No disease is deadlier in Africa than malaria. Trump's US aid cuts
weaken the fight against it
[March 10, 2025]
By RODNEY MUHUMUZA and CHINEDU ASADU
KAMPALA, Uganda (AP) — Malaria season begins this month in a large part
of Africa. No disease is deadlier on the continent, especially for
children. But the Trump administration's decision to terminate 90% of
USAID’s foreign aid contracts has local health officials warning of
catastrophe in some of the world’s poorest communities.
Dr. Jimmy Opigo, who runs Uganda’s malaria control program, told The
Associated Press that USAID stop-work orders issued in late January left
him and others “focusing on disaster preparedness.” The U.S. is the top
bilateral funder of anti-malaria efforts in Africa.
Anti-malarial medicines and insecticide-treated bed nets to help control
the mosquito-borne disease are “like our groceries,” Opigo said.
“There’s got to be continuous supply.”
As those dwindle with the U.S.-terminated contracts, he expects a rise
in cases later this year of severe malaria, which includes problems like
organ failure. There is no cure. Vaccines being rolled out in parts of
Africa are imperfect but are expected to largely continue with the
support of a global vaccine alliance.
The Washington-based Malaria No More says new modeling shows that just a
year of disruption in the malaria-control supply chain would lead to
nearly 15 million additional cases and 107,000 additional deaths
globally. It has urged the Trump administration to “restart these
life-saving programs before outbreaks get out of hand.”
Africa's 1.5 billion people accounted for 95% of an estimated 597,000
malaria deaths worldwide in 2023, according to the World Health
Organization.
Health workers in the three African nations most burdened by malaria —
Nigeria, Congo and Uganda — described a cascade of effects with the end
of most U.S. government support.
The U.S. has provided hundreds of millions of dollars every year to the
three countries alone through the USAID-led President’s Malaria
Initiative.
The U.S. funding has often been channeled through a web of
non-governmental organizations, medical charities and faith-based
organizations in projects that made malaria prevention and treatment
more accessible, even free, especially for rural communities.
Uganda in 2023 had 12.6 million malaria cases and nearly 16,000 deaths,
many of them children under 5 and pregnant women, according to WHO.
Opigo said the U.S. has been giving between $30 million and $35 million
annually for malaria control. He didn't say which contracts have been
terminated but noted that field research was also affected.
Some of the USAID funding in Uganda paid for mosquito-spraying
operations in remote areas. Those operations were supposed to begin in
February ahead of the rainy season, when stagnant water becomes breeding
ground for the wide-ranging anopheles mosquito. They have been
suspended.
“We have to spray the houses before the rains, when the mosquitoes come
to multiply,” Opigo said.
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Women wait to have the malaria vaccine R21/Matrix-M administered to
their children at the comprehensive Health Centre in Agudama-Epie,
in Yenagoa, Nigeria, Monday, Dec. 9, 2024. (AP Photo/Sunday Alamba,
File)
 Already, long lines of malaria
patients can be seen outside clinics in many areas every year.
Malaria accounts for 30% to 50% of outpatient visits to health
facilities across the country, according to Uganda National
Institute of Public Health.
Nigeria and Congo
Nigeria records a quarter of the world's malaria cases. But
authorities have reduced malaria-related deaths there by 55% since
2000 with the support of the U.S. and others.
That support is part of the $600 million in health assistance the
west African country received from the U.S. in 2023, according to
U.S. Embassy figures. It was not immediately clear whether all of
that funding has stopped.
The President’s Malaria Initiative 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 in pregnancy and insecticide
for 121,000 homes since 2011, the embassy says.
In Congo, U.S government funding has contributed about $650 million
towards malaria control since 2010.
Now, some of the successes in fighting malaria in Congo are being
threatened, which will complicate already difficult efforts to
identify and track disease outbreaks across the vast country as
supplies and expertise for malaria testing are affected.
Worsening conflict in Congo's east, where some health workers have
fled, has raised the risk of infection, with little backup coming.
With the loss of substantial U.S. support, “a lot of people are
going to be affected. Some people are really poor and cannot afford
(malaria treatment),” said Dr. Yetunde Ayo-Oyalowo, a Nigerian who
runs the Market Doctors nonprofit providing affordable local
healthcare services.
Up to 40% of her organization's clients are diagnosed with malaria,
Ayo-Oyalowo said.
There is hope among health workers in Africa that, even after the
dismantling of USAID, some U.S. funding will continue flowing via
other groups including the Global Fund to Fight AIDS, Tuberculosis
and Malaria. But that group also received U.S. support and has not
issued a public statement on the dramatic cuts in U.S. aid.
Opigo in Uganda said the U.S. Centers for Disease Control and
Prevention and the National Institutes of Health might be sources of
help.
But he added: “We need to manage the relationship with the U.S. very
carefully."
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