Over the past five months, important bilateral and international agencies such as USAID, PEPFAR, UNAIDS, UNFPA, UNICEF, UNHCR, WFP, WHO and the National Oceanic and Atmospheric Administration have faced significant cuts that undermined their ability to support communities affected by wars, climate change, and epidemics. This has been followed by the erosion of global agreements aimed at addressing these issues, beginning with the Paris Agreement, the Just Energy Transition Project, the Fund for Responding to Loss and Damage, among an escalating number of others.

Additionally, the Trump Administration has proposed cutting all funding for the African Development Bank and the African Development Fund starting in 2026, while the World Bank’s International Development Association is projected to receive only $3.3-billion from the US over the next three years. Most recently, the United States has made overt attempts to destabilise economies through nonsensical tariffs, which the International Trade Centre has described as catastrophic for developing countries.

In response to the backlash, our initial reaction was radical denial. We foolishly assumed that an administration known for its vaccine scepticism and climate change denial would eventually recognise the error of its ways, listen to reason and evidence, and reconsider its cost-cutting agenda after a reasonable review process. While we anticipated that some cuts might continue, we believed they would not be as severe as initially planned. We also expected other donor countries and foundations to fill the funding gaps. It is important to note that, although the spotlight has primarily been on cuts made by the United States, other donor nations, including the United Kingdom, France, Germany, and the Netherlands, have also reduced their foreign aid contributions.

Not surprisingly, the math during our denial phase did not add up. USAID provided $59.2-billion in health and humanitarian assistance across the continent in 2023 alone. In contrast, development aid from US foundations totalled $8.3-billion, with the Gates Foundation contributing 60% of that amount. With our hopes resting on the Gates Foundation to help bridge the funding gap, we were encouraged when, after absorbing its shock, it announced increased funding for maternal and child health and climate mitigation initiatives in various countries. However, the reality is that foundations alone cannot sufficiently close the financial gap.

Our response step was to cautiously turn to our national governments for assistance in addressing the financial gaps caused by cuts in foreign aid. Our governments are cash-strapped, but we also know that much more money is wasted through corruption than we lost through foreign aid cuts. In 2024, widespread protests across Africa, recognising the impact of political corruption and the increased cost of living on our daily lives, were met with swift repression. Obtaining a clear response from our governments on how they plan to bridge these financial gaps has been depressing, to say the least. For individuals who rely on life-saving medication, this situation has become a nightmare.

After some performative soul-searching, we argued that Africa should never have relied on foreign funding in the first place. This led to a range of proposed solutions, few of which address the immediate impact of the withdrawal of funding on health and humanitarian services throughout the continent.

The African Development Bank, in a working paper released in March 2025, argued that remittances—private transfers made by migrants to relatives in their home countries—could potentially solve our problems. While this may hold true in the long term for some nations, it certainly does not address the short-term needs. Between 2018 and 2022, a total of US$90-billion in remittances flowed to Africa, with the majority going to Nigeria and Egypt. However, when considering remittances as a percentage of a country’s GDP, they can make a notable difference; for instance, remittances account for up to 10% of GDP in Zimbabwe and 20% in Lesotho. It is important to remember that remittances are seldom used for investment and often occur through informal channels, primarily aimed at covering families’ daily living expenses.

Some have proposed implementing an HIV tax, referencing Zimbabwe’s 3% AIDS levy introduced in 1999. After 25 years, this levy has provided only a small contribution compared to the significant investment needed to improve a health system beleaguered by inflation. As of April 2025, inflation rates reached 16.5% in Zambia, 30% in Malawi, and 85% in Zimbabwe.

Other ideas, such as carbon credits, may offer benefits but are often characterised by lengthy negotiation processes, a lack of consultation with local communities, and land grab risks that threaten livelihoods. Meanwhile, the African Union designated this year as the Year of Reparations for Africans. While the AU’s initiative for reparations is morally appropriate, albeit very belated, it is critical to consider the immediate crises faced across Africa.

While we ignore the reality, the impact of cuts in funding is profound, particularly for countries in East and Southern Africa that are heavily affected by the HIV pandemic. A recent modelling study published in The Lancet estimates that the international HIV funding crisis could lead to millions of new HIV infections and HIV-related deaths, with Mozambique, South Africa, and Uganda being significantly affected. Reductions in healthcare funding threaten to undo years of progress in prevention efforts, including condom distribution and PrEP (pre-exposure prophylaxis), potentially reversing a decade or more of advancements in just a few years. The most vulnerable are the HIV services for key populations. Even if national budgets compensate for a shortfall in antiretroviral funding, additional resources will still be needed to cover gaps in the procurement and distribution of essential commodities previously funded by USAID. Countries are already reporting impending shortages of antiretrovirals, condoms, HIV testing kits, and PrEP. Decades of investment in training health workers, community workers, and technicians to tackle HIV and improve health services are at risk, as many of these skilled individuals now face unemployment. The loss of these invaluable human resources will have long-lasting effects on public health efforts for years. Acceptance of the current situation therefore cannot be the answer.

So how can we close the financing gap in the short term? Debt servicing is another way resources are exploitatively extracted from Africa. One approach is to refrain from paying our debts and to challenge the financial systems that have led to Africa’s dependency on foreign aid. This question arises every few years during a crisis (think Covid-19 and the 2008 financial crisis), so it’s nothing new. Yet while we can use debt relief to address our immediate crises, exploitative debt should not be allowed to simmer, compounded by the legacy of colonialism and the ongoing, exploitative extraction of our continent’s natural and human resources.

According to the International Debt Report 2024, low- and middle-income countries (LMICs) face a much higher debt burden than in the previous decade. Debt servicing and interest payments consume a significant portion of national budgets, hindering governments’ ability to invest in agriculture, health, education, and the environment.

Contrary to popular belief, foreign debt often does not support equitable development. In December 2024, Indermit Gill, the Senior Vice President and Chief Economist of the World Bank, made a striking statement in the report’s foreword: “It’s time to face the reality: the poorest countries facing debt distress need debt relief if they are to have a shot at lasting prosperity.” He pointed out that since 2022, foreign private creditors have extracted nearly $141-billion more from public sector borrowers in developing economies in debt service payments than they have provided in new financing.

Though multilateral institutions like the World Bank and ADB offer interest rates designed to be low with extended repayment periods, bilateral donors and private creditors often charge rates close to 10%. In 2024, the gross interest payments-to-GDP ratio continued to rise, further escalating the debt-to-GDP ratio. To make matters worse, it is anticipated that about one-third of the outstanding fixed-rate debt will mature in the next three years and likely be refinanced at higher rates. Countries urgently needing debt relief include Lesotho, Madagascar, Malawi, Zimbabwe, Zambia, Mozambique, Tanzania, and the Democratic Republic of Congo.

Which takes us to the next stage of dealing with the current crisis – bargaining. Achieving debt relief or a debt standstill requires swift action that encompasses a range of creditors and addresses the diverse political interests tied to these debts. Such interventions are crucial given the precarious economic environment in Africa, which, in addition to foreign aid cuts, is affected by factors like armed conflict, geopolitical risks, trade fragmentation, higher global inflation, and economic downturns. But this is not the point at which we go cap in hand to the US administration asking for a “deal”. We need to remain firm and united in our demands.

Ultimately, the issue isn’t just about filling financial gaps but changing overall financial hierarchies. This sentiment is echoed by African leaders, the African Union and Volker Türk, the High Commissioner for Human Rights, who has called for the June/July 2025 Fourth UN Financing for Development (FfD4) conference to acknowledge how the current debt architecture leads to human rights violations and requires urgent reform.

For example, we need to address the inherent flaws in the G20 Common Framework, which permits countries to request debt restructuring. While the IMF and World Bank may sound alarms about the state of the debt crisis, their policies often do little to alleviate the debt crisis in Africa. Ultimately, funding must involve consultation with and benefits for local communities.

Without global action, individuals will be left to fend for themselves—a daunting task for many, which could result in lost lives and livelihoods. Those who are most marginalised will be the least able to bear this burden, yet they are also the least likely to access any resources that do become available.

Written by Anneke Meerkotter, Director, Southern Africa Litigation Centre