logo
End of US aid poses death threat to women and girls in Africa

End of US aid poses death threat to women and girls in Africa

Khaleej Times24-03-2025

Zimbabwean mother Getrude Mucheri had walked miles in the rain to get her expired contraceptive implant removed and a Depo-Provera birth control injection instead.
But the 35-year-old mother, who relies on free family-planning services, was out of luck when she arrived at the Chitakatira health clinic in eastern Zimbabwe.
Nurses at the public health facility, which is outside the city of Mutare and supported by charities including Population Services Zimbabwe, said they had run out of stock for that day.
"I am stressed. I do not have money to buy birth control pills," Mucheri told the Thomson Reuters Foundation.
"I cannot have more children. I am even struggling to feed the ones I have," said the unemployed mother of four.
Mucheri is among millions of women worldwide who rely on free contraceptives from aid programmes that have been plunged into turmoil since President Donald Trump gutted the US Agency for International Development, a key global donor.
Lydia Zigomo, regional director for the United Nations sexual and reproductive health agency UNFPA, said the cuts would have "severe consequences" with hundreds of thousands in east and southern Africa losing access to contraception.
"Many countries in the region are expected to run out of contraceptives and life-saving maternal medicines within the next three to six months," Zigomo said by email.
"Given that countries like South Sudan, the DRC (Democratic Republic of Congo) and Madagascar already have high maternal mortality rates, the withdrawal of funding will have catastrophic consequences," Zigomo said.
The immediate loss of US funding for UNFPA in DRC, South Sudan and Ethiopia came to about $4 million, she said, noting that many local health providers had also lost US funding.
"With the US freeze, the entire ecosystem for improving sexual, reproductive, maternal, neo-natal, child and adolescent health has been compromised."
Violence against women, maternal mortality and unplanned pregnancies would all increase, while menstrual hygiene and pregnancy-related care would suffer, she added.
Longer term, there will be more sexually transmitted infections and unsafe abortions. Child marriage and teen pregnancies could also rise as families fall into poverty.
And there would be major disruptions in the supply chain for contraceptives and reproductive health medicines, Zigomo said.
Unsafe pregnancies
Pester Siraha, a country director at Population Services Zimbabwe, an affiliate of Marie Stopes International, said the USAID cuts violate women's rights.
"This is a cruel decision," she said.
"The sudden suspension created a lot of chaos and uncertainty. Sudden stoppage of services without notice is not ethically right."
In 2024, USAID provided up to $360 million for health and agriculture programmes in Zimbabwe, whose own government has underfunded healthcare for decades. Each year, the health budget falls far short of the target set in the 2001 Abuja Declaration, in which African Union governments committed to spend at least 15 per cent of national budgets on health services.
Zimbabwe's deputy health minister Sleiman Kwidini said the government had been buying its own family planning supplies through the National Pharmaceutical Company, a government agency, with funding from donors.
"We have enough supplies and stock to provide family planning services around the country," he told the Thomson Reuters Foundation, without giving further details.
Siraha said more than half of all funding for sexual and reproductive health services in Zimbabwe came from USAID, so the cuts would inevitably boost unplanned pregnancies.
"(This leads) to unsafe abortions and maternal mortality. Teenage pregnancies lead to school dropouts and worsen the higher percentage of teenagers dying during delivery," she said.
In January, Trump also recommitted to two international anti-abortion pacts, cutting all US family planning funds for foreign organisations that provide or promote abortions.
Jobs lost
The fallout from the aid cuts is already rippling through Zimbabwe: thousands of health workers were told via WhatsApp to vacate work premises in late January after Trump's executive orders kicked in, according to some of those affected.
A 29-year-old single mother of two, who did not want to give her name for fear of reprisals, said on the eve of January 28, she was told not to report for work the following day at a USAID-funded not-for-profit organisation providing sexual health services to young girls in Gokwe, in Midlands Province.
"I signed for unpaid leave. The last salary and savings is the one that I am using for all expenses and upkeep of my family," she said.
"I am trying to find ways to get income. I am buying and selling clothes and food, but it is not yielding much."
Ekenia Chifamba, director of Shamwari Yemwanasikana, a community-based organisation that promotes girls' rights, said the cuts were "unbearable" as they affected whole families.
"It is quite devastating and disturbing," she said.
Zigomo said UNFPA was seeking alternate funding, be it engaging with national governments, asking more of other donors or tapping the private sector and philanthropic organisations.
It is also trying to mobilise civil society and grassroots organisations to push for local solutions and funding.
"Despite these efforts, it appears highly unlikely that most (east and southern African) countries will mobilise resources to fill in the gaps ... in the short term," she said.
"There remains an urgent need for sustainable and predictable funding to prevent a devastating rollback in progress on women's health and rights."

Orange background

Try Our AI Features

Explore what Daily8 AI can do for you:

Comments

No comments yet...

Related Articles

South Africa: Lesotho's health system has been decimated by US funding cuts
South Africa: Lesotho's health system has been decimated by US funding cuts

Zawya

time3 days ago

  • Zawya

South Africa: Lesotho's health system has been decimated by US funding cuts

In March, Lesotho's health minister Selibe Mochoborane boldly stated that the country's HIV response will survive without support from the US. The US model was ' too expensive ', he said, and methods would have to be adapted 'to align with our available resources". He was confident that Lesotho would still reach its ambitious HIV prevention and treatment targets by 2030. But senior health officials seemed less confident while presenting to Parliament's portfolio committee on pandemics last week. 'When you cut community HIV prevention services, you inevitably increase new infections,' said Tapiwa Turambiswa, who manages the Ministry of Health's HIV/Aids programmes. Pepfar distributes its funds in Lesotho via the United States Agency for International Development (USAid) and the US Center for Disease Control (CDC). Turambisa said that 93% of USAid's funding and 6% from the CDC has been cut. In total, funding from USAid and the CDC has been slashed from about R1.4bn to R600m. 652 frontline workers have lost their jobs due to the cuts. The country has lost 60% of its counsellors who were providing HIV testing services, said Turambiswa. This will decrease the number of people tested, increasing the number of people unknowingly spreading the virus, he said. In August last year, 11,702 people were tested but in April this year, only 9,054 were tested. Llang Mamma, the ministry's national TB programme manager, said that many people diagnosed with TB are not being tested for HIV as per government policy, because of staff shortages. 'That means we will delay detection of new infections and related treatment,' Maama said. Donor-dependent Of the country's M2.2bn (one loti, M, is equal to one rand, R) health budget last year, only M278m was funded by the government. Almost all of this is spent on antiretroviral medicines (ARVs). The remainder of the health budget comes from international donors. This includes programmes for HIV prevention, treatment and other supportive services. USAid and the CDC accounted for more than half the health budget last year, with the Global Fund contributing more than a fifth of the budget. Pepfar is a major contributor to the Global Fund. Terminated programmes HIV prevention services have been the worst affected by US aid cuts. M212.4m in USAid funds were earmarked for the SECURE project – an HIV prevention programme in 10 districts that included condom distribution, voluntary medical male circumcision, and pre-exposure prophylaxis (PrEP), said Turambiswa. A M168m project called Bophelo Bo Botle, supporting more than 120,000 people on ARVs was also terminated, despite a waiver protecting Pepfar's life-saving programmes, said Turambiswa. 'This is a treatment and care project whereby the Elizabeth Glaser Pediatric Aids Foundation deployed doctors, nurses, pharmacists, psychologists, counsellors, and the whole comprehensive list of human resources, putting them into ART clinics to see patients,' he said. A M78m project that was going to introduce long-acting PrEP injections, MOSAIC, was also ended. M90m for mental health and M77m for primary healthcare has also been cut. 'We have also lost support for pharmacy regulation, surveillance activities like mortality and drug resistance monitoring, community-led monitoring, and all quality assurance systems,' Turambiswa said. TB response falters The funding crisis is also derailing Lesotho's fight against TB, said Maama. While drugs and test kits are still available, outreach programmes have been put on hold. The World Health Organisation's Global TB Report 2024 estimates Lesotho's TB incidence at 664 cases per 100,000 people. About half of TB patients are also HIV-positive. Maama now warns that the situation is deteriorating. The Global Fund recently froze M19-million and suspended the full-scale rollout of its TB programme pending a funding model re-evaluation. 'We were scaling up community services to find every Mosotho with TB,' she said. She added that the freeze likely means a permanent loss even though the Global Fund used the word 'pause'. One suspended initiative, worth M4m, was set to upgrade TB wards in Mohale's Hoek and Leribe to serve as regional referral centres for drug-resistant TB.

Zimbabwe sees huge jump in malaria cases as US withdraws funding
Zimbabwe sees huge jump in malaria cases as US withdraws funding

Zawya

time12-05-2025

  • Zawya

Zimbabwe sees huge jump in malaria cases as US withdraws funding

Zimbabwe is recording a huge jump in malaria deaths at a time the United States, the biggest funder of the country's health delivery system, is scaling back its support due to President Donald Trump's policies on foreign aid. The southern African country's Health ministry on Friday said malaria cases had increased by 180 percent since the beginning of the year from 21,309 in 2024 to 59,647 this year while bemoaning the withdrawal of US funding for prevention programmes. Malaria deaths have increased by 218 percent from 45 in 2024 to 143 in 2025, the ministry said. Zimbabwe's health delivery system is heavily reliant on donor funding and the US government was the largest contributor through USAID whose operations have been heavily curtailed by President Trump's new administration. Read: Dead aid? African leaders forced to move on fast in Trump eraThe US early this year said its initiatives through USAID and the US Centers for Disease Control and Prevention had helped reduce the incidence of malaria in Zimbabwe by 40 percent in the last 15 years. American funding helped procure 800,000 mosquito nets, 1.2 million malaria test kits and 100,000 'life-saving anti-malaria medications as our teams on the ground train health care workers and educate communities about malaria prevention and early treatment,' the US embassy in Harare said then. Those gains are in danger of being reversed with the Zimbabwe government now raising the alarm following the sharp increase in new cases and deaths.'This increase is being driven by a combination of environmental and behavioural factors,' the Health Ministry said.'Increased rainfall, humility, and temperatures have created favourable conditions for mosquito breeding.'At the same time, more people are engaging in outdoor activities such as artisanal mining, farming, tobacco curing, and cross border trading, particularly during dusk to dawn when mosquitoes are most active.'Many of these activities take place in remote areas where access to health services is limited, leading to delays in treatment and an increase in fatalities.'The government said the number of reported malaria outbreaks had jumped from just one in 2024 to 115 in 2025.'Out of these, only 23 have been brought under control. The majority of outbreaks have been reported in provinces with high levels of artisanal mining and agricultural activities,' the ministry added.'Mashonaland Central, Manicaland, and Mashonaland West are the most affected provinces, contributing a combined 82.8 percent of all cases and 72.9 percent of all deaths.'Children under the age of five account for 14 percent of the total malaria cases.'The government said the distribution of malaria prevention kits such as insecticide treated nets (ITNs) had been affected by the withdrawal of funding from the US.'A total of 1,615,000 ITNs are being distributed in 14 high-risk districts, although there is a shortfall of 600,000 nets due to the withdrawal of funding from the United States government,' the Health ministry added.'The government remains committed to closing this gap through increased domestic financing.'Larvicides are being applied to breeding sites where available, although supply remains limited.'The country currently has adequate stocks of malaria medicines and diagnostic kits'The kits were acquired before the withdrawal of US funding early this year. Anti-malaria campaigns have been rolled out to target artisanal mining populations, who are highly mobile and often difficult to access.'Despite these efforts, challenges remain. Climate change continues to expand the mosquito breeding season and increase the vector population,' the government added.'Artisanal mining activities are increasing, and with them, the number of breeding sites and the population exposed during peak mosquito biting hours.'Many of these communities remain difficult to reach and are hesitant to engage with health authorities.'The Ministry reminds the public that this is the high malaria transmission period.' Malaria symptoms include fever, chills, sweating, headaches, joint pain, nausea, vomiting, or diarrhoea. Read: Africa's healthcare funding crisis: 3 strategies to manage deadly diseasesZimbabwe's health delivery system has been crumbling over the years due to years of chronic underfunding, and a serious brain drain. This week a minister raised the alarm over the state of the public health system after visiting a hospitalised relative. Youth minister Tinoda Machakaire publicly invited President Emmerson Mnangagwa to visit hospitals to see for himself the state of the rot. Addressing President Mnangagwa directly, he said: 'Under your leadership, many have found renewed hope.'It is because of this trust in your care for the people that I respectfully plead with, please find time from your busy schedule to visit these institutions yourself.'There is no substitute for seeing, listening and understanding first-hand what our citizens are going through.'The Health ministry, however, dismissed the minister's comments as 'part of a broader pattern of unwarranted and mischievous attacks.'Zimbabwe says its once vibrant health delivery system is a victim of western sanctions that have resulted in the southern African country's isolation from the international community for over two decades. After the withdrawal of funding, the US embassy in Harare said: 'It is time for Zimbabwe to take seriously its responsibility for the health of its people.''For HIV, Zimbabwe has hit the 95/95/95 targets. They urgently need to be focused on buying antiviral therapy and getting nurses in clinics. They can do this.' © Copyright 2022 Nation Media Group. All Rights Reserved. Provided by SyndiGate Media Inc. ( Kitsepile Nyathi

How should Africa respond to foreign aid cuts?
How should Africa respond to foreign aid cuts?

Zawya

time18-04-2025

  • Zawya

How should Africa respond to foreign aid cuts?

A global storm is gathering – and Africa is directly in its path. Under President Donald Trump, the US has frozen $40bn in USAID funding, slashing 83% of grants. European donor countries are also drastically cutting their foreign-aid commitments, signaling a broader shift in priorities. The devastating effects are already being felt across Africa, particularly in sectors like healthcare, education, and social services, which have long relied on external support. For decades, African governments have depended heavily on foreign aid, often at the expense of building sustainable domestic financing systems. But the current wave of aid cuts underscores an uncomfortable truth: foreign aid is inherently unreliable. It can be paused, reduced, or redirected at any time, without warning, and is often subject to political shifts in donor countries. The current financial crisis, then, should serve as a wake-up call. African countries must reclaim control of their futures by adopting bold, innovative strategies to close funding gaps and build resilient, self-sufficient health systems. To this end, African governments must invest in homegrown financing solutions for essential public services. In the health sector, the main focus should be achieving universal health coverage through a robust, well-funded primary healthcare (PHC) system. Most donor-funded health initiatives – vaccinations, childcare, nutrition, sanitation, and disease control – fall squarely within the PHC framework. According to the World Health Organisation, up to 90% of an individual's health-care needs can be addressed at the PHC level. Focusing on prevention and health promotion thus remains the fastest and most cost-effective way to improve health outcomes across Africa. Preventive PHC measures such as childhood vaccinations, hypertension screenings, prenatal care, and nutrition services could significantly reduce mortality rates among mothers and children under five. Malnutrition alone contributes to nearly half of all deaths among children in this age group, underscoring the urgent need for early, community-based care. Unfortunately, more than four decades after the 1978 Alma-Ata Declaration defined PHC as the foundation of equitable health care, many of its goals remain unfulfilled. Consequently, African governments must develop independent health financing mechanisms to ensure long-term accessibility and accountability. Health insurance represents an opportunity for African countries to draw on their cultural traditions of collective responsibility and community-based support. South Africa's Zulu people live by the principle of Ubuntu – 'I am because you are' – while the Igbo people of Nigeria uphold 'Igwebuike' ('strength in unity'). These deeply rooted values mirror the essence of health insurance: protect individuals by pooling resources. Rwanda and Morocco offer compelling models for strengthening PHC systems and expanding access. Rwanda's community-based health insurance, rolled out nationwide in 2004, now covers more than 90% of the population, making it one of Africa's most effective health financing models. The scheme is funded through a combination of member premiums, government contributions, international donors, and other mechanisms. It is also supported by roughly 59,000 community health workers, who serve as vital links between households and formal services. Over the past two decades, the programme has reduced financial barriers and decentralised service delivery, bringing health care to the communities that need it most. In Morocco, the government introduced a dual national health insurance system in 2005: Assurance Maladie Obligatoire (AMO) for workers in the formal sector and Regime d'Assistance Médicale) for informal workers. In 2022, these programmes were consolidated into the AMO-Tadamon programme, enabling beneficiaries to access both public and private facilities. This reform not only eased pressure on public-health facilities but also promoted equitable access through strategic financing, with insurance coverage surging from just 15% in 2005 to nearly 80% today. In 2023, the World Bank approved a $450mn programme-for-results loan to advance universal health coverage in Morocco and increase access to quality care. The need for universal coverage in Africa is particularly urgent as the continent faces a surge in noncommunicable diseases (NCDs), including hypertension, heart disease, diabetes, and cancer. Collectively, NCDs – driven by unhealthy diets, sedentary lifestyles, and excessive alcohol and sugar consumption – claim 41mn lives annually, with 32mn deaths occurring in low- and middle-income countries. As foreign aid shrinks, African leaders must adopt bold policies that encourage healthier lifestyles and boost domestic revenue. One such solution is taxation. As the WHO's Sugar Tax Report shows, taxing sugary beverages reduces consumption and lowers the risk of obesity and diabetes. Experts at the recent Global NCD Alliance Forum underscored the need for stronger excise taxes across Africa to curb the growing NCD epidemic and generate sustainable revenue streams for public-health investments. South Africa and Mexico demonstrate the promise of such measures. Mexico implemented a one-peso-per-liter excise tax on sugar-sweetened beverages on January 1, 2014, and consumption of sugary drinks fell by 7.6% over the two-year period from 2014 to 2015. In South Africa, a 2018 sugar tax led to a 51% reduction in purchases of sugary drinks, 52% reduction in calories, and 29% reduction in the volume of beverages purchased per person per day. Diaspora remittances represent a promising and sustainable source of funding. While talent continues to leave Africa, remittances also create a powerful 'brain gain,' delivering a stable flow of funds to the continent. In 2024, remittances to Africa exceeded $100bn, outpacing foreign aid. Diaspora Nigerians alone accounted for 20% of this figure. Globally, remittances reached $590bn in 2020, far surpassing official development assistance, which stood at $180bn, and philanthropic outflows, which totaled $70bn. If African countries had allocated just 1% of every remittance dollar to health insurance – as I proposed in 2019 – the $100bn in remittances sent by the African diaspora in 2024 could have generated $1bn for healthcare, bringing the continent closer to achieving universal health coverage. But to unlock remittances' full potential, African governments must improve governance, strengthen accountability, and foster trust with diaspora communities. Of course, Africa is not a monolith. Solutions must be tailored to each country's unique context, complementing broader efforts to boost domestic resource mobilisation. What is clear, however, is that lasting independence depends on financial self-reliance. For African countries to control their financial futures, they must ensure that they can fund essential services like healthcare without relying on external support. – Project Syndicate Ifeanyi M. Nsofor, a public-health physician and behavioral-science researcher, serves on the Global Fellows Advisory Board at the Atlantic Institute. © Gulf Times Newspaper 2022 Provided by SyndiGate Media Inc. (

DOWNLOAD THE APP

Get Started Now: Download the App

Ready to dive into the world of global news and events? Download our app today from your preferred app store and start exploring.
app-storeplay-store