Kenyans hit hard after US Aid freeze order by Donald Trump

Health stakeholders are emphasizing the need for domestic health financing to break the dependency on donor funding for critical programs.

Shock and uncertainty has gripped the health sector as the realities of the U.S. funding freeze sink in.

The stop-work order, signed by U.S. President Donald Trump on his first day back in office, temporarily suspended all U.S. foreign assistance programs for 90 days pending reviews to determine whether they align with his policy goals.

The directive has left many local government and non-governmental organizations that ran programs supported by U.S. funding cash-strapped and struggling to stay afloat.

Kisii County government, for instance, has suspended all U.S.-funded activities and sent over 500 workers home with only their January 2025 salaries. The letter by the county director of public health and sanitation directed the workers to hand over and wait for further guidance.

"Yes, it’s true the U.S. government has suspended funding of the HIV program they were working on in Kisii. This is affecting the entire government," stated Ronald Nyakweba.

Homa Bay County government has also asked staff of the affected programs to hand over to the in-charge within their departments as they implement the order.

In Kisumu County, HIV care and treatment services have been integrated into routine healthcare services in all level 2 and level 3 facilities. The county has resorted to phasing out standalone HIV comprehensive care centres.

USAID has also announced that all workers under the Fahari ya Jamii project will proceed on a compulsory three-month unpaid leave effective February 1, 2025.

The directive affects over 700 personnel operating under the program run through the University of Nairobi in Kajiado and Nairobi counties.

The 4.2-billion-shilling project, which was in its fourth year, was scheduled to end in May next year. Over 72,000 HIV patients who were on ARVs have been adversely affected by the abrupt closure of over 150 clinics, which were run in collaboration with county governments.

The impact goes beyond the health sector, as Faith Ndung’u, the advocacy manager at the Health NGOs Network, explains.

"Programs affected include support for vulnerable children, youth empowerment, research, and technical training of local staff," Faith Ndung’u said.

She insists that the discussion on donor transition plans is pertinent to avoid such knee-jerk disruptions.

"When an abrupt decision like this is made, we are talking about over one million HIV patients. We are talking about many children. The humane way to go about it is to have a conversation with the countries and tell them that in the next three months or five years, we are going to be changing strategy and transitioning from your country. How prepared are you? And even walk together throughout the preparedness plan," she added.

Considering the shrinking donor funding space, she emphasizes the need for domestic health financing to ensure sustainability.

Faith added, "The silver lining in this sad situation is that it is our wake-up call. When we have the LM 2019 declaration, why haven’t we invested in health as envisioned in that document by our leaders? We need to invest in domestic financing for health and implement it. If we fund our healthcare more, then if a donor, for instance, fails to meet their objective, we will not be in a crisis."

In the meantime, the Trump administration has issued waivers on existing life-saving humanitarian assistance programs, including core life-saving medicine, which may apply to health programs such as PEPFAR, the U.S. President’s Emergency Plan for AIDS Relief, which works with partners in 55 countries worldwide.