As World Health Summit opens, IRC warns global health investment in fragile states is declining as disease outbreaks pose growing threat

Berlin, Germany, October 9, 2026 —  As global health leaders gather in Berlin for the World Health Summit, the International Rescue Committee (IRC) warns that a sharp retreat in global health spending is putting lives and hard-won health gains at risk in the world’s most fragile and conflict-affected states. 

The consequences of that retreat are increasingly urgent. In eastern Democratic Republic of Congo (DRC), an outbreak of the Bundibugyo strain of Ebola–for which there is no approved vaccine– has spread across seven provinces and into neighboring Uganda and Kenya. Since the first case was confirmed in May, nearly 8,500 people have been infected and more than 4,000 have died. 

“Every dollar cut from health in fragile states is a risk to lives and livelihoods not just locally but globally,” said Alyoscia D’Onofrio, vice president and head of technical excellence at the IRC. “Resilience is built in the places where crises begin. We have shown that it’s possible to cost-effectively vaccinate children even in the most hard–to-reach places if we have the resources.” 

IRC has proven progress in fragile and conflict-affected states is possible. The Gavi-funded Reaching Every Child in Humanitarian settings (REACH) consortium, led by the IRC, has now delivered more than 40 million vaccine doses to children in six conflict-affected countries, up from 20 million a year ago. REACH was built for communities that government health systems cannot safely reach, some of which had not seen a vaccine in more than a decade. When it launched in 2022, humanitarian organizations could access just 16% of its 156 target communities; today they reach all of them. 

Those hard-won gains are now at risk as donors cut health budgets to a 15-year low – widening the gulf in health equity and outcomes between fragile and stable settings. In Afghanistan alone, the number of health facilities the IRC supports fell by 70% in 2025. Fragile and conflict-affected settings experience more than 70% of global outbreaks of epidemic-prone diseases such as cholera, measles and meningitis. One in five of the world’s children now live in these countries, where children face a mortality rate three times higher than their peers in stable settings, and are three times less likely to receive any routine vaccines. The maternal mortality ratio for a woman living in a fragile or conflict-affected setting is five times higher than her peers in stable settings. 

The IRC is calling on governments, donors and multilateral institutions at the World Health Summit to:

• Restore global health financing and direct a fair share to fragile and conflict-affected settings, where outbreak risk and preventable deaths are highest.
• Disburse pledged Ebola funds now and route them to the local health workers and community leaders leading surveillance, case-finding and community engagement.
• Invest in prevention before the next outbreak: routine immunization, disease surveillance and the community health workers who detect threats first. The IRC supports more than 15,000 community health workers across its programs.
• Engage humanitarian organizations at both the global and grassroots levels to systematically and at scale to extend childhood immunizations to people in conflict-affected settings and challenging contexts.

The IRC is a global leader in delivering essential health services and building resilient health systems in fragile and conflict-affected areas. The IRC’s health programs are designed to address both immediate crises and long-term challenges faced by vulnerable populations worldwide, focusing on foundational primary health care programming – ensuring we continue to deliver lifesaving services during crisis and recovery, while building resilient health systems. In FY2025, the International Rescue Committee (IRC) delivered vital health services to nearly 17 million people.