Africa stands on the brink of a public health disaster. The recent suspension of U.S. foreign aid through the U.S. Agency for International Development (USAID) threatens to dismantle decades of progress in the fight against HIV across the continent. According to the World Health Organization (WHO), eight countries — Haiti, Kenya, Lesotho, South Sudan, Burkina Faso, Mali, Nigeria, and Ukraine — are at immediate risk of running out of life-saving HIV treatments. Six of these countries are in sub-Saharan Africa, the region that bears the heaviest burden of the global HIV epidemic.
The situation is dire. WHO Director-General Dr. Tedros Adhanom Ghebreyesus warned that the disruptions “could undo 20 years of progress” and potentially result in 10 million new HIV infections and 3 million HIV-related deaths worldwide. The consequences in Africa, where nearly two-thirds of all people living with HIV reside, could be devastating.
Africa’s HIV Burden in Numbers
According to UNAIDS (2023):
- 25.6 million people in sub-Saharan Africa are living with HIV — approximately 67% of the global total.
- In 2022, Africa accounted for 65% of global new HIV infections (around 1.3 million new cases).
- 380,000 people died of AIDS-related illnesses in the region in 2022 alone.
- Over 5 million people in Africa still do not have access to antiretroviral therapy (ART), making consistent supply lines vital.
Countries such as Nigeria, Kenya, Lesotho, and South Sudan have made substantial strides in expanding access to ART, promoting awareness, and reducing transmission rates — largely supported by international funding from the U.S. government, including the President’s Emergency Plan for AIDS Relief (PEPFAR) and USAID. This aid is now in jeopardy.
USAID Cuts: A Ticking Time Bomb
The USAID aid pause, introduced under the Trump administration, has caused an abrupt halt in funding and supply chains supporting HIV programs across the continent. In Nigeria alone, where 1.9 million people live with HIV, the national agency for AIDS control reports 1,400 new infections and 50,000 deaths weekly — figures likely to rise in the absence of consistent treatment access.
Kenya, another major recipient of USAID HIV funding, has approximately 1.4 million people living with HIV, with around 1.1 million currently receiving ART. Interruptions in supply threaten to increase drug resistance, mortality, and new infections, especially among vulnerable populations such as children, sex workers, and men who have sex with men.
In Lesotho — one of the countries with the highest HIV prevalence rates globally, a staggering 22.7% — nearly 80% of people living with HIV rely on international donor-supported ART programs.
The ripple effects of these cuts go beyond just HIV. According to WHO, programs targeting malaria, polio, tuberculosis, and maternal and child health are also at risk. The Global Measles and Rubella Laboratory Network, a critical surveillance system with over 700 labs worldwide (many in Africa), faces shutdown — just as measles outbreaks are reemerging globally.
A Fragile Health Infrastructure
Africa’s health systems remain chronically underfunded. Donor funding accounts for up to 70% of total HIV-related expenditures in some sub-Saharan African countries. USAID’s abrupt funding pause has already led to:
- Shortages of essential HIV drugs in several countries.
- Suspension of community-based outreach and prevention programs.
- Threats to healthcare worker salaries and retention.
The threat is also economic. An increase in preventable deaths and illness places strain on national economies, reduces productivity, and risks destabilizing already fragile communities.
WHO’s Plea and the Way Forward
Dr. Ghebreyesus emphasized that the U.S. has a “responsibility to ensure that if it withdraws direct funding, it’s done in an orderly and humane way that allows countries to find alternatives.” However, the current withdrawal has been sudden and unstructured, leaving millions exposed.
In response, African governments must act swiftly:
- Increase domestic health funding, especially for HIV programs.
- Diversify funding sources, including the private sector and philanthropic foundations.
- Strengthen supply chains and local pharmaceutical production for essential medicines.
Regional collaboration through bodies like the African Union and Africa CDC could play a crucial role in cushioning the impact by sharing resources and advocating for emergency support from other international partners.
Conclusion
This is not just a funding issue; it’s a humanitarian emergency. The U.S. withdrawal from HIV aid in Africa could trigger a surge in new infections, millions of preventable deaths, and a collapse of health gains that took decades to build. The time to act is now — before an avoidable catastrophe becomes a painful reality.