JANUARY 28, 2025
The recent directive from the U.S. administration issued on January 24, 2025 has paused nearly all foreign aid including significant funding to Uganda. The withdrawal of funding from USAID-funded projects has far-reaching and multifaceted effects on local communities in Uganda given the significant role USAID has played in supporting the essential sectors of health, education, food security, economic development, and governance. The absence of this support disrupts services that millions of Ugandans depend on for their wellbeing and livelihoods.
Health
In the health sector, USAID funding has been instrumental in combating infectious diseases, improving maternal and child health, and strengthening health systems. Programs like the President’s Emergency Plan for AIDS Relief (PEPFAR) provide antiretroviral therapy (ART) to thousands of HIV-positive individuals. The withdrawal of funding will lead to interruptions in treatment, putting patients at risk of drug resistance and increased mortality. There are currently more than 1,416,800 people on ARV treatment across 2,051 health facilities. The suspension of services will mean immediate disruptions in care for thousands of individuals dependent on consistent medication.
Among the most affected are pregnant women living with HIV, who rely on PEPFAR for treatment to protect their health and prevent mother-to-child transmission. In Uganda alone, 41 newborns are estimated to contract HIV every day during the stoppage. Over a 90-day period, this could lead to more than 3,690 babies being born with HIV, many of whom will also go undiagnosed due to the suspension of infant HIV testing services. These infants face a significantly higher risk of mortality if they do not receive immediate treatment.
Beyond direct beneficiaries, Uganda’s healthcare workforce is also severely impacted. The country has 20,809 PEPFAR-supported healthcare providers, including 923 doctors, 1,622 nurses and midwives, 756 laboratory staff, and 12,551 community health workers. With stop-work orders in effect, many facilities will be left understaffed, making it difficult to provide even basic medical care. This will not only affect HIV services but also disrupt the broader healthcare system, straining already limited resources
USAID has supported immunization, malaria and TB campaigns. Rural clinics will likely face shortages of vaccines, essential medicines, and health care staffing, resulting in a resurgence of preventable diseases. Maternal and child health services also face disruptions, potentially increasing maternal mortality rates.
Education
Education is another sector heavily impacted by the withdrawal of USAID funding. The agency has supported the construction of schools, provision of learning materials, and teacher training programs. Digital learning tools provided to schools in remote regions have improved access to education for many children. A work stoppage order means schools are under-resourced and unable to meet the growing demand for quality education. Programs addressing barriers to girls’ education, such as early marriage and menstrual health, are also at risk and hard-fought efforts to improve gender equity in education will be lost.
Food security
Food security is a critical concern, especially for Uganda’s refugee population of over 1.3 million people. USAID has funded food aid programs that provide life-saving assistance to refugees in settlements like Bidi Bidi and Nakivale. The cessation of funding jeopardizes these programs leading to increased hunger and malnutrition. USAID’s agricultural development initiatives, such as the Feed the Future program, have helped smallholder farmers improve productivity and adopt climate-resilient practices. Without these interventions, communities reliant on agriculture will struggle to sustain their livelihoods, particularly in the face of climate-related challenges.
Economic development and livelihoods
The withdrawal of funding also affects economic development and livelihoods. USAID has supported programs that empower women through financial literacy and entrepreneurship training. Initiatives with women in Kampala’s slums have enabled many to start small businesses and improve their household incomes. Youth vocational training programs funded by USAID have equipped young people with skills that have reduced youth unemployment. The funding halt limits these opportunities, exacerbating poverty and increasing the risk of social unrest.
Humanitarian assistance is another area where the impact of USAID funding withdrawal will be felt deeply. In times of natural disasters, such as floods in Kasese or droughts in Karamoja, USAID has provided emergency aid, food, shelter, and medical supplies. The absence of such support in future crises leaves communities vulnerable and less prepared to respond effectively. Access to clean water and sanitation, particularly in rural areas and refugee settlements, has been bolstered by USAID projects like borehole drilling and hygiene campaigns. The risk of waterborne disease outbreaks can only increase with funding withdrawals.
Strain on Civil Society and Governance Initiatives
Civil society and governance programs are also at risk. Many local organizations in Uganda rely on USAID funding to advocate for child protection, gender equality, and education. These organizations face significant challenges in sustaining their work without external financial support. USAID’s efforts to promote good governance, transparency, and institutional strength may stall and hinder progress toward accountable and effective public sector management.
The impact of the funding withdrawal is evident in past crises. During a temporary funding shortfall in 2022, refugee clinics in northern Uganda reported overcrowding, drug shortages, and increased mortality rates. Similarly, in Karamoja, USAID-supported resilience programs helped farmers adapt to drought, but without funding the region’s food insecurity increased. These examples highlight the ripple effect of reduced aid on Uganda’s most vulnerable populations.
Joy for Children Uganda has actively reached out to organizations to understand the depth and breadth of the impact of the funding withdrawal and to explore possible collaboration to mitigate the crisis. Unfortunately, these organizations, while empathetic, are not in a position to share meaningful information or extend support, as they themselves are grappling with the consequences of reduced funding flows. With a stop work order and without access to data or resources many of these groups are unable to assess the full extent of the crisis or respond effectively. Most importantly, this creates a domino effect, where the entire ecosystem of support and service delivery for vulnerable communities becomes weaker, leaving the highest risk populations with fewer lifelines and options for support.
The withdrawal of USAID funding has profound consequences not only for those directly benefiting from aid programs but also for individuals at the very bottom of the social ladder and organizations indirectly connected to these initiatives. The lowest-income individuals in Uganda, such as daily wage earners, subsistence farmers, and marginalized groups, often rely on ripple effects from aid-funded programs for survival. When funding dries up, the trickle-down impact on these vulnerable populations becomes more pronounced. These individuals may lose access to essential services like healthcare, food aid, or education initiatives, further entrenching poverty and creating cycles of deprivation.
Overall, the suspension of U.S. foreign aid has prompted urgent appeals from aid organizations which are calling for the swift resumption of funding to prevent what inevitably could become a humanitarian crisis.
