Critical Malaria and HIV Programs Face Uncertainty Amid US Funding Withdrawal
The decision by former US President Donald Trump to withdraw the United States from the World Health Organization (WHO) has sent shockwaves through global health initiatives, with Nigeria among the hardest-hit nations. The move threatens funding for essential health programs, including HIV/AIDS, tuberculosis, and malaria prevention.
The Conversation Africa’s Adejuwon Soyinka spoke with Professor Oyewale Tomori, a renowned virologist and former WHO Africa regional expert, to discuss Nigeria’s heavy reliance on US aid, the potential impact of funding cuts, and strategies to mitigate the crisis.
Nigeria’s Dependence on US Health Aid
Nigeria, like many African nations, leans heavily on donor funding for healthcare. According to a US Embassy report, the United States has committed nearly $20 billion to health programs across Africa since 2021. In 2023 alone, over $600 million was invested in Nigeria’s health sector—accounting for approximately 21% of the country’s annual health budget.
Despite being Africa’s largest economy, Nigeria allocates only about 5% of its national budget to health, with three-quarters of this amount covering salaries and recurrent expenses. The 2025 proposed budget earmarks just 4.8% for healthcare, a decline from 5.15% in 2024.
US-Supported Health Programs at Risk
The US government funds critical initiatives such as:
- The President’s Malaria Initiative (PMI) – Providing insecticide-treated bed nets, rapid diagnostic tests, and preventive treatments.
- The President’s Emergency Plan for AIDS Relief (PEPFAR) – Offering HIV testing, antiretroviral treatment, and mother-to-child transmission prevention.
- Vaccine Distribution – Supporting COVID-19, polio, HPV, and other immunization efforts.
Nigeria bears the highest global malaria burden, with an estimated 68 million cases and 194,000 deaths in 2021. It also ranks fourth worldwide in HIV prevalence, with 1,400 new cases reported weekly in 2023. Additionally, outbreaks of yellow fever, cholera, meningitis, and Lassa fever further strain the country’s fragile health system.
Beyond disease management, US funding has enhanced Nigeria’s disease surveillance capacity, upgraded laboratory diagnostics, and supported the establishment of a Public Health Emergency Management Program.
The Risks of Funding Cuts
The withdrawal of US funding places Nigeria’s healthcare system at a critical juncture. Key concerns include:
- Malaria control setbacks – Reduced access to bed nets, diagnostic tests, and treatment drugs.
- HIV/AIDS interventions compromised – Limited testing, reduced prevention programs for pregnant women, and a decline in care for orphans and vulnerable children.
- Laboratory diagnostics weakened – A potential shortage of reagents and equipment maintenance disruptions.
While other nations such as Japan, Germany, Canada, and the UK provide assistance, their contributions may not be sufficient to bridge the funding gap left by the US exit.
Why Nigeria Remains Dependent on Foreign Aid
Professor Tomori argues that Nigeria’s reliance on donor funding is a reflection of governance failure rather than a lack of resources. “Nigeria is not resource-limited; it is resource-wasteful. The country is not constrained by a lack of funds, but by corruption and mismanagement,” he states.
He highlights the country’s proven capacity in disease control, citing the successful containment of the 2014 Ebola outbreak in just three months—while the epidemic devastated other West African nations for years. However, he warns that a continued dependency mindset prevents Nigeria from taking full ownership of its healthcare needs.
The Path Forward: Mitigating the Impact
To counter the fallout from US funding withdrawal, Nigeria must:
- Allocate emergency health funds – To cover immediate gaps in malaria, HIV, and vaccine programs.
- Prioritize disease prevention and control – Strengthening local healthcare infrastructure with sustained funding.
- Decentralize healthcare responsibilities – Empowering state and local governments to lead public health initiatives, while the Nigeria Centre for Disease Control (NCDC) coordinates efforts.
- Invest in health workforce retention – Addressing the mass exodus of Nigerian doctors due to poor working conditions.
Trump’s previous actions signaled unpredictability in US global health commitments. With another potential term on the horizon, Nigeria must act swiftly to build a self-reliant healthcare system—before future political shifts deal an even harsher blow.
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