Navigating USAid funding cut in the health sector

The ripple effect of the United States Agency for International Development (USAID) funding cut on healthcare including reproductive health advocacy is bound to be felt by women and communities. These groups need reproductive health services, including maternal care, access to safe family planning, gender-based violence pre and post-care, and other lifesaving care.

In many African countries, Civil Society Organisations (CSOs) and women’s rights groups play a key role in advocating for policy and legal reforms to advance women’s rights. They are the link between evidence from the community to decision-makers and shape the discourse on reproductive justice.

CSOs hold decision-makers accountable by constantly challenging societal order, thus creating the momentum needed for African governments to act on discriminatory laws against marginalised communities, including women and girls. However, decades of advancements made by CSOs in promoting women’s rights are being reversed by the USAID funding cut.

For years, USAID’s family planning programme was the main source for contraception and HIV prevention and treatment in some countries. In 2023, USAID allocated approximately $607.5 million to its family planning and reproductive health programs. The funding supports a range of initiatives, including access to family planning services and commodities in support of the FP2030 strategy for ensuring family planning for all, promoting safe motherhood, and other community interventions globally.

CSOs have been leading programmes that intervene in rural, hard-to-reach areas and humanitarian settings in Africa. Without the funding, they will be forced to scale down or shut down some of the programs, putting the lives of vulnerable communities including women and girls at risk. The role of CSOs in national, regional, and global convenings where decision-makers converge cannot be underestimated. However, with the discontinuation of the funding, many CSOs will not be able to participate in spaces where they represent marginalised voices and participate in important policy dialogues.

In the healthcare sector, the funding cuts have created a lot of uncertainty for healthcare providers and frontline workers, leading to shortage of resources, heavier workloads, and concerns over job stability. These constraints have made it increasingly difficult to sustain the delivery of essential reproductive health services, particularly for vulnerable populations who rely on them the most.

The USAID funding cut presents a significant challenge to the health sector. However, it is also a wake-up call for governments to allocate more funding to the health sector. Specifically, African governments need to raise funds within their economies to fund health programs rather than relying on external donor aid. In 2001, African governments adopted the Abuja Declaration in which they set a target allocating at least 15 percent of their national budgets to healthcare.

Almost everyone in one way or another has been affected by the USAID funding cut. With the changing funding landscape, the health sector stakeholders need to rethink their funding strategies. African governments need to prioritise healthcare and mobilise domestic resources to ensure quality, affordable, and accessible services for all.

-The writer is a policy advocacy manager at African Population and Health Research Centre.