The United States is cutting almost all its spending on aid. The biggest loser will be Africa.
For years, sub-Saharan Africa has received more U.S. aid money than any other region — except for 2022 and 2023, when the United States came to Ukraine’s aid after the Russian invasion.
In 2024, $12.7 billion of $41 billion in American foreign assistance went straight to sub-Saharan Africa, and billions more went to global programs — including health and climate initiatives — for which Africa was the main beneficiary.
Practically all of that aid is set to disappear in the wake of President Trump’s decision to dismantle the U.S. Agency for International Development. The cuts are expected to undo decades of efforts to save lives, pull people out of poverty, combat terrorism and promote human rights in Africa, the world’s youngest, fastest-growing continent.
Trump officials have accused the agency of waste and fraud. In his speech to Congress on Tuesday, Mr. Trump railed against aid to Africa, saying the United States was spending millions to promote L.G.B.T.Q. issues “in the African nation of Lesotho, which nobody has ever heard of.”
The Supreme Court on Wednesday ruled that U.S.A.I.D. and the State Department must pay contractors as much as $2 billion for work already completed, but the ruling will have little affect on the wider consequences of eliminating most U.S. foreign assistance.
A New York Times examination of government spending data found that most aid has been spent on humanitarian, health and disaster assistance. In many African countries, it will be harder to accurately track the consequences of these tragedies, since a major program focused on collecting global health data has also been axed.
Surveys show that Americans are divided on whether foreign aid is valuable or effective. But W. Gyude Moore, a scholar and former Liberian minister, said the way it is being dismantled is “almost gratuitous in its cruelty.”
Seven of the eight countries most vulnerable to the U.S.A.I.D. cuts are in Africa (the other is Afghanistan). Here is a breakdown of what Africa stands to lose as the United States draws down its aid contributions across the world.
Humanitarian Relief During Conflicts
Africa is struggling with several humanitarian crises marked by extreme hunger and violence, from warring factions in Sudan to armed groups ravaging eastern Congo and a wave of extremist violence destabilizing the Sahel.
Last year the United States spent $4.9 billion helping people flee such conflicts or survive natural disasters like floods and hurricanes.
The biggest American humanitarian program in the world in 2024 was in the Democratic Republic of Congo, where the United States spent $910 million on food, water, sanitation and shelter for more than seven million displaced people, according to Bruno Lemarquis, the United Nations’ humanitarian coordinator in the country.
As a donor, the U.S. was “ultra dominant” in Congo, Mr. Lemarquis said, paying 70 percent of the humanitarian costs last year. Now 7.8 million people stand to lose food aid, and 2.3 million children risk facing deadly malnutrition, he said.
Last week, the U.N. said Congo needs $2.54 billion to provide lifesaving assistance to 11 million people in 2025.
The United States was also the biggest donor last year to Sudan, where it funded over 1,000 communal kitchens to feed starving people fleeing a brutal civil war. Those kitchens have now shuttered, and Sudan is facing “mass deaths from famine,” according to the United Nations human rights chief, Volker Turk.
For decades, the United States led efforts to combat famine worldwide, but now famines will likely multiply and become deadlier, according to the International Crisis Group, an independent, nongovernment organization that seeks to prevent and resolve conflict.
Assistance Fighting H.I.V. and Other Illness
In 2003, President George W. Bush created the U.S. President’s Emergency Plan for AIDS Relief, which has since invested over $110 billion to fight H.I.V. and AIDS globally.
The program’s primary focus has been sub-Saharan Africa, where the majority of people living with H.I.V. reside — 25 million of the globe’s 40 million patients.
For many African governments facing limited resources, the program has been a lifeline, filling gaps in national health budgets, paying health care workers and putting millions of H.I.V. patients on antiretroviral drugs.
In countries where the program was active, new H.I.V. cases have been reduced by over a half since 2010, according to the U.N. But experts have warned the cuts could reverse that progress: more than half a million people with H.I.V. will die unnecessarily in South Africa alone, according to one estimate.
In Congo, when fighting recently prevented patients from taking their antiretroviral drugs, 8 percent of them died in one month, Mr. Lemarquis said. Based on that mortality rate, 15,000 people in Congo could die in a month because of the U.S.A.I.D. cuts, he said.
In Ivory Coast, where the program provides half the funding for the national H.I.V. response, approximately 516 health care facilities have been forced to shut this year.
But the U.S. funding on global health extends beyond H.I.V. The U.S. President’s Malaria Initiative, also launched by Mr. Bush, has spent over $9 billion to fight malaria since inception in 2005.
Nigeria and Congo, which together account for over a third of the world’s malaria infections, are both major recipients of U.S. global health funding, and Nigeria relies on it for about 21 percent of its national health budget.
With the funding gone, every year there will be up to 18 million more cases of malaria, 200,000 children paralyzed by polio and one million more children not treated for the most fatal kind of hunger, according to U.S.A.I.D. estimates.
A Longtime Global Leader in Aid
The Trump administration’s decision to dismantle U.S.A.I.D. is in line with a global trend among Western nations of scaling back on foreign assistance programs.
France reduced its aid by a third last year, while Germany — one of the world’s most generous donors — cut aid and development assistance by $5.3 billion in the past three years. The Netherlands has cut aid, too.
But none of these countries’ aid programs were anywhere near the size of what has been provided by the United States.
The United States has spent less than 0.3 percent of its Gross National Income on aid since 1972. But in Africa — by far the poorest continent — that was big money.
With the United States now in retreat, China is poised to take on an even bigger role on a continent where U.S. influence has lately been slipping. Last year, China promised the continent investment, loans and aid worth $50 billion over three years, and pledged to create one million jobs.
China has largely focused on developing infrastructure and accessing African resources. It is unlikely to provide health and humanitarian aid on the scale the West has done in the past, experts say.
“Trump has unleashed something, and development aid as we know it will probably never be the same again,” said Mr. Moore.
Sustenance ‘From the American People’
Last week, court filings revealed that Secretary of State Marco Rubio had decided to eliminate over 90 percent of U.S.A.I.D. grants and 40 percent of those from the State Department.
Several aid organizations and advocacy groups have sued the Trump administration, trying to stop it from permanently gutting U.S.A.I.D. These cases are now going through the courts.
In the meantime, Mr. Rubio said the government would temporarily continue lifesaving assistance abroad, issuing waivers for humanitarian aid including emergency food in January. But even those programs that received waivers have struggled to carry on, as U.S.A.I.D.’s payments system has been blocked, and thousands of agency workers have been fired or put on leave.
For some of those affected by the cuts, survival appears to depend on whether Elon Musk, the billionaire leading the Department of Government Efficiency, takes notice of their cause.
Last week the chief exec of a company in Georgia that makes pouches of special fortified peanut butter for severely malnourished children told C.N.N. that U.S.A.I.D. had canceled all his company’s contracts.
After a podcast host brought the interview to Mr. Musk’s attention, the contracts were reinstated. But because those who transport the peanut butter are not getting paid, the food may never reach the children who need it.
Each pouch is labeled, “From the American people.”
