LANCASTER, United Kingdom — On Jan. 20, President Donald Trump began his second term by signing a series of executive orders, rolling back several Biden administration policies. Among them, he suspended all U.S. aid programs for 90 days, except for those in Israel and Egypt. The move has caused concern in countries dependent on U.S. aid, particularly Uganda, which relies on foreign assistance for HIV/AIDS and malaria treatments. The suspension threatens medical supplies for 14.2 million Ugandans affected by the diseases, prompting urgent efforts to fill the gap.
What the Suspension Means
Uganda depends on U.S. foreign aid to sustain deliveries of medicines and supplies for HIV/AIDS and malaria, both widespread in the country. In 2024, an estimated 5.1% of Ugandans had HIV, while in 2023 saw about 12.6 million malaria cases. The prevalence of both diseases is higher than Africa’s average, posing a significant economic burden. Malaria alone is estimated to cost Uganda’s government $500 million annually.
The suspension of U.S. aid has severely disrupted drug supply chains in Uganda. Programs like the President’s Emergency Plan for AIDS Relief (PEPFAR), which provides antiretroviral (ARV) drugs and the President’s Malaria Initiative (PMI), which supplies insecticide-treated nets, diagnostic tests and medications, have been halted, raising concerns about shortages. The USAID Global Health Supply Chain Program (GHSC-PSM) has also been paused, causing procurement and technical issues that are further delaying the already strained supply chain.
U.S. aid initiatives have played a key role in Uganda’s progress against HIV/AIDS and malaria. Since 2010, new HIV infections have decreased from 83,000 to 38,000 in 2024, while AIDS-related deaths have dropped from 53,000 to 19,000 in the same period. With Uganda having the highest malaria incidence rate in the world, according to the World Health Organization (WHO), the pause in funding for the PMI will worsen the situation.
The Government’s Response
The Ugandan government has taken proactive steps in response to the suspension of U.S. aid programs, unveiling four strategies to bridge the gap left by the cut:
- Resource Mobilization: Uganda, led by Health Minister Dr. Diana Atwine, aims to maintain critical health programs despite the suspension of aid. Atwine emphasized Uganda’s partnerships beyond U.S. aid, highlighting stockpiles of ARV drugs and malaria treatments and an increased budget to ensure continued care.
- Emergency Assessment and Strategic Planning: Following the suspension announcement, the Ministry of Health met to reallocate funding and ensure uninterrupted services for HIV and malaria programs.
- New HIV Treatment Guidelines: The Uganda AIDS Commission (UAC) issued new guidelines advising patients to continue accessing HIV services at both government and private health facilities. Health workers have been trained to follow these updated guidelines to ensure ongoing care.
- Advocacy and Engagement With International Partners: Ugandan officials are working with international partners to lessen the impact of the aid suspension. The UAC has urged the U.S. to continue leading the fight against AIDS while securing a $700 million pledge from the Global Fund to combat AIDS, tuberculosis and malaria. The Global Fund, a key partner, remains committed to supporting Uganda despite the setback.
Conclusion
As Uganda faces the challenges of reduced U.S. aid, the government’s quick response domestically and proactiveness on the international stage has meant that those living with the challenges faced by Malaria and HIV/AIDS are protected for now. While the government’s actions domestically and internationally must be praised, the path forward remains fragile. Sustaining the coalition it has formed will be crucial during this period as it waits for the Trump administration’s decision regarding the aid suspension and the broader fight against HIV/AIDS and malaria.
– Oliver Hedges
Oliver is based in Lancaster, UK and focuses on Global Health for The Borgen Project.
Photo: Flickr