Mike Elvis Tusubira, a 35-year-old motorcycle taxi rider in Uganda, has seen his life take a devastating turn since U.S. President Donald Trump halted foreign aid last month.
Living with HIV, Tusubira relies on life-saving antiretroviral (ARV) drugs, while his wife, who is HIV-negative, depends on pre-exposure prophylaxis (PrEP) to prevent infection. However, with the U.S. aid freeze, their supply of crucial medication has been cut off.
“It means my marriage will end,” he told the BBC. “Without preventive measures, she won’t stay. No condoms, no lubricants, no PrEP—nothing. We can’t continue like this.”
The couple had previously received their medication and contraceptives through funding from USAID, the U.S. government’s primary foreign aid agency. But after the abrupt suspension, they have been unable to replenish their supplies. His wife has completely run out of PrEP, and while they still have some condoms left, they worry that relying solely on them is too risky.
U.S. Aid Freeze Shuts Down HIV Programs
On his first day back in office, Trump ordered a 90-day suspension of foreign aid, leading to immediate stop-work orders for USAID-funded organizations. While waivers were later issued for humanitarian projects, it was too late for the HIV program Tusubira depended on, which had already shut down.
Seeking answers, he called his health counselor at Kiswa Health Centre III in Kampala, only to learn that the counselor had left the clinic altogether.
Tusubira, who was diagnosed with HIV in 2022, has since missed a crucial test to monitor his viral load and immune system strength. “I’m moving in darkness,” he said. “I don’t know if my viral load is suppressed. I’m traumatized.”
His worries extend beyond his health. His five-year-old son, who had been receiving education and meals through a USAID-supported NGO, is now out of school.
“Without these services, everything is falling apart,” he said.
Uganda’s health system heavily relies on donor funding, with 70% of its HIV/AIDS programs supported by international aid. In 2023 alone, Uganda received $295 million from USAID, ranking as the third-largest recipient in Africa after Nigeria and Tanzania.
Widespread Impact on Healthcare Workers and Clinics
The aid freeze has also left thousands of healthcare workers in limbo.
Dr. Shamirah Nakitto, a clinician with Reach Out Mbuya (Rom)—a faith-based organization providing HIV care—previously treated 200 HIV and tuberculosis patients daily at Kisenyi Health Centre IV in Kampala. After the funding was halted, all Rom-supported health workers were dismissed.
“Everything stopped abruptly,” she said. “We didn’t even have a proper handover—we just stopped working.”
Uganda’s health ministry has acknowledged the crisis and is seeking ways to minimize disruptions. Officials have urged health workers to volunteer in the “spirit of patriotism” while awaiting a resolution.
Malawi Also Hit Hard
Further south, Malawi has also been severely impacted by the USAID funding freeze. The country, which received $154 million from USAID in 2023, has seen major disruptions to its HIV services.
In the northern city of Mzuzu, a key HIV treatment center, Macro Mzuzu Clinic, has been shut for 18 days. Vehicles sit idle, and the gates remain locked. Despite a waiver allowing the delivery of ARVs, the absence of healthcare workers means that distributing medicine remains a challenge.
Eddah Simfukwe Banda, a 32-year-old farmer living with HIV, now faces uncertainty as she has only three weeks of ARVs left. She and her sister-in-law, who also depends on donor-funded medication, fear the worst.
“We have to pray,” she said. “But this should also be a lesson—we depend too much on foreign aid.”
Malawi is one of the most aid-dependent countries in the world, with its economy vulnerable to external shocks such as droughts and cyclones. Experts warn that losing such a critical source of funding could have devastating consequences.
The Global Impact of the USAID Shutdown
The U.S. has long been Africa’s most significant partner in public health, particularly through the President’s Emergency Plan for AIDS Relief (PEPFAR), which has saved more than 25 million lives since its launch in 2003.
According to the head of the Africa Centres for Disease Control and Prevention (Africa CDC), USAID provided $8 billion in aid to Africa last year—73% of which was dedicated to healthcare.
Health experts warn that replacing this funding will be extremely difficult, especially for low-income nations already burdened with debt and economic instability.
South Africa and Kenya have made progress in funding their own HIV programs, covering 80% and nearly 60% of their costs, respectively. But for countries like Uganda and Malawi, self-sufficiency remains a distant goal.
Dr. Githinji Gitahi, CEO of Amref Health Africa, warns that without urgent action, global health security is at risk.
“With the rise in outbreaks due to climate change and environmental conflicts, this will leave the world vulnerable—not just Africa, but everyone,” he said.
Millions at Risk as HIV Crisis Worsens
In 2023, there were 630,000 AIDS-related deaths and 1.5 million new infections worldwide. Experts fear the situation will worsen without sustained funding.
Winnie Byanyima, head of UNAIDS, predicts catastrophic consequences if the U.S. does not restore aid.
“If this continues, we expect 6.3 million additional AIDS-related deaths in the next five years,” she warned. “There will be 8.7 million new infections and 3.4 million additional AIDS orphans. The progress we’ve made could be completely undone.”
Médecins Sans Frontières (MSF) has also cautioned against the dangers of disrupting HIV treatment, emphasizing that patients who stop taking their medication risk developing resistance and life-threatening complications.
A Bleak Future for Many
For people like Mike Elvis Tusubira, the outlook is grim. With just one month’s supply of ARVs left, he is considering leaving Kampala and returning to his village—fearing that his time is running out.
“At least in the village, if I die, they can bury me there,” he said. “I don’t know how I can survive without my treatment.”
SOURCE: BBC
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