US aid withdrawal forced African countries to absorb health programs or lose them, report says

The Trump administration's dissolution of USAID and withdrawal from global health initiatives forced countries across Africa to restructure their health systems abruptly, according to a report published Monday by the Accra Reset, a health initiative led by Ghanaian President John Dramani Mahama.

Nigeria absorbed 28,000 health workers previously employed by USAID at a cost of $200 million, the report says. In South Africa, the withdrawal of Pepfar funding — more than $400 million a year — led to HIV clinics closing and left 1.4 million people living with HIV uncertain about their treatment. Mahama said Ghana lost $78 million when USAID programs shut down, affecting maternal healthcare, malaria treatment, nutrition, and HIV interventions.

External financing for health in Africa contracted by nearly 70% between 2021 and 2025, the report states. Mahama calls the cuts evidence that donor dependency is unsustainable and argues that countries in the Global South should set their own health priorities rather than rely on Western aid.

Africa produces less than 1% of its vaccines while bearing about 25% of the global disease burden, according to figures cited by the initiative.