The abrupt withdrawal of American aid has exposed African nations’ dependence on foreign funding, forcing them to seek domestic alternatives. In response, some governments have moved swiftly to offset the loss.
In Nigeria, some of the government’s response was the immediate $1 billion budget for healthcare, with an additional $3.2 million to purchase HIV treatment packs to replace USAID funding. In another turn of events, the government announced employment retentions for the 28,000 health workers earlier dismissed after the USAID closure.
The Kenyan government in the same vein began reallocating funds from the development budget to finance critical health programs that were heavily reliant on USAID funding. Media reports quoted John Mbadi, the Cabinet Secretary of the National Treasury, saying the government “have started to put measures in place to ensure that health programmes that depended heavily on foreign aid are not paralysed”.
Over the years, BBC reports, African governments have tried boosting local humanitarian contributions to reduce aid dependency. Kenya, for instance, currently funds about 60 percent of its HIV treatment budget, while South Africa funds up to 80 percent.
Despite these efforts, experts like Ndeayo Iwot, the general secretary of the Health Sector Reforms Coalition, are raising concerns on the sustainability of the government funding. She said that US support remains crucial and African countries need new partnerships to sustain the programs that were shutdown by USAID.
“Even when they’re releasing the available funds on time, they will not be able to cover all the areas that those [aid] funds were helping them to achieve. It will take time, probably two, three years,” said Iwot.
Nowhere are these challenges more visible than in South Africa. On February 5, as the shutdown took full effect, the consequences became severe. Within weeks, the strain on the country’s healthcare system was overwhelming, particularly in the treatment of HIV, where millions rely on aid-funded medication. In Johannesburg, the closure of a USAID-funded hospital barred HIV patients from entering to receive medications.
According to Associates Press (AP) over 8 million people are HIV-positive in South Africa, and they constantly rely on funding for medical support from the President’s Emergency Plan for Aids Relief (PEPFAR), a United Nations aid agency. Almost 5.5 million people are recorded beneficiaries of this initiative.
This dilemma exposes South Africa’s heavy reliance on foreign aid. There are other outreach projects funded by USAID, like food packages for school children, campaigns for girl-child education, and infrastructures to enhance education in remote areas. With the immediate closure, most local NGOs dismissed their initiatives, potentially ending the journey to quality education for thousands of children.
In Nigeria’s conflict-ridden northeast, the abrupt closure of USAID-funded hospitals has left vulnerable communities in crisis. Facilities that once treated up to 200 patients daily have shut their doors, leaving many without access to essential care. In Konduga, a rural community in Borno state, malnourished children and critically ill patients are stranded without medical support.
Yana Modu, a mother of a three-year-old child who relied on USAID-funded treatment, was turned away from a local clinic as the workers told her bluntly about the imminent closure of the facility.
The consequences of the shutdown extend beyond healthcare. Across various USAID sub-agencies, thousands of African workers who once collaborated with the organisation have lost their jobs, adding to the continent’s already high unemployment burden.
The scale of Africa’s dependence on foreign aid is evident in the numbers. According to data from the United States Foreign Assistance Dashboard, Nigeria alone received up to $2.8 billion between 2022 and 2024 through USAID. These funds supported malaria treatment, maternal and child healthcare, and nutrition programs for malnourished children, among other initiatives.
Outside Nigeria, USAID funds have landed in several African countries. In 2023, Ethiopia received the highest donation from the U.S. agency, amounting to $1.37 billion. In fact, USAID was the largest aid provider to Africa that year, contributing $40 billion in funding.
According to Iwot, to fill the loopholes created by USAID’s exit, Africa needs new partnerships, especially for health programs. Because “there are certain things you shouldn’t do alone as a country,” she said. “Going through resource pulling from many partners and stakeholders is a recommended approach to financing health activities.”
