In an instant, more than 1,000 patients at my health care clinic outside Nairobi lost access to lifesaving HIV treatments. Thousands more could no longer receive treatment for tuberculosis or contraception that prevents teenage pregnancies, hurting the well-being of our communities and threatening the progress we’ve made in their medical care.
These are only a fraction of the consequences of the U.S. government’s sudden decision to stop foreign aid managed by the U.S. Agency for International Development. While some HIV treatments have resumed, the future of these services is still uncertain.
I’m the head of CFK Africa, a nongovernmental organization that empowers youth and fights extreme poverty in Kenyan slums. The sudden dismantling of USAID means lives are being disrupted, and people with few resources who need lifesaving medicine are scrambling to make new plans.
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CFK Africa works in slums throughout Kenya, including Kibera, which is located just outside of Nairobi and is one of the largest informal settlements in Africa. In the places where we operate, aid can be the difference between life and death. In this crowded slum, residents live on just $3 a day and have little access to health care.
Today, there is a pervasive sense of fear — of losing access to critical health care services and of livelihoods lost. Even programs that were not directly supported by USAID have been affected as it disrupted the supply chain of medications in Kenya.
Patients are apprehensive about being able to continue their HIV and tuberculosis regimens when stopping would mean increased viral load or even death. They are asking for longer prescription refills and making desperate plans for what they might do if they cannot get their medication. Public health professionals are worried that this could lead to a resurgence of HIV, undoing decades of progress against this terrible disease. Thousands of Kenyans have lost jobs due to the sudden rollback of aid. Our staff is witnessing a new sense of volatility in the health care industry and among nongovernmental organizations. We are trying to ease the anxieties of those in our communities and have referred patients to our Youth Friendly Services Center in Kibera for counseling.
CFK Africa is just one of the many nongovernmental organizations supporting over 1.3 million people in Kenya with lifesaving care and treatment in poverty-stricken communities. The consequences of the aid freeze on our communities will be vast. The progress that has been painstakingly built over the years in global health, in fighting generational poverty, and in sustainable development is at risk of unraveling.
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My team at CFK Africa and other organizations are doing what we can to mitigate the losses, and we recognize that collaboration is essential for real change. The sudden withdrawal of funding has sparked conversations around decolonizing aid and the importance of localization. At CFK Africa, we believe in local solutions, in the power of partnerships, and that positive change is possible when we work together and play to our strengths.
In the average year, foreign aid makes up a little over 1% of the U.S. federal budget, a tiny sliver of government spending. But those dollars go far in developing countries that receive them, saving lives, improving education and economic opportunity, and increasing global health security for all.
During the Covid-19 pandemic, we all saw this firsthand. Our medical clinic in Kibera, where access to health care is limited, became a crucial place to share information on the virus, collect data on how it was spreading, and administer the vaccine. The pandemic underscored how interconnected global health is, as an outbreak in Kenya could quickly spread halfway across the world, and the only way to contain it anywhere was to work to stop it everywhere.
Now we are facing a new challenge. As before, nongovernmental organizations will work together to replace the lost resources, address issues in our most vulnerable communities with compassion, and rethink our approach to public health. We hope that the United States government will one day rejoin us in these efforts. Until then, we need to figure out how to do the work without them.
Jeffrey Okoro is the executive director of CFK Africa.
