Over the last 50 years, Africa has made significant progress in improving health outcomes. Countries such as Mauritius, Tunisia, and Morocco now boast life expectancies that are above the global average, reflecting sustained efforts to combat communicable diseases and improve healthcare infrastructure. International partnerships and funding, including from the United States Agency for International Development (USAID), have been instrumental in these achievements and have supported programs focusing on HIV/AIDS, malaria, and maternal health among others.
However, in 2025, this progress is now facing unprecedented threats. A surge in health emergencies that are being fueled by climate change, ongoing conflicts, emerging infectious diseases, and the recent freeze on USAID funding has placed Africa’s healthcare system in jeopardy.
Funding freeze fuels a growing crisis
The global health sector had already experienced a shortage of funding in 2024, with only 40% of the funding required being donated, including 18% from the World Health Organization (WHO). In a health emergency appeal made in 2025 before the funding freeze, the WHO requested US$1.5 billion to address 42 ongoing health emergencies, including 17 that were categorized as Grade 3 which is the most severe level.
The 90-day freeze on U.S. foreign aid announced by US President Donald Trump immediately after his inauguration in January 2025 and the withdrawal of the U.S. from the World Health Organization (WHO) subsequently came as a severe blow. These decisions have disrupted some of the most effective foreign aid programs, including the President’s Emergency Plan for AIDS Relief (PEPFAR) which was viewed as a cornerstone in Africa’s fight against HIV/AIDS.
See also: U.S. foreign aid freeze threatens critical programs in Africa
The impact has been immediate. Clinics have closed, thousands of healthcare workers have lost their jobs, and UNAIDS has warned that at least one million individuals may face disruption to their treatment, potentially leading to tens of thousands of preventable deaths.
The halt in operations has already led to a significant escalation of health emergencies across Africa this year. On February 6, the Centers for Disease Control and Prevention (CDC) issued a Health Alert Network advisory regarding an Ebola outbreak caused by the Sudan virus in Uganda. The CDC also reported a dramatic rise in the outbreaks of diseases from 153 in 2022-2023 to 242 in 2024, highlighting Africa’s increasing vulnerability to pandemics.
Other outbreaks are compounding the crisis. The Marburg virus, first detected in Rwanda in late 2024, had reached Tanzania by 2025, with a fatality rate as high as 88%.
Moreover, experts predict that malaria deaths in high-burden countries such as Nigeria, the Democratic Republic of Congo (DRC), and Mozambique could rise by 20%. In addition, a lack of funding for early disease detection could lead to more pandemics while a shortage of funding may leave 500,000 tuberculosis patients without treatment this year alone.
The impact of USAID’s suspension
The consequences have been dire. In Kenya, a country that received US$402 million in aid in 2023, the sudden suspension of USAID funding has disrupted over 230 health projects, including those tackling HIV/AIDS, tuberculosis, and malaria. Moreover, the country has seen approximately 54,000 healthcare workers being suspended which seriously limits access to medical services and increases the likelihood of a healthcare brain drain.
See also: Kenya’s 2024 humanitarian aid landscape: Impact of US 90-day aid suspension
In Uganda, where USAID had allocated an annual budget of US$950 million, the funding freeze has forced Makerere University Kampala, a leading research institution, to lay off 200 staff members, with over 2,000 healthcare workers also losing their jobs.
Personal stories illustrate the human toll of the crisis. In Zimbabwe, Florence Makumene fears a return to an era when HIV diagnosis was a death sentence, as the aid freeze threatens her access to life-saving treatment.
Setback for sustainable development goals
These setbacks are directly jeopardizing the achievement of Sustainable Development Goal 3 (SDG 3) by 2030, which aims to ensure healthy lives and promote well-being for all.
Countries that are most dependent on USAID funding – Ethiopia, Jordan, Afghanistan, Somalia, DRC, Syria, Nigeria, Yemen, and South Sudan – have previously received billions in aid annually but now face devastating consequences. Ethiopia, for instance, is on the brink of famine following the shutdown of USAID-supported food security initiatives that previously assisted 8 million people each year. The funding cut has also disrupted aid to over a million refugees and hindered the recovery efforts of survivors of sexual violence.
The impact on the response to outbreaks of disease is equally severe. The DRC, currently battling an Ebola outbreak with eight deaths and 12 infections having been reported, is struggling with containment efforts. Somalia, already facing recurring cholera outbreaks, remains at risk of the spread of Ebola because of regional dynamics.
Fragile healthcare workforce
Africa’s healthcare workforce is alarmingly ill-equipped to handle these mounting challenges, and fewer than 10% of African countries can respond effectively to major outbreaks. The continent currently has only 1,900 field epidemiologists rather than the 6000 who are needed. Similarly, 25,000 frontline epidemiologists are needed but only 5,000 are available. This shortage severely hampers prompt detection of diseases and crisis management.
In South Sudan, multiple disease outbreaks, including measles and malaria, are overwhelming the healthcare system, and while an estimated 9.3 million people in the country will require aid in 2025, security challenges, bureaucratic obstacles, and climate-induced barriers will continue to hinder humanitarian assistance.
A call for sustainable solutions
Without adequate and sustainable funding, governments and aid organizations will face impossible choices about who receives care. The consequences of this could reverse decades of progress in health security across Africa.
Health is deeply interconnected with other critical sectors, including agriculture, education, and economic stability. Dr. Jean Kaseya, head of the Africa CDC, emphasized the urgent need for a cohesive, coordinated response to these challenges. He warned that these overlapping crises could unravel Africa’s hard-won healthcare advances if immediate action is not taken.
