Global cuts, local consequences: Why the NHS needs international aid

This week, the government made a tough call – reducing the UK’s international aid budget from 0.5% to 0.3% of GNI to boost defence spending. The decision came fast and the backlash came faster.  

Many in the global health community felt blindsided. For millions in low- and middle-income countries, these cuts could mean fewer vaccines, weaker health systems and reduced access to life-saving treatments.  Lives will be lost. And yet only a few weeks earlier, UK Ministers had reinforced the importance of international aid in the wake of the US plans to slash the foreign aid budget. Now, the tables have turned. The shockwaves are still rippling.  

Beyond the global consequences, this decision poses a growing challenge at home – one that could hit the NHS hard.  

Because when Britain pulls away from the world, the world pulls away from Britain.  

The NHS runs on global talent  

Right now, nearly one in five NHS staff – including doctors, nurses, paramedics, and midwives – hold a nationality other than British. They don’t just keep our health service running; they keep it thriving.  

Their expertise, language skills and global connections strengthen patient care and link us to over 200 health systems worldwide. They help make the NHS one of the most internationally engaged healthcare systems on the planet.  

Through health partnerships like those led by Global Health Partnerships (formerly THET), these diaspora professionals bring insights that improve NHS healthcare delivery. The NHS learns from best practices worldwide, adopting new techniques, technologies and models of care. In our 2022 survey of 1,000 NHS workers, 88% said the NHS can learn from overseas health systems and 96% agreed that sharing clinical skills worldwide makes healthcare better for everyone.  

But these professionals are already under pressure. From staff shortages and racism to gruelling shifts and limited career progression, the challenges they face are stacking up. And now, with Britain seemingly retreating from global commitments, many may start seeing the UK as a career stepping stone, not a destination.   

Worse still, we risk losing the soft power advantage that has made Britain a leader in global health. The NHS isn’t just a national treasure – it’s a bridge to the world. But that bridge is weakening.  

A nurse’s dilemma: stay or go?  

Nchima Mwaba, a nurse from Zambia, arrived in the UK expecting to build on her career. Back home, she advanced quickly, but in the NHS, she was pushed into a lower role than her qualifications deserved – a frustration many internationally trained staff face.  

Struggling to balance work and family, she moved into a training role for flexibility- but the real shock came when she looked around. Of the five African nurses she started with, she’s the only one still in the NHS. The others left, feeling undervalued, overworked or simply unable to progress.  

Now, as Treasurer of the Association of Zambian Nurses UK (AZNUK), she sees the same pattern repeating: talented international staff leaving the NHS for better opportunities elsewhere – Australia, Canada, the US – where salaries are higher and visas are easier. And if more follow, the UK faces a workforce crisis it cannot afford.  

On March 18-19, Health Ministers, Permanent Secretaries and key policymakers from across 15 African countries will gather in London for the landmark 2025 UK-Africa Health Summit. They’ll join representatives from the UK government and WHO to discuss health workforce migration, international recruitment and the role of diaspora staff in UK and African health systems. The appetite for collaboration is clear.   

If the UK withdraws from international health partnerships, what message does that send to the very professionals who staff our hospitals, train our workforce and keep our NHS afloat?  

Global projects, local benefit  

Global health partnerships address some of the biggest health challenges that affect us all.    

Take our highly successful international programme on tackling superbugs – the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS). Across Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Uganda, and Zambia, this programme has trained over 6,500 healthcare workers to improve antibiotic use and infection control. It has helped create standardised treatment guidelines in nearly 70 African hospitals, strengthening patient care and reducing drug resistance. By embedding pharmacists in hospital wards and decision-making teams, it has empowered healthcare workers and built more resilient health systems – benefiting both local populations and the global fight against antimicrobial resistance (AMR).  

These partnerships aren’t just acts of goodwill – they create stronger, safer healthcare everywhere. When the UK supports health systems overseas, it also strengthens its own, ensuring shared solutions to shared challenges.   

Public perception vs. reality  

A recent YouGov survey found that 64% of Britons believe the UK spends too much on international aid.   

What many don’t realise is that foreign aid is a tiny fraction of UK Government spending – just 0.5p (now dropping to 0.3p by 2027) in every tax pound, far below the UN’s 0.7p target that the UK previously committed to.  

The reality is UK aid isn’t just about helping others – it’s about learning from what others can teach us and strengthening Britain’s place in the world.  

It prevents health crises before they reach UK shores, strengthens diplomatic ties and helps retain the international workforce that keeps our NHS running.  

That’s why we urge the government to think carefully about what’s at stake. Ministers know better than anyone that these cuts weren’t a choice they wanted to make. But as we move forward, we must not lose sight of the bigger picture – keeping Britain open, connected and leading on global health.  

Because when we cut ties with the world, the impact is felt not just in distant countries – it’s felt in lives lost to preventable diseases, in communities without access to vital medicines and in an NHS struggling to recruit and retain the global talent it relies on. Global health partnerships save lives, improve healthcare and protect us all.