“We all will suffer”.
That is how one health expert reacted after the Donald Trump administration moved to stop the supply of lifesaving drugs for HIV, malaria and tuberculosis, as well as medical supplies for newborn babies, in countries supported by the United States Agency for International Development (USAID) around the globe.
USAID-funded programs help millions fight against HIV/AIDS and provide support for everything from access to clean water, healthcare infrastructure and children's health.
Contractors and partners who work with the USAID began receiving memos yesterday to stop work immediately, sources said.
The move is part of a wider freeze on US aid and funding put in place since Trump took office on January 20, while programmes are reviewed.
The Trump administration has also put about 60 senior career officials in the USAID on leave, sources familiar with the matter said. The move was allegedly in relation to actions in the agency that "appeared to be designed to circumvent the President's Executive Orders and the mandate from the American people”.
"As a result, we have placed a number of USAID employees on administrative leave with full pay and benefits until further notice while we complete our analysis of these actions," Acting Administrator Jason Gray said in a memo.
The administration's actions threaten billions of dollars of life-saving aid from the world's largest single donor. In fiscal year 2023, the US disbursed $72 billion in assistance. It provided 42% of all humanitarian aid tracked by the United Nations in 2024.
On Friday, the State Department issued a stop-work order worldwide even for existing assistance.
A second memo on Saturday made it clear to USAID staff that the pause on foreign aid spending meant “a complete halt”. The only exceptions are for emergency humanitarian food assistance and for officials returning to their duty stations.
In response to the move, a former USAID official who is now president of Refugees International, Jeremy Konyndyk said: "If this is not reversed, it will wreck US foreign aid... It would permanently weaken USAID.”
UCT Chair of Public Health Medicine in the School of Public Health and Family Medicine, Professor Leslie London added: “Firstly, it will have a devastatingly bad impact on HIV control, and secondary illnesses will rise, including TB, for which South Africa is already a world ‘leader’ in morbidity and mortality rates. Once HIV control wanes, TB incidence will rise along with all the other HIV-associated conditions.
“Secondly, it’s not in anyone’s interest, including the USA, that the HIV epidemic should have a global resurgence. It will destabilise economies around the world. The US wants people to buy their products – and not just in High Income Countries but all countries (Coca Cola is ubiquitous, for example, across Low Income Countries). But if people aren’t well enough to earn enough to purchase, that’s not good for the USA’s markets. Even taking the most market oriented view of things, it is self-defeating. But the US President is unable to think in any terms other than inward – he is very mistaken if he thinks cutting PEPFAR will Make America Great Again. Put simply, this is geopolitics at the expense of global security. We all will suffer.”
London said this was a wake up call to all countries to reduce dependence on donor funding for essential health services.
“That said, I suspect other large economies will move in to fill the gap, China, BRICS, etc. Trump is ceding US influence which he does not realise.”
The World Health Organisation (WHO) said it was analysing the impact of Trump’s actions.
“Developments in this area are ongoing. WHO is analyzing the impact of the actions, we may have more to say about this later.”
Stellenbosch University Africa Centre for Inclusive Health Management (formerly the Africa Centre for HIV/Aids Management) director, Dr Munya Saruchera said Trump’s decision will take the fight against HIV/Aids, TB and related health and socio-economic issues backwards.
“The interconnectedness of nations and humanity today is such that the indirect costs of this decision will be felt over time, by largely the poorer countries that have been receiving tremendous USAID-PEPFAR support, and indirectly the Americans who come to their shores. As we saw with Covid-19 health security does not insulate some nations more than others for long given the increased contact and inter-relationships between nations through sport, cultural activities, education and training etc.”
Meanwhile closer to home with local organisations also directly impacted by the decision, the Sex Workers Education and Advocacy Taskforce (Sweat) called on the government to ensure uninterrupted access to life-saving medications.
“Without immediate intervention, South Africa faces a dire risk of mass treatment defaulting, heightened vulnerability to HIV, and a reversal of years of progress in addressing public health crises,” the organisation said.
Additional reporting by Reuters.
Cape Times