The Africa Centre for Disease Control and Prevention (Africa CDC) has issued a dire warning ahead of the U.S. Congress’s debate on the reauthorization of the President’s Emergency Plan for AIDS Relief (PEPFAR) on March 25. The agency cautions that millions of lives across Africa are at risk due to abrupt cuts in U.S. and European development aid, threatening to reverse decades of progress in global health.
Director-general of Africa CDC, Dr. Jean Kaseya speaking during a bi-weekly media webinar on Thursday, stated that reductions in foreign aid could result in two to four million additional deaths annually. He described the situation as a “total disaster” for Africa’s health sector, emphasizing the devastating impact on HIV/AIDS treatment, maternal and child health, and overall disease control efforts.
According to Science Nigeria, the recent termination of several PEPFAR-funded programs follows decisions by the Trump-appointed Elon Musk’s Department of Government Efficiency (DOGE). Additionally, USAID has withdrawn critical support and major European donors have significantly reduced their Official Development Assistance (ODA) budgets.
The World Health Organisation (WHO) has warned that countries like Nigeria, Kenya, Lesotho, and South Sudan could run out of life-saving antiretroviral (ARV) drugs within months. For some African nations, external assistance covers up to 80 per cent of their HIV and malaria response efforts. The loss of funding jeopardises the health of millions of people living with HIV/AIDS, many of whom rely entirely on donor-supported programmes for treatment.
Kaseya underscored the gravity of the situation, revealing that 30 per cent of Africa’s total health expenditure comes from ODA. However, in 2025, ODA funding to Africa has been slashed by 70 per cent, plunging from $81 billion to just $25 billion.
Beyond the HIV/AIDS crisis, the funding cuts come at a time when disease outbreaks in Africa have surged by 41 per cent over the past two years.
In the Democratic Republic of Congo (DRC), the withdrawal of USAID funding has severely affected Mpox (monkeypox) testing, leading to a 16 per cent drop in confirmed cases. However, this does not indicate progress but rather a lack of resources to track infections.
– Testing turnaround times in multiple regions have significantly increased due to logistical challenges and financial constraints.
– Healthcare systems in many African nations are now at risk of total collapse, potentially pushing 39 million more people into extreme poverty due to unaffordable healthcare costs.
Kaseya warned that these developments threaten to undo 20 years of progress in global health, particularly in maternal and child health, infectious disease control, and poverty reduction.
One of Africa’s biggest challenges has been securing sustainable health financing.
Currently, only two African countries – Botswana and Rwanda – meet the Abuja Declaration’s commitment to allocate 15 per cent of GDP to healthcare. Only 16 African nations have structured national health financing plans, leaving most countries highly dependent on donor aid to sustain their health systems.
Kaseya stressed that without external funding, many nations will struggle to keep their healthcare services afloat.
As the U.S. Congress debates the future of PEPFAR, African leaders are urgently seeking alternative funding solutions.
Kaseya has been meeting with African ministers and the African Union to push for increased domestic health investment. He has also advocated for “blended financing” strategies, incorporating private sector investment in public health. One innovative proposal involves leveraging the $95 billion in annual remittances from the African diaspora, potentially through a taxation model to fund healthcare initiatives.
However, with limited time to find solutions, Dr. Kaseya announced plans to meet with members of the Trump administration, PEPFAR officials, and U.S. lawmakers to argue for the continuation of vital aid programs.
In response to growing concerns, WHO Director-General Dr. Tedros Adhanom Ghebreyesus has urged donor countries to ensure that if they withdraw funding, it is done in a “responsible and humane” manner. He emphasized the need for a structured transition plan to allow affected nations to develop alternative financing mechanisms.
As African nations brace for worsening health conditions, the world is watching to see whether Washington will step in to prevent a humanitarian catastrophe or if decades of progress in global health will be undone within months.
With millions of lives hanging in the balance, the outcome of the PEPFAR debate could determine the future of Africa’s fight against infectious diseases and the survival of millions of vulnerable people across the continent.
