The US cuts almost all of its spending to aid. The biggest loser is Africa.
For years, sub-Saharan Africa has received more US aid money than any other region, except in 2022 and 2023, when the US came to aid Ukrainians after the Russian invasion.
In 2024, $12.7 billion in US foreign aid travelled directly to sub-Saharan Africa, with billions more going to global programs that included health and climate initiatives, where Africa was the main beneficiary.
Virtually all of that aid is set to disappear in the wake of President Trump's decision to dismantle the US International Development Agency. The cuts are expected to rescind decades of efforts to save lives, separate people from poverty, fight terrorism and promote human rights in Africa, the youngest and fastest growing continent in the world.
Trump officials have denounced the agency of waste and fraud. In a speech to Congress on Tuesday, Trump opposed aid to Africa, saying the US is spending millions of people promoting LGBTQ issues that “no one has ever heard of in the African Lesotho nation.”
The Supreme Court on Wednesday held that USAID and the State Department must pay $2 billion for work already completed, but the ruling would have little effect on the broader consequences of eliminating most foreign aid in the United States.
A New York Times survey of government spending data found that most of the aid is spent on humanitarian, health and disaster relief. Many African countries also have major programs focused on collecting global health data, making it difficult to accurately track the outcomes of these tragedy.
Research shows that Americans are divided on whether foreign aid is valuable or effective. However, scholar and former Liberian minister W. Gyude Moore said the way it is being dismantled was “almost free in its cruelty.”
Of the eight countries most vulnerable to USAID reductions, seven are in Africa (the other is Afghanistan). This is a breakdown of what Africa will lose as the US reduces its aid contributions around the world.
Humanitarian relief during conflict
Africa suffers from several humanitarian crises characterized by extreme hunger and violence, from the fighting factions in Sudan to the waves of extreme violence that destabilise the militant group and the Sahel.
Last year, the US spent $4.9 billion to help people escape such conflicts and overcome natural disasters such as floods and hurricanes.
The world's largest American humanitarian program in 2024 was the Democratic Republic of the Congo, and the United States spent $910 million on food, water, sanitation and shelter on more than 7 million displaced people, according to the nation's humanitarian coordinator Bruno Lemarquis.
As a donor, the US was “super dominant” in Congo, said Lemarquis paid 70% of humanitarian expenses last year. He said that 7.8 million people now represent the loss of food aid, and 2.3 million children are at risk of facing fatal malnutrition.
Last week, the United Nations said Congo would need $2.54 billion this year to provide lifesaving assistance to 11 million people.
Last year, the US was the largest donor to Sudan, funding more than 1,000 communal kitchens and fled the starving people from a brutal civil war. These kitchens are now closed, and Sudan is facing “a massive death from hunger.”
For decades, the United States has led efforts to combat hunger around the world, but hunger will likely increase and become fatal, according to International Crisis Group, an independent, non-governmental organization that seeks to prevent and resolve conflicts.
Supporting fight HIV and other illnesses
In 2003, President George W. Bush created an AIDS relief plan for the President of the United States. This has since invested more than $110 billion to fight HIV and AIDS worldwide.
The program's main focus is sub-Saharan Africa, where the majority of people living with HIV live, 25 million of the 40 million patients worldwide.
For many African governments facing limited resources, the program is a lifeline, filling gaps in national health budgets, paying health workers, and putting millions of HIV patients into antiretroviral medications.
According to the United Nations, countries where the program is active have seen a decline in new HIV cases more than half since 2010. But experts warn that it could reverse that progress. One estimate warns that more than half a million people with HIV will die unnecessary in South Africa alone.
In Congo, when combat recently prevented patients from taking antiretroviral drugs, 8% of them died in a month, Lemarquis said. Based on that mortality rate, 15,000 people in Congo could die in a month due to a reduction in USAID, he said.
Around 516 health facilities have been forced to close this year in Ivory Coast, where the program provides half of funding for HIV response nationwide.
However, US funding on global health has expanded beyond the US President's malaria initiative, which was also launched by Bush, and since its establishment in 2005, it has spent more than $9 billion fighting malaria.
Nigeria and Congo account for more than a third of the world's malaria infections, both of which are major recipients of the US global health fund, with Nigeria relying on approximately 21% of its national health budget.
USAID estimates that up to 18 million cases of malaria and polio paralyze 200,000 children each year, with more than one million children untreated for the most fatal hunger, according to the lack of funds.
Long-standing global leader in aid
The Trump administration's decision to dismantle USAID is in line with the global trend of Western countries reducing foreign aid programs.
France reduced aid in a third of last year, but Germany, one of the world's most generous donors, has cut aid and development assistance by $5.3 billion over the past three years. There is also assistance in the Netherlands.
However, none of these countries' aid programs were close to the scale of what was provided by the US.
Since 1972, the United States has spent less than 0.3% of its gross national income on aid.
With the US currently retreating, China is ready to play an even bigger role in the continent where US influence is currently sliding around. Last year, China pledged $50 billion worth of continental investment, loans and aid over three years, and promised to create 1 million jobs.
China is primarily focused on infrastructure development and access to African resources. Experts say it is unlikely that the West will provide health and humanitarian aid on a scale it has done in the past.
“Trump has unleashed something, and development aid probably won't be the same again, as we know,” Moore said.
Nutrition from Americans
Last week, a court application revealed that Secretary of State Marco Rubio had decided to eliminate more than 90% of the USAID grants and 40% of the State Department.
These cases are now passing through court, where several aid and advocacy groups are trying to stop them from suing the Trump administration and obstructing USAID forever.
In the meantime, Rubio said the government will temporarily continue life-saving assistance overseas and will issue a humanitarian aid waiver, including emergency food, in January. However, even exempt programs are struggling to continue as USAID's payment system is blocked and thousands of agent workers have been fired or taken leave.
For some of those affected by the cut, survival appears to depend on whether Elon Musk, the billionaire who leads government efficiency, is aware of their cause.
Last week, the CEO of the Georgia company was making special fortified peanut butter pouches for severely malnourished children.
The deal was revived after the podcast host brought an interview to Musk's attention. However, since those who transport peanut butter are not paid, the food may never reach children who need it.
Each pouch is labeled “From American.”
