The intergenerational legacies of research disinvestment, aid retrenchment and transactional compacts on global women's health.

Global health funding by the United States government declined precipitously in 2025, triggering a cascade of international disinvestment in women's health in low and middle-income countries, followed by a new era of 'America First' aid policy. Successive budget cuts by other high-income countries compounded the effects of these abrupt policy and geopolitical changes on women's health, safety, and access to life saving and health assuring prevention, care and treatment, worldwide. Abandonment of active programmes and research studies disproportionately harms women by disrupting employment, reversing progress in education, eroding essential services and undermining community partnerships. The global health funding crisis weakens systems and diminishes capacity, impacting women's physical and mental health, economic survival, and equity of opportunity across the life-course. New proposals to tie aid funding to data sharing have disproportionate impacts on women, while continued hostility to gender diversity places non-binary and transgender people at increased risk of further marginalisation. The current moment of crisis also illuminates profound limitations of the international systems which previously governed global health, indicating opportunities for transformation. In this Essay, we outline the foreseeable, intergenerational harms of defunding initiatives which promote and enhance the health and safety of women everywhere or tie their funding to agendas which would erode women's reproductive autonomy. Amid deliberate efforts to disorientate opposition through simultaneous and sequential upheavals and concerted censorship of academic freedom, we call for concerted outcry, organised resistance, and synchronous action to safeguard women's health and rights before more damage is done.