Across nine African nations, government-run health services are edging toward collapse, as dwindling U.S. aid and funding uncertainties leave clinics without medicine and life-saving care. The consequences are already severe—and growing.
“Suddenly, they’ll just not have drugs, and it’s going to be very difficult for other actors to step in,” said Singh, a health worker involved in crisis mapping. Her team is now racing to identify where the most dangerous service gaps could emerge.
In South Sudan, a cholera outbreak is hitting vulnerable communities hard, just as U.S.-funded clinics have shuttered.
In Jonglei state, children are reportedly walking hours to find treatment, with at least five dying en route, according to Save the Children.
Just across the border in Kenya’s Kakuma refugee camp—home to over 300,000 people—frustration is boiling over. Protests erupted in March after officials slashed food rations. Meanwhile, doctors say medical supplies are nearly gone.
“All the clinics around, you can get paracetamol. But all other drugs, no,” said one camp elder, requesting anonymity.
In Kinshasa, the capital of the Democratic Republic of Congo, the Kinkole General Hospital is treating dozens of mpox patients in makeshift tents, using funds provided by the U.S. government.
But as that support wavers, uncertainty deepens.
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“We’re thinking a disaster is coming,” warned Yvonne Walo, an epidemiologist at the hospital. The outbreak has already infected 16,000 and claimed 1,600 lives in the region.
The ripple effect may go further still. Reports from Washington suggest a potential pullback from funding Gavi, the global vaccine alliance supplying immunizations to the world’s poorest nations. Gavi CEO Sania Nishtar called the shortfall “too big a hole to be filled.”
The expected funding gap could derail immunization programs later this year, warned John Johnson of Doctors Without Borders.
In Nigeria’s Borno State—a region still grappling with insecurity from Boko Haram insurgents—laid-off aid worker Kunduli painted a bleak picture. “Even with U.S. funding, the work was overwhelming,” he said. “Now, I could only imagine.”
What’s unfolding in these regions is more than a local crisis. It’s a global warning: when international aid retreats, public health unravels—and it’s the world’s most vulnerable who pay the highest price.