Mike Elvis Tusubira, a motorcycle taxi operator living with HIV in Uganda, has faced significant challenges following the cessation of foreign aid by US President Donald Trump. The 35-year-old not only worries about his own well-being as he relies on life-saving antiretroviral drugs but also faces the heart-wrenching prospect of separating from his HIV-negative wife due to the lack of preventive measures that were once accessible to them.
Their ability to maintain a safe and healthy relationship has been compromised as they no longer have access to essential medications and contraceptives provided through funding from the US government’s international aid agency, USAID. The sudden halt in aid has left them scrambling to find alternative sources for critical supplies, leading to a depletion of their stockpiles and heightened fears about the risks associated with relying solely on condoms for protection.
The abrupt suspension of foreign aid, initiated by President Trump shortly after taking office, has had far-reaching consequences for individuals like Mr. Tusubira, whose access to vital healthcare services has been disrupted. The closure of the HIV programme he was enrolled in has left him feeling stranded and uncertain about the status of his health, as he struggles to navigate the complexities of managing his condition without essential support.
With the closure of clinics and the withdrawal of services provided by NGOs receiving USAID funding, Mr. Tusubira and his family find themselves grappling with a multitude of challenges, from medication shortages to the disruption of educational and nutritional support for their son. The impact of the aid freeze extends beyond their personal circumstances, affecting thousands of healthcare workers and jeopardizing essential health programs across Uganda.
As the country heavily relies on donor funding to sustain its efforts in combating HIV and other health crises, the repercussions of the funding freeze are deeply felt throughout the healthcare system. The significant contributions made by USAID to various health initiatives, including malaria, tuberculosis, and maternal and child health services, underscore the critical role played by international aid in supporting vulnerable populations in Uganda.
The plight of individuals like Mr. Tusubira serves as a stark reminder of the human cost of political decisions that disrupt essential aid flows, leaving already vulnerable communities at greater risk and uncertain about their future.
In the densely populated slum of Kampala, she used to attend to an average of 200 patients with HIV/AIDS and tuberculosis every day. However, following a stop-work order, all health workers supported by Rom were laid off. As a result, the tuberculosis unit now remains silent, and the section for orphans and vulnerable children at Kisenyi has been closed.
“We are waiting for the 90 days. So, this mandatory leave, I was not prepared for it,” she shared with the BBC. “It was so sudden. We did not have a proper handover at the facility. We just stopped working.”
The Ministry of Health in Uganda is working to minimize disruptions, with Dr. Diana Atwine, the top civil servant at the ministry, encouraging staff willing to volunteer and continue working in the spirit of patriotism to reach out.
In Malawi further south, activities funded by USAID have also come to a halt. The country received $154 million from USAID’s health budget in 2023, making it the 10th largest recipient in Africa. In Mzuzu, a northern city, a key provider of HIV services, the Macro Mzuzu Clinic, remains closed with no signs of activity. Despite a waiver from the US State Department allowing the delivery of essential medicines, many clinics have closed due to the absence of critical staff coordinating USAID’s activities.
The Trump administration plans to significantly reduce USAID staff, causing concerns about the future of health services and funding in African countries. Eddah Simfukwe Banda, a 32-year-old farmer in Malawi, and many others who rely on donor-funded medication are facing uncertainty and challenges due to the funding freeze.
As the healthcare system in Malawi grapples with this disruption, many are concerned about the future of essential services. The country’s vulnerability to external shocks makes this situation even more challenging. Despite efforts to encourage independence, the heavy reliance on aid presents a persistent struggle for one of the world’s poorest countries.
For decades, the US has played a crucial role in public health in Africa, particularly through programs like Pepfar, which have been instrumental in combating the spread of HIV/AIDS. The recent funding cuts and staff reductions by USAID are having a profound impact on healthcare in the region, leaving many in a state of uncertainty.
In a recent issue of Newsday, health experts issued a stark warning about the challenges that lie ahead in the fight against HIV/AIDS in Africa. While some progress has been made in reducing aid dependency, many low-income nations continue to grapple with debt burdens, climate disasters, and economic shocks that hinder their ability to achieve self-sufficiency.
African governments such as Kenya and South Africa have taken significant steps towards funding their HIV responses, with Kenya now covering nearly 60% and South Africa almost 80% of their respective programs. However, the road to complete self-reliance remains fraught with obstacles.
Amref Health Africa, a prominent health NGO on the continent, emphasized the urgent need for action to safeguard global health security. Dr. Githinji Gitahi, CEO of Amref Health Africa, highlighted the challenges African governments face in increasing their own funding amidst current debt distress conditions. Failure to address these issues could have far-reaching consequences for not only Africa but the world at large.
The year 2023 saw 630,000 AIDS-related deaths and 1.5 million new infections worldwide. While some countries have experienced a decline in infection rates, the recent shutdown of USAID funding raises concerns about the potential reversal of progress made in combating the disease.
Winnie Byanyima, head of UNAids, painted a grim picture of the future if significant funding gaps are left unaddressed. She warned of a potential surge in AIDS-related deaths, new infections, and the rise of AIDS orphans if critical support is not maintained.
The international medical charity Médecins Sans Frontières (MSF) also voiced apprehension over the disruption of HIV treatments, emphasizing the importance of consistent medication intake to prevent resistance and serious health complications.
In Uganda, the impact of funding cuts on individuals like Mr. Tusubira is palpable. With dwindling medication supplies, he faces a stark choice between staying in Kampala without access to life-saving treatments or returning to his village where resources may be limited but more accessible.
The unfolding situation underscores the interconnectedness of global health and the critical need for sustained support to combat HIV/AIDS effectively. It serves as a stark reminder that the consequences of inadequate funding and disrupted healthcare services extend far beyond individual countries, affecting communities and populations worldwide.
For more news and updates on the evolving health landscape in Africa, visit BBCAfrica.com. Stay connected with us on Twitter @BBCAfrica, Facebook at BBC Africa, and Instagram at bbcafrica for the latest developments and stories from across the continent.
