The Trump administration’s decision to cut nearly 90% of USAID’s foreign aid contracts is expected to severely impact malaria control efforts in several African countries.
Malaria remains one of the deadliest diseases on the continent, particularly for children, raising concerns as transmission season begins. Health officials warn that some of the world’s poorest communities could face a catastrophic surge in cases.
Dr. Jimmy Opigo, head of Uganda’s malaria control program, told The Associated Press that USAID stop-work orders issued in late January have shifted focus toward disaster preparedness. The U.S. has been the largest bilateral funder of malaria prevention efforts in Africa.
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Opigo likened anti-malarial medicines and insecticide-treated bed nets to essential groceries, stressing the need for an uninterrupted supply. With U.S. funding halted, he anticipates a rise in severe malaria cases later this year, potentially leading to complications such as organ failure. There is no cure for severe malaria, and while vaccines are being rolled out in parts of Africa, their effectiveness remains limited without sustained global support.
The nonprofit Malaria No More estimates that a one-year disruption in the malaria-control supply chain could result in nearly 15 million additional cases and 107,000 more deaths globally. The organization has urged the Trump administration to reinstate funding to prevent widespread outbreaks.
Africa accounted for 95% of an estimated 597,000 malaria deaths worldwide in 2023, according to the World Health Organization.
Health workers in Nigeria, the Democratic Republic of Congo, and Uganda—three of the most malaria-affected nations—report mounting concerns over the end of most U.S. government support.
For years, the U.S. has provided hundreds of millions of dollars annually to these countries through the USAID-led President’s Malaria Initiative. This funding has been channeled through non-governmental organizations, medical charities, and faith-based groups to ensure malaria prevention and treatment reach rural communities at little or no cost.
In 2023, Uganda recorded 12.6 million malaria cases and nearly 16,000 deaths, with children under five and pregnant women among the most affected. Opigo noted that the U.S. has contributed between $30 million and $35 million annually to malaria control in Uganda. While he did not specify which contracts have been terminated, he confirmed that field research has also been disrupted.
Some of the lost USAID funding had supported mosquito-spraying operations in remote Ugandan communities, which were set to begin in February before the rainy season—when stagnant water fosters mosquito breeding. These operations have now been suspended.
“We need to spray before the rains, when mosquitoes multiply,” Opigo emphasized.
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Every year, long lines of malaria patients can be seen outside clinics in Uganda. Malaria accounts for 30% to 50% of outpatient visits to health facilities, according to the Uganda National Institute of Public Health.
Nigeria, which bears a quarter of the world’s malaria burden, has reduced malaria-related deaths by 55% since 2000 with the help of U.S. support. In 2023, Nigeria received $600 million in health assistance from the U.S., though it remains unclear how much of that funding has been withdrawn.
Since 2011, the President’s Malaria Initiative has helped Nigeria combat malaria by supplying nearly 164 million fast-acting medicines, 83 million insecticide-treated bed nets, over 100 million rapid diagnostic tests, 22 million preventive treatments for pregnant women, and insecticide for 121,000 homes.
In Congo, U.S. government funding has contributed roughly $650 million toward malaria control since 2010. However, the recent cuts threaten to reverse progress, complicating efforts to track disease outbreaks and distribute malaria testing kits across the country.
The ongoing conflict in eastern Congo has further increased infection risks, with many health workers forced to flee and little reinforcements available.
Dr. Yetunde Ayo-Oyalowo, who runs the Nigerian nonprofit Market Doctors, warned that the loss of U.S. support will have devastating consequences. “Many people are extremely poor and cannot afford malaria treatment,” she said, adding that up to 40% of her organization’s patients are diagnosed with malaria.
Some health workers hope that funding will continue through alternative sources such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria. However, the group also relies on U.S. funding and has not yet addressed the impact of these aid cuts.
Opigo remains cautiously optimistic that agencies like the U.S. Centers for Disease Control and Prevention and the National Institutes of Health may step in to help. However, he acknowledges the delicate situation, stating, “We need to manage our relationship with the U.S. very carefully.”
With malaria season underway and key programs at risk, the coming months could be devastating for millions across Africa.
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