• Trump’s decision to suspend US foreign aid has disrupted essential health, education, and humanitarian programs across Africa
• Programs for HIV/AIDS, Ebola, tuberculosis, malaria, maternal and child healthcare, and food security impacted in countries including Tanzania, Uganda, Kenya, South Sudan, and Ethiopia
• Analyst warns of security risks for Africa: ‘When people lose access to food and healthcare, they lose faith in their governments. That’s when instability takes root' 

In the remote village of Kibeleje in Tanzania’s Mkuranga district, Sophia Mwenda sat on a worn wooden bench inside a small clinic, her hands trembling.

She had walked six miles under the scorching sun to refill her supply of antiretroviral (ARV) medication, only to hear the devastating words she had feared: “We don’t have the drugs at the moment.”

For years, Mwenda had relied on US-funded HIV programs for free treatment, but after the Trump administration’s sudden freeze on foreign aid – including the President’s Emergency Plan for AIDS Relief (PEPFAR) – clinics across Africa began running out of lifesaving medication.

Now, millions across the continent face an uncertain future like Mwenda, as Washington’s abrupt aid suspension disrupts essential health, education, and humanitarian programs.

When President Donald Trump signed an executive order freezing all new government spending on foreign aid for 90 days pending review, the United States Agency for International Development (USAID) shut down its operations overnight.

Its website went dark, social media accounts disappeared, and staff were locked out of email servers. PEPFAR, which had invested over $110 billion since 2003 to combat HIV/AIDS, saw its funding dry up.  

Looming health crisis

The impact has been immediate. Across Africa, health clinics, NGOs, and hospitals reliant on US aid are scrambling to fill the void, while governments, already struggling with limited resources, are left with few alternatives.

Some 15 million people in Sub-Saharan Africa depend on PEPFAR-funded ARVs. UNAIDS estimates that within months, at least 1 million people could face treatment disruptions, leading to tens of thousands of preventable deaths.

Beyond HIV/AIDS, the aid freeze is affecting maternal and child healthcare, tuberculosis, and malaria programs.

USAID previously contributed over $800 million annually to maternal and child health initiatives. With funding halted, UNICEF warns that 2.5 million women and children may lose access to life-saving medical services.

The US was also the largest donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria, contributing over $1.5 billion annually, and its withdrawal jeopardizes efforts that have prevented 44 million malaria deaths since 2000.

Africa accounts for around 95% of global malaria cases, and for years, US funding provided free mosquito nets, diagnostic tests, and treatments in countries across the continent. Now, experts warn that malaria deaths could surge by 20% in high-burden nations like Nigeria, the Democratic Republic of Congo, and Mozambique.

Similarly, the Global Fund warns that 500,000 tuberculosis patients could go untreated this year alone. Additionally, Washington was the top donor to the World Food Program (WFP), providing $7 billion in 2023. Without that funding, WFP warns that at least 12 million people in East and West Africa are at risk of severe food insecurity.  

AIDS programs in jeopardy

For nearly two decades, PEPFAR helped turn the tide against HIV/AIDS in Africa, leading to declining infection rates and rising life expectancy in countries like Tanzania, Uganda, and Zambia. Now, those hard-won gains are at risk.

In Tanzania alone, 1.4 million people rely on PEPFAR-funded ARVs, and health experts warn that within six months, hospitals will be overwhelmed with AIDS-related complications.

“We are already seeing treatment interruptions,” said Dr. Julius Lymo, an HIV/AIDS specialist at Bagamoyo District Hospital in Tanzania’s eastern Pwani Region.

“Patients who stop taking ARVs develop drug resistance, and then the virus comes back stronger.”

Uganda faces a similar crisis, with 150,000 people at risk of losing HIV treatment, while Zambia has already reported a 20% increase in untreated HIV cases since the aid freeze began.  

Emerging Ebola threat

The funding freeze is also crippling Africa’s ability to respond to infectious disease outbreaks. In Uganda’s Kasese district, a hotspot for Ebola, health officials warn that funding cuts have halted disease surveillance programs.

“While we have a strong local response in Uganda, many of our efforts are supported by external aid. This freeze will undoubtedly strain our ability to mobilize resources quickly,” Dr. Andrew Kambugu, director of the Infectious Diseases Institute in Uganda, told Anadolu.

According to Kambugu, the freeze has come at a dangerous time, when the threat of an Ebola outbreak is high and every resource is critical.

“Halting financial support now, when every resource matters, could have consequences far beyond Uganda’s borders,” he said. “It sends a dangerous message that we are less valuable when it comes to global health emergencies.”

While Uganda will mobilize domestic resources for the crisis, without the vital support of foreign aid, it may face challenges that could have been avoided, he said.

“It’s important for us to have a safety net, and right now, that net has been compromised.”

Liberia and Sierra Leone, two nations that fought devastating Ebola outbreaks in the past, have also been affected.

US-funded research labs that played a key role in containing previous outbreaks have shut down, and health experts fear that without early intervention, new outbreaks could spiral into regional epidemics.  

Economic and social turmoil

The consequences of the US funding cuts could extend beyond public health in Africa and other developing regions, as food insecurity, unemployment, and collapsing health services create fertile ground for political instability.

The aid freeze is devastating Africa’s civil society sector, which employs thousands of workers in health, education, and humanitarian fields.

In Kenya, over 5,000 health workers and NGO employees have been laid off as foreign-funded projects shut down, while small NGOs in Nigeria that relied on US grants for education and healthcare services are closing.

Over in Ethiopia, USAID-supported food security programs that helped 8 million people annually have ceased operations, while the specter of famine is looming larger in Sudan and South Sudan, where millions relied on USAID emergency food aid.

For the Sahel region, apprehensions grow that economic desperation could drive more youth into extremist groups.

“The US may see this as a cost-cutting measure, but for Africa, it’s a security risk,” said Samuel Okello, a researcher in Nairobi.

“When people lose access to food and healthcare, they lose faith in their governments. That’s when instability takes root.”

With Washington unlikely to reverse course, African nations are scrambling for alternatives.

The African Union is lobbying European donors and private philanthropists, while China has pledged additional healthcare investments, though critics warn of debt-heavy conditions.

The Gates Foundation has also increased its support, though its funding remains only a fraction of what the US provided.

For people like Sophia, sitting in that quiet clinic in Kibeleje with empty medicine shelves, the aid freeze is more than just a political decision – it’s a matter of life and death.

“I don’t understand why this is happening,” she said. “I just want to live.” By Kizito Makoye, Anadolu agency