven by health and economic insecurity. If the U.S. steps back, does Europe step forward? -Or does it cede influence to China and Russia, who are actively expanding their presence in Africa?

From Colonial Past to Constructive Partnership
Europe's history with Africa is fraught with a colonial legacy that has shaped many of today's geopolitical realities. But as Europe looks to redefine its relationship with the continent, investing in malaria eradication offers a pathway to a new, cooperative partnership. This is not about charity-it is about mutual benefit. A Europe that leads on malaria will foster goodwill, promote economic integration, and strengthen its diplomatic standing across African nations.

Critics might argue that European budgets are already strained. However, the macroeconomic analysis by Patouillard et al. (2023) suggests that scaling up malaria control in high-burden countries could add $152 billion in economic dividends over the next decade. The cost of inaction, on the other hand, is far greater. Malaria prevention and treatment drains already strained national healthcare budgets which in many cases are less than US$ 20 per person per year.  The disease keeps millions of people out of work, reducing productivity and perpetuating poverty.

The vacuum created by the overnight dismantling of the US President`s Malaria initiative offers a clear opportunity for leadership at the European commission.

A Strategic Opportunity for Europe
The current U.S. administration has deprioritized soft power initiatives in favor of transactional diplomacy. This shift leaves a vacuum-one that China and Russia are eager to fill. Europe, with its expertise in global health, financial muscle, and historical ties to Africa, is uniquely positioned to step in.

The Global Fund to Fight AIDS, Tuberculosis, and Malaria, as well as initiatives by the World Health Organization and local African governments, provide existing frameworks that Europe can build upon. A dedicated European Malaria Initiative, backed by public and private sector funds, could ensure continuity in life-saving interventions while demonstrating Europe's commitment to a forward-looking partnership with Africa.

Europe is already a key supplier of the insecticides and insecticide-treated nets used in malaria control, with major EU-based companies leading global production. A European Malaria Initiative could leverage this industrial strength by establishing a financing mechanism that scales up vector control interventions through public-private partnerships-ensuring both economic and public health dividends.

Europe's Opportunity to Lead: A Vision in Contrast To Insular Politics
The slogan "America First" reveals a win-lose perspective on global economics and politics. Whereas individual governments ponder the cost of being the last to follow suit, the European Union may find a win-win approach based on strategic partnerships that fill the leadership void. Malaria elimination is not beyond Europe's capabilities-it is a challenge that aligns with its economic, strategic, and humanitarian interests. Moreover, it is an opportunity to present what Europe stands for. On February 14, in Munich, during his first speech in Europe, Vice-President JD Vance issued a scathing challenge: Is Europe departing from its fundamental values? This is an opportunity to offer much more than lip service to the EU's founding values of human dignity, equality and human rights by creating a dedicated malaria fund which could be relocated from existing development funds and expanded with the involvement of the private sector through public-private partnerships.

Reducing malaria burden by 90% by 2030 would take roughly one year of USAID's budget. As Africa moves towards economic growth and regional integration through initiatives like the African Continental Free Trade Area, Europe has an opportunity to forge a healthier, more prosperous relationship with its southern neighbor. Ending malaria is not just a moral imperative; it is a strategic opportunity. Now, at times of uncertainty, is the time for Europe to lead and to make itself generous again through a transformative partnership with Africa. While some are busy running a wood chipper, planting a tree would be a most welcome sign of hope.

This article was originally published in Le Figaro. Read the original.