Health Chronicle /2026: Africa faces challenges posed by international cuts to health aid

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Extract from the article: The year 2025 saw a significant reduction in international health aid for many African countries. According to the WHO, external health aid fell by 30% to 40% compared to 2023, causing major disruptions to essential services, including vaccination, m

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The year 2025 saw a significant reduction in international health aid for many African countries. According to the WHO, external health aid fell by 30% to 40% compared to 2023, causing major disruptions to essential services, including vaccination, maternal care and emergency response, in low- and middle-income countries. This decline is linked to a strategic shift by traditional donors, the reconfiguration of key programmes such as USAID/PEPFAR, and political uncertainty in some donor powers.

The 14th Annual Meeting of the Ouagadougou Partnership (RAPO), held in Lomé in December 2025, focused its discussions on the theme: ‘Accelerating domestic financing for sexual and reproductive health and rights: what strategies for sustainable commitment?’ At the end of the meeting, participants from member countries called on governments to: increase national funding to ensure the continuity of health services in the face of declining foreign aid; diversify sources of domestic funding and strengthen health sovereignty; and implement more resilient and local financing arrangements to reduce dependence on external donors.

The United States of America leaves the WHO

The United States, one of the WHO's largest financial contributors, has announced its withdrawal from the organisation in 2025. Without its mandatory and voluntary contributions, estimated at around 18% of the total budget, the WHO is struggling to meet its operating costs and support African countries, particularly in the implementation of their health policies.

Direct effects on health in Africa

Africa is heavily dependent on external aid to finance its health systems. The withdrawal of the United States from global funding and the dissolution of structures such as USAID, once a pillar of global health financing, have led, among other things, to: the cessation or reduction of key programmes, particularly those related to HIV/AIDS, tuberculosis and malaria; increased pressure on national and household funding, with the risk of increased direct expenditure for already vulnerable populations; disruption of drug and vaccine supply chains; and weakened health surveillance.

Some experts predict that the cessation or reduction of US funding could result in millions of new infections or preventable deaths if alternative solutions are not found in time.

Gamé KOKO (Source: WHO)