A Looming Catastrophe: Trump’s aid cut increases concern

Concern over malaria, a disease deadlier than many others in Africa, particularly for children, has intensified following the Trump administration's decision to significantly cut foreign aid. With the malaria season beginning this month across large parts of Africa, the administration's move to terminate 90% of USAID's foreign aid contracts has local health officials warning of a potential catastrophe in some of the world's most vulnerable communities. USAID's stop-work orders, issued in late January, have forced many to focus on disaster preparedness. As the largest bilateral funder of anti-malaria efforts in Africa, the U.S. has played a critical role in providing anti-malarial medicines and insecticide-treated bed nets, which are essential for controlling the mosquito-borne disease. These supplies, likened to groceries in their necessity, are now at risk of severe shortages due to the aid cuts. As supplies dwindle, there is widespread fear of a surge in severe malaria cases later this year, including complications like organ failure.

A new modelling study by the Washington-based organisation Malaria No More reveals that just one year of disruption in the malaria-control supply chain could lead to nearly 15 million additional cases and 107,000 additional deaths globally. According to a WHO report, Africa's 1.5 billion people accounted for 95% of the estimated 597,000 malaria deaths worldwide in 2023. The withdrawal of most U.S. government support is expected to have a cascading effect, particularly in three of the most vulnerable countries: Nigeria, Congo, and Uganda. U.S. funding has traditionally been channelled through a network of non-governmental organisations, medical charities, and faith-based groups, making malaria prevention and treatment more accessible, often free, especially for rural communities.

Meanwhile, mosquito-spraying operations in remote areas, which were supposed to begin in February ahead of the rainy season when stagnant water becomes a breeding ground for malaria-carrying Anopheles mosquitoes, have been suspended. Already, long lines of malaria patients are a common sight outside clinics in many areas each year. Since 2011, the PMI has supported Nigeria's malaria response with nearly 164 million fast-acting medicines, 83 million insecticide-treated bed nets, over 100 million rapid diagnostic tests, 22 million preventive treatments for pregnant women, and insecticide for 121,000 homes. In Congo, U.S. government funding has contributed approximately $650 million toward malaria control since 2010. Now, some of the successes in fighting malaria in Congo are under threat, complicating already challenging efforts to identify and track disease outbreaks across the vast country as supplies and expertise for malaria testing are affected. The worsening conflict in eastern Congo, where some health workers have fled, has further raised the risk of infection, with little backup available.

Despite the dismantling of USAID's programs, health workers in Africa hope that some U.S. funding will continue through other channels, such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria. However, the Global Fund also relies on U.S. support and has yet to issue a public statement on the dramatic aid cuts. The Trump administration is being urged to reinstate these life-saving programs before malaria outbreaks spiral out of control. The stakes are high, and the consequences of inaction could be devastating for millions of people across the continent.