Several African countries’ health systems remain critically vulnerable to the fallout from President Donald Trump’s ongoing efforts to scale back U.S. foreign assistance, most notably through the dismantling of the U.S. Agency for International Development (USAID).
- Several African countries are critically vulnerable due to reduced U.S. foreign assistance, particularly from cuts to USAID programs.
- For some nations like Somalia and South Sudan, U.S. health aid constitutes over 200% of their government health spending, making them heavily reliant.
- Cuts to U.S. health aid threaten African public health progress and may lead to global health risks due to weakened disease surveillance capabilities.
Newly released data shows how heavily African health systems rely on U.S. aid, raising serious concerns about the impact of abrupt funding cuts on public health across the continent.
According to the Center for Global Development, the United States has been a central player in supporting global health supply chains, particularly through the Global Health Supply Chain – Procurement and Supply Management (GHSC-PSM) project.
In 2024 alone, the project supported 73 countries and disbursed $1.15 billion in donated health commodities and technical assistance.
The majority of the funding focused on HIV (71.1%), followed by malaria (20.3%), family planning (7%), and maternal, neonatal, and child health (1.5%).
In nine countries, this aid accounted for more than 10% of total government health spending, levels that are difficult to replace with domestic resources.
Trump’s freeze on $72 billion in U.S. foreign aid spending led to the suspension of hundreds of development projects in over 200 countries and territories, affecting nearly 10,000 USAID personnel.
In total, the administration terminated 5,341 projects worth $75 billion and initiated a sharp reduction in USAID staffing, signaling a dramatic shift in America’s approach to global development.
For Africa, where U.S. aid often supports core health services, these actions threaten to reverse years of progress in disease control, maternal health, and emergency preparedness, while exposing millions to increased health risks.
African nations most hit by US health aid cuts
Recent data sourced from Business Daily Africa shows that countries like Somalia, South Sudan, and Malawi are among the most at risk, with U.S. health aid making up 237%, 235%, and 207% of their government health spending, respectively.
The chart below ranks the top 10 African countries most vulnerable to Trump’s health aid cuts, based on U.S. health aid as a percentage of government health spending:
In over 20 African countries, U.S. assistance forms a vital share of national health budgets. For nations like Uganda, Liberia, and Mozambique, it covers more than 80% of health spending, supporting key services such as HIV/AIDS treatment, immunizations, and maternal care.
The impact would be especially severe in fragile states like Somalia and South Sudan, where local systems cannot absorb such a shock. In these countries, U.S. aid underpins essential services, and its loss could trigger a collapse in healthcare delivery and a rise in preventable diseases.
Although experts warn that cutting U.S. support could weaken disease surveillance and emergency response, increasing the risk of regional outbreaks with global consequences, African leaders are being urged to reconsider their approach to health funding and broader public health strategy.
