Johannesburg: HIV patients are losing access to medication, while healthcare programs have come to a halt. What impact are the Trump administration’s USAID cuts having on healthcare in Africa? For the inhabitants of remote South African villages, getting access to medication is a challenge. HIV patients like 19-year-old Nozuko Majola must travel more than an hour to get the vital antiretroviral medication they need. But it wasn’t always like this.
According to Deutsche Welle, US funding cuts to South Africa’s HIV/AIDS programs could lead to more than 500,000 deaths over the next decade, as stated by Linda-Gail Bekker, head of the Desmond Tutu HIV Foundation, in February. After taking office on January 20, President Trump issued an executive order pausing foreign aid assistance for 90 days, culminating in the decision to dismantle USAID as an independent agency. This resulted in a 90% reduction in foreign contracts and grants funded by the US aid agency.
Such funding cuts have been a significant blow to many
African countries. Sub-Saharan Africa, the second-largest recipient of USAID funding worldwide, received $12.7 billion in 2024. The Africa Centres for Disease Control and Prevention (Africa CDC) warns that up to 4 million additional people could now die from treatable diseases in Africa due to the loss of US funding.
The pan-African NGO Amref Health Africa, which trains specialists and provides medical care to nearly 20 million people annually, lost 20% of its budget primarily due to these US cuts. In Ethiopia, educational programs for thousands of young people have been canceled, and in Tanzania, 500,000 tuberculosis screenings could not be carried out, according to Amref.
“We are seeing massive gaps in all countries. All sectors where humanitarian aid is needed are affected,” said Lara Dovifat, head of advocacy at Doctors Without Borders (Medecins Sans Frontières, MSF) in Germany. In South Sudan, MSF is struggling to respond to a cholera outbreak due to a shortage of aid workers after USAID-funded clinics
were forced to close.
Dovifat also highlights the situation in Somalia, where the number of malnourished children is rising as numerous nutrition centers have closed. In Sudan, a USAID-funded water supply system was shut down overnight.
The cut in funding related to the fight against HIV/AIDS is particularly severe. The US no longer funds UNAIDS, the UN’s HIV/AIDS funding program. In Kenya, funding has plummeted from $846 million to just $66 million for 2025, leading to the closure of numerous HIV treatment centers and leaving up to a million people infected with HIV without medication.
In Nigeria, although the government managed to release around $3.2 million in US aid for HIV medication, setbacks in combating HIV/AIDS, tuberculosis, and malaria are certain without continued US support. The international community had set up the Global Fund in Geneva in 2002 to finance the fight against these infectious diseases.
Michael Byrne, head of the Global Fund’s technical advice and partnerships department, expre
ssed concern about the cutbacks in malaria prevention programs. “If you don’t get malaria under control, then it’s very likely that there will be a significant resurgence and deaths,” Byrne told DW. Malaria claims 600,000 lives annually, most of them children under the age of 5 in Africa, according to the World Health Organization.
MSF’s Dovifat also fears that the cuts could undo the progress made in disease prevention over the past 10 to 20 years. Many programs, including those for tuberculosis and outbreak control, have been stopped. The US is also cutting funding to Gavi, the Vaccine Alliance, which provides vaccines to children in low-income countries. USAID accounts for about 13% of Gavi’s budget. As a result, 75 million children are expected to miss routine vaccinations over the next five years, potentially leading to up to 1.3 million preventable deaths.
Countries like the Democratic Republic of Congo, where MSF plays a crucial role in providing vaccines in areas with limited access to healthcare, w
ill be significantly affected by the withdrawal of US funding to Gavi. Despite the setbacks, Byrne remains hopeful about the future, noting that countries across sub-Saharan Africa have been quick to plan on the national level and come up with domestic funding.
For instance, Uganda and Malawi have issued communiques stating that their countries would step in to fill the gaps, implementing policy measures to support community health workers. Many in the sector hope that other countries will not follow the US in cutting funds. “The situation we find ourselves in now is not just about one country. There has been a trend in this direction for some time,” Byrne said. “If we don’t get infectious diseases under control, we will have to pay more later – and wealthier countries will feel that too.”