Though the main impact I suspect won't be the lack of global vaccine development and availability ( the US is important - but not the whole world ), but rather in the diminishing of the US science and industry base.
The gates foundation notoriously doesn’t pay any sort of reasonable overhead so taking their money often costs as much as they give. They are still giving, which is fantastic, but there are some footnotes with that giving.
Though the main impact I suspect won't be the lack of global vaccine development and availability ( the US is important - but not the whole world ), but rather in the diminishing of the US science and industry base.