The Ripple Effect: How the US Aid Freeze is Crippling Reproductive Health and More in Africa
The announcement reverberated through the African continent like a seismic event, a cruel blow to the progress of women and girls. The suspension of US aid, declared on January 24th, has triggered a cascade of devastating consequences that experts fear will set back years of hard-won gains in reproductive health, disease prevention, and human rights. Carole Sekimpi, Africa Regional Director of MSI Reproductive Choices, an NGO that provides contraception and abortion services in 36 countries, expressed deep concern about the far-reaching impact.
For half a century, the United States has stood as the foremost donor in the realm of family planning, its contributions representing a staggering 43% of global funding for reproductive health in 2023. A substantial portion of these funds, a consistent $336 million annually since 2016, has been directed towards 41 African nations. Ethiopia and Nigeria have been among the largest beneficiaries, each receiving $22 million, followed by Uganda ($20 million) and Tanzania ($19 million). In countries like Kenya and Uganda, US aid has accounted for as much as 60% of the national health budget.
The question looming large is how many African women and girls will bear the brunt of this sudden withdrawal. According to NGOs, the repercussions are already unfolding with alarming speed. Elizabeth Sully, a senior researcher at the Guttmacher Institute, a research organization focused on sexual and reproductive health rights, estimates that a staggering 2.7 million women worldwide, including 2 million in Africa, have been deprived of access to contraceptives in just three weeks. Projecting forward to the end of the 90-day aid freeze, the institute anticipates that 8,000 women and girls globally will succumb to complications during pregnancy and childbirth, with 7,200 of these preventable deaths occurring in Africa.
On the ground, the effects of the funding cessation are acutely felt. A leader of an association in Côte d’Ivoire, speaking on condition of anonymity due to USAID restrictions on communication, reported shortages of contraceptives in certain areas. The lack of resources will lead to a surge in unintended pregnancies and unsafe abortions. Sarah Shaw, Associate Director at MSI, highlighted the dire situation in Burkina Faso, where thousands of displaced women, facing sexual violence and disease, are no longer receiving adequate care. Zambia has exhausted its contraceptive supplies. A public hospital supported by US aid has been forced to lay off 50 nurses. The family planning efforts depend 70% on US aid.
The aid freeze has broader implications for women’s health, including the fight against malaria. Pregnant women and children are especially vulnerable to the disease. The seasonal malaria prevention campaigns will be significantly disrupted. One prominent leader in the fight against malaria warned that they can no longer distribute mosquito nets, jeopardizing countless lives. Forced to speak anonymously to protect her organization’s access to future funding, she also faces the painful decision to lay off 1,400 employees, including 1,000 in Africa.
Organizations fear the loss of programs focused on women’s rights. In South Africa, facing some of the world’s highest rates of violence against women, local associations are bracing for a surge in such incidents. Sophie Hobbs, director of Nacosa, one of the leading gender-based violence prevention associations, stated that around 50% of the women they assist are under 18. They expect violence to go up as a result of this funding cut.
Projects dedicated to protecting sexual minorities are also endangered. South African organizations active in the fight against HIV, which rely on USAID funding, have had to cease operations. Engage Men’s Health, a group that operated numerous clinics across the country, is among those affected.
Even organizations supported by private American funds are feeling the squeeze. Armando Ayala, president of Pride Shelter Trust, the first association in Africa to offer emergency shelter to LGBT+ individuals, explained that while the association does not receive direct USAID funding, the withdrawal of the US government as the largest donor creates a domino effect. Fund-raising efforts for all organizations in the sector will become more difficult.
Richard Lusimbo, director of the Uganda Key Populations Consortium, which defends the LGBT community with an annual budget of $2.5 million, lamented the termination of the American funding, which accounted for 70% of his organization’s budget. The funding was abruptly cut off on January 30th with a letter announcing an end to support for activities deemed radical and expensive. This has forced him to lay off 28 of his 35 employees, dismantling a critical rapid response program providing assistance to homeless LGBT+ individuals in Uganda.
As organizations struggle to survive the 90-day review period imposed by the administration, few anticipate a return to the status quo, given the potentially irreversible damage to the reproductive health ecosystem. Elizabeth Sully cautions that even if aid is eventually restored, family planning may be permanently excluded, despite its demonstrated effectiveness as a fundamental investment in development. The consequences of this short-sighted policy will be borne by the most vulnerable women and girls in Africa.
The withdrawal of US aid is not just about dollars and cents, it’s about the denial of essential healthcare, the erosion of women’s rights, and the abandonment of marginalized communities. The repercussions will be felt for years to come, potentially undermining the progress made in reproductive health, disease prevention, and the fight for equality and justice. The freeze serves as a stark reminder of the fragility of international partnerships and the devastating impact that political decisions can have on the lives of ordinary people, particularly women and girls, in the developing world. The hope is that this pause will be short lived and that the US will soon resume its role as a leading advocate for women’s health and rights in Africa.
