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After U.S. cuts billions, East African countries steps up to plug budget gaps

Finance ministers across East Africa have increased health spending following U.S. President Donald Trump’s sudden withdrawal of billions of dollars in aid earlier this year.

After U.S. cuts billions, East African countries steps up to plug budget gaps
  • East African finance ministers have increased health expenditure due to a significant withdrawal of U.S. aid.
  • Uganda announced an allocation of $32 million for antiretroviral medication to address the issue.
  • Tanzania committed $31.8 million to cover immediate funding gaps resulting from aid withdrawal.
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Finance ministers across East Africa have increased health spending following U.S. President Donald Trump’s sudden withdrawal of billions of dollars in aid earlier this year.

The move, along with his protectionist policies that sparked tit-for-tat trade wars, sent shockwaves around the world, but nowhere has the impact been more deeply felt than in Africa.

Already, tens of thousands of healthcare workers across the continent have lost their jobs. And for many of the 17 million Africans living with HIV, two-thirds of all cases globally, access to life-saving treatment is now slipping out of reach, according to Bloomberg.

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Sub-Saharan Africa remains at the heart of the global HIV crisis. According to Statista, millions across the region live with the virus, with thousands more newly infected each year, a stark reminder of the urgent need for sustained support and investment.

Health advocates like Vincent Bagambe, Planning Director at the Uganda AIDS Commission, have raised the alarm that without swift action, recent funding cuts could undermine years of progress in reducing new HIV infections and curbing AIDS-related deaths.

In response, Uganda, Tanzania, and Kenya announced new plans in their 2025–26 budgets, delivered on Thursday, to fill the growing funding gap. The U.S. had allocated $200 million in aid for these countries this year, support that has now been withdrawn.

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Uganda, often praised as one of Africa’s success stories in tackling HIV and AIDS, is stepping up its response. The country plans to spend an additional 116.8 billion shillings ($32 million) on antiretroviral medication, Finance Minister Matia Kasaija announced.

Uganda currently has about 1.5 million people living with HIV, with a national prevalence rate of 5.1%, according to the Uganda AIDS Commission. In 2024, it received $194 million in HIV/AIDS assistance from the United States, the fifth-highest allocation globally, according to Statista.

Next door in Tanzania, which received $166 million in U.S. HIV/AIDS assistance in 2024, the government has already disbursed over 82 billion shillings ($31.8 million) to help cover funding shortfalls caused by the abrupt withdrawal, according to Finance Minister Mwigulu Nchemba.

Kenya, East Africa’s biggest economy and a recipient of $187 million in U.S. aid, is also responding. Treasury Secretary John Mbadi announced plans to allocate 17.3 billion shillings ($134 million) to the Global Fund, which supports efforts to combat HIV/AIDS, malaria, and tuberculosis. Another 4.6 billion shillings will go toward vaccines and immunization programs.

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