Africa’s Healthcare at a Crossroads: A Wake-Up Call for Self-Reliance amid USAID Cuts

As African health leaders convened this week at the Africa Health Agenda International Conference, a pressing concern loomed over discussions: the abrupt decision by US President Donald Trump to cut foreign aid. The move cast uncertainty over the future of healthcare funding across the continent, making the four-day summit a pivotal moment for policymakers, health organizations, and international stakeholders.

The conference, co-hosted by Amref Health Africa, provided a platform to address Africa’s persistent healthcare challenges—many exacerbated by financial constraints and the growing impact of climate change. With more than 70 sessions, the event tackled critical issues, including the development of climate-resilient health systems, the rising burden of infectious and non-communicable diseases, mental and maternal health, healthcare innovation, and strategies for securing sustainable financing.

But the dominant concern was funding. The USAID withdrawal has left a substantial gap in Africa’s healthcare financing, prompting urgent calls for alternative funding mechanisms. Many health leaders stressed the need for African governments to prioritize healthcare in their national agendas to ensure long-term sustainability.

A 12 billion dollar shortfall

Data presented at the conference underscored the scale of the crisis.

While non-African philanthropists contribute approximately USD four billion annually and African-based philanthropists add USD three billion, the US decision has created a staggering USD 12 billion shortfall. In 2023 alone, USD 3.8 billion in foreign aid was allocated to healthcare across 10 sub-Saharan African nations.

In 2024, USAID had earmarked USD 4.2 billion for healthcare in Africa as part of its USD 40 billion global aid budget. But the unexpected funding cut threatens essential programs, particularly those supporting reproductive and primary healthcare services for millions of women and girls.

The consequences could be dire for several nations heavily reliant on US funding. In at least five African countries—most notably Ethiopia, Kenya, and Uganda—USAID contributions account for over 20 percent of total foreign development aid.

Githinji Gitahi (MD), Group CEO of Amref Health Africa, warned that even with existing financial support, sub-Saharan Africa’s healthcare system remains precariously underfunded. He highlighted the stark contrast in healthcare spending: just USD 40 per person annually in sub-Saharan Africa, compared to USD 4,000 per person in high-income nations.

“We need bold decisions from policymakers to dismantle the current system and develop a mechanism that ensures an efficient and effective public health system,” he said.

 Gitahi called for a holistic approach to population health, emphasizing the need for universal access to clean water, sanitation, immunization, and improved food systems to combat non-communicable diseases.

On the issue of declining resources, he stressed the importance of reallocation. “The sudden drop in resources is concerning. But if we redirect financial priorities, shift our mindset, and protect the communities that initially benefited from these funds, we can repurpose our efforts to sustain critical healthcare services,” he said.

As African governments grapple with the fallout of the U.S. aid cuts, the conference underscored a broader shift: the continent’s need to take greater ownership of its health financing. The challenge now is whether African leaders will rise to the occasion—or whether millions will be left behind in the wake of disappearing foreign aid.

Chikwe Ihekweazu (MD), acting director for the World Health Organization (WHO) Africa, acknowledged a shifting geopolitical landscape that has led to financial strain in the continent’s healthcare sector. Speaking at the Africa Health Agenda International Conference, he reaffirmed WHO’s commitment to supporting African nations, even as the organization itself faces budgetary challenges following the United States’ withdrawal of funding.

Recognizing the loss of US support as a major setback, Ihekweazu called on African nations to increase domestic investment in their healthcare systems.

“No country can afford to outsource its responsibility to its people,” he said. “Every nation must invest in developing its own human resources and institutions.”

While stressing that governments bear the primary responsibility for providing essential medicines, he underscored the need for collaboration with global partners. “Any cuts in funding at any level will inevitably impact the entire healthcare system’s efficiency,” he warned.

The Fallout

The US has historically been the largest donor to WHO, contributing USD 1.5 billion annually—18 percent of the organization’s total budget. President Trump’s executive order to withdraw US funding is expected to have far-reaching consequences for WHO’s ability to assist African nations.

Despite this, Ihekweazu expressed WHO’s willingness to maintain partnerships. “We remain open to engaging with colleagues in the U.S., including the CDC and other organizations we have worked with for years. Our work together remains crucial for global health,” he said.

He emphasized that the crisis triggered by the aid cut is not just WHO’s burden but a wake-up call for African nations. “If we can fund infrastructure projects like roads, bridges, and airports, there is no reason why we cannot finance vaccines for our children or family planning services for our women,” he asserted.

In the coming weeks, WHO and other continental health stakeholders will outline immediate and long-term intervention strategies while seeking new partnerships to mitigate the impact of the funding gap.

Calls for African Self-Reliance

 Ihekweazu remained optimistic about Africa’s resilience, drawing parallels to the continent’s response during the early months of the COVID-19 pandemic. During times of crisis, “we have seen remarkable solidarity within and between African nations. I am confident that this challenge will trigger a similar response, strengthening the continent’s self-reliance,” he said.

Rwanda’s Minister of Health, Sabin Nsanzimana (MD), echoed this sentiment, urging African nations to take full ownership of their healthcare systems.

“We have no other choice,” he said. “This is our health, our system, and we cannot afford to go backward. Our only option is determination, strength, and innovative thinking beyond traditional systems.”

He warned that reliance on external donors leaves African nations vulnerable. “If we continue to depend on others, we risk losing everything overnight. But if we take control, we can build sustainable solutions,” he emphasized.

Nsanzimana argued that success is not solely dependent on the amount of funding available but on how resources are allocated. “It’s not about how much you spend but how and where you spend it,” he said. “Local solutions, creativity, and intentional targets will be key.”

Health experts at the conference urged African governments to develop comprehensive national health strategies, foster regional collaboration, and engage both the private sector and African philanthropists. They stressed that efficiency in resource allocation will be critical to ensuring long-term sustainability in healthcare provision.

Article first published on https://www.thereporterethiopia.com/44090/