Trump administration pushes Africa to pay for U.S. health support

The United States is shifting its stance on global health assistance, urging African nations to take financial responsibility for health initiatives previously supported by American aid.

The new approach follows significant cuts to U.S. health funding for Africa, which has historically supported critical programs in maternal health, HIV, malaria, and emergency response.

In a meeting last Wednesday, senior officials from the Africa Centres for Disease Control and Prevention (Africa CDC) met with Susan Monarez, the newly appointed head of the U.S. Centers for Disease Control and Prevention (U.S. CDC), alongside other high-level American officials. The discussions, held in Washington D.C., focused on health security, financing options, and Africa CDC’s funding future.

Ngashi Ngongo, head of incident management at Africa CDC, described the U.S. administration’s position: “From their perspective, they would like to see health as a business, rather than something that functions on grants.”

This marks a departure from previous U.S. commitments, shifting toward a model that emphasizes private-sector involvement and African nations bearing more financial responsibility.

The sudden withdrawal of U.S. funds has left gaps in crucial African health programmes, including in HIV/AIDS and malaria treatments.

“We have seen major funding shortfalls in areas such as maternal and child health, HIV, malaria, and emergency preparedness,” said Ngongo.

Africa CDC Director General Jean Kaseya, also present at the meetings, underscored the urgency of securing alternative financing. Discussions will continue in April, coinciding with the World Bank’s spring meetings in Washington.

Health as a Business

The Trump administration’s push for a business-driven approach includes exploring private-sector partnerships in local pharmaceutical production, digital health infrastructure, and the electrification of medical facilities. “The question is how can we form partnerships that translate health into a viable business?” Ngongo explained.

U.S. officials acknowledged the importance of global health security but stressed Africa’s role in securing its own funding. “We made the point, which was accepted by our American counterparts, that global health security starts with what happens outside the U.S.,” said Ngongo.

Africa CDC currently faces a funding deficit of $224 million, exacerbated by the U.S. backing away from a previous commitment made under the Biden administration. Official development assistance (ODA) to Africa has plummeted, from $81 billion in 2021 to an expected $25 billion by 2025. Meanwhile, disease outbreaks on the continent have surged by 41% between 2022 and 2024.

Without new funding mechanisms, “We risk reversing two decades of health achievement on the continent,” Ngongo warned. The lack of funds, combined with fragile health systems and ongoing conflicts, could lead to a severe public health crisis.

“It doesn’t help to complain,” Ngongo stated. “If this is the new normal, we have to figure out how to adapt and ensure our health systems remain functional.”