As West Africa enters its rainy season, bringing a surge in malaria-carrying mosquitoes, healthcare systems across the region are faltering. In Nigeria’s Borno State, nurse Musa Adamu Ibrahim now sits at home, unemployed, as once-busy clinics have shut their doors.
“Nobody is handing out free drugs or mosquito nets anymore,” Ibrahim said, citing the abrupt withdrawal of U.S. aid under President Donald Trump’s administration. Nigeria, which accounts for 30% of the world’s annual 600,000 malaria deaths, has been especially hard-hit.
The dismantling of USAID—the U.S. government’s primary international aid agency—is unraveling public health networks in Africa built over years through collaboration between governments, NGOs, and foreign donors.
The fallout is already visible:
– **Clinics are closed.**
– **Malaria and malnutrition treatments have stopped.**
– **Medical supply chains are disrupted.**
– **Refugee camps in Kenya are facing drug shortages.**
“People with money will find a way, but the poorest—especially those in remote regions—will be left behind,” said Lawrence Barat, former advisor to the U.S. President’s Malaria Initiative.
**Forecasts Derailed**
During the peak malaria season, Ibrahim’s clinic used to treat 300 patients weekly. His colleague, Fatima Kunduli, said her clinic in Borno handled 60 children a day before it was closed.
The seasonal rains have begun in Nigeria and are expected soon in countries like Senegal. With USAID pulling out, health ministries are scrambling. In Mali, drugs are still arriving—but without U.S. support, distribution efforts are in disarray. In the Democratic Republic of Congo, nine provinces relied on USAID to supply malaria drugs and tests. Now, there’s uncertainty.
Saschveen Singh of Doctors Without Borders said teams are “scrambling” to map out service gaps. “Suddenly, people just won’t have access to drugs.”
**Cholera Treatment Cut Off**
In South Sudan, USAID-funded clinics shut down amid a cholera outbreak. Children have died walking for hours to reach the nearest open clinic. In Kenya’s Kakuma refugee camp, hosting over 300,000 people, protests erupted in March over food ration cuts, while doctors face medicine shortages.
“All the clinics have paracetamol—but nothing else,” said a camp elder.
In Kinshasa, at Kinkole General Hospital, 23 mpox patients are currently being treated in tents. Staff fear support will soon vanish, despite a national outbreak infecting 16,000 and killing 1,600.
“We’re bracing for disaster,” said epidemiologist Yvonne Walo.
**Vaccination Program Threatened**
Even more challenges may lie ahead. The U.S. is considering slashing its support for Gavi, the vaccine alliance supplying low-cost immunizations to the world’s poorest countries.
“This hole is too big to fill,” said Gavi CEO Sania Nishtar. Doctors Without Borders warns that vaccine access could crumble by the end of the year.
In Borno, where fears of renewed Boko Haram activity are growing, Kunduli says even with U.S. aid, the health needs were overwhelming. Now, she says, “I can only imagine what’s next.”
