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In Khartoum, the capital city of conflict-ridden Sudan, approximately 800 soup kitchens operate in different neighborhoods, each catering to an average of 300 families.
These soup kitchens serve at least one meal each day to individuals displaced by war and climate change-induced floods that frequently affect the country. Due to these disasters, one in three Sudanese have been forced to leave their homes, resulting in over half of the country's population — around 26 million people — facing critical levels of hunger. A majority of these individuals depend on these soup kitchens to avoid starvation.
Suddenly one morning in late January, most of these soup kitchens were shut down.
Largely funded by the United States Agency for International Aid (USAID), the soup kitchens were among the first casualties of President Donald Trump’s January 20 executive order freezing all foreign aid for 90 days. USAID is the mainstay agency through which the US government funnelled tens of billions in foreign aid annually.
In the ensuing chaos, famine intensified in Sudan. “Sudan’s situation has been dire for months, but it can still get much, much worse,” noted a report by Operation Broken Silence, a non-profit that operates in the troubled North African country that is also grappling with cholera, malaria and measles. “We expect to witness a surge in deaths from starvation, preventable diseases and the further collapse of healthcare services in the coming weeks if USAID’s critical work in Sudan does not fully resume.”
After Trump’s order, US Secretary of State Marco Rubio announced that programmes offering ‘life-saving’ assistance, including medicine, medical services, food and shelter would be exempted from the aid freeze. But due to jumbled communication, it remained unclear to most beneficiary non-profits what qualified for this waiver. In this confusion, many of them were closed, suspended in dilemma.
As many as 22 of the world’s 26 poorest countries are in Africa, according to the World Bank. So, the impact of the US aid freeze is most severely felt on the continent. These countries have relied on American aid for decades for a large variety of functions. These included demining exercises, fighting female genital mutilation, disease control, eradication, sexual rights, climate mitigation, human rights, democracy, all sorts of researches and training and everything in-between. At the announcement of the freeze, USAID alone was funding some 62 programmes in different African countries.
The US foreign assistance to Africa is channelled towards three broad categories, namely economic development, health and humanitarian aid. The bulk of these funds came through USAID, the state department and the treasury. It is these funds that have been frozen, throwing the programmes into turmoil.
In eight of the world’s poorest countries (seven of them African), over a fifth of the total assistance comes from USAID specifically, according to an analysis done by the Centre for Global Development (CGD). The countries are South Sudan, Somalia, Democratic Republic of Congo, Liberia, Sudan, Uganda and Ethiopia.
“In all but two of these countries, USAID’s focus is categorised as ‘emergency response’ — albeit for relatively protracted crises,” the report noted. “This suggests aid is being used to address acute needs within these countries. In Liberia, basic health is the main sector while in Uganda it is population and reproductive health.”
USAID spent over $12 billion in sub-Saharan Africa in 2024, according to government records, most of it on health and humanitarian aid. Of this, the troubled Democratic Republic of Congo received $1.3 billion, followed by Ethiopia and Sudan.
Fears of increased deaths are also abounding in Eswatini, Zimbabwe, Zambia, Malawi, Lesotho, Mozambique and other southern African countries that not only have threadbare health systems, but also have sizeable segments of their populations living with the HIV virus.
“The world is baffled,” reacted Aaron Motsoaledi, the health minister of South Africa, the country with the highest number of people living with HIV. The US funds nearly 20 per cent of South Africa’s $2.3 billion annual HIV / AIDS containment project through the 22-year-old US President’s Emergency Plan for AIDS Relief (PEPFAR) programme, he said.
PEPFAR is credited with saving the lives of more than 25 million people in Africa. More than eight million in South Africa lives with HIV and PEPFAR helps provide life-saving antiretroviral (ARV) treatment to 5.5 million people.
African countries receive varying amounts from the US for their health programmes. For example, Zimbabwe — a country with 1.2 million people on ARV treatment — receives over $200 million annually from PEPFAR.
PEPFAR funds also support salaries and incentives for poorly paid healthcare workers in the country, in addition to funding HIV and viral load testing, prevention, cervical cancer screening and tuberculosis treatment.
For a country like Zimbabwe, 98 per cent of whose medicines bill is paid for by donors, the effect of the US aid freeze would be catastrophic. “Any country with HIV / AIDS challenge will be impacted,” Zimbabwe’s finance minister Mthuli Ncube said, reacting to the freeze.
The withdrawal of the US funding will increase new HIV infections six times and lead to an upsurge in AIDS deaths, warned UN Aids Agency (UNAIDS) executive director, Winnie Byanyima.
“This will cost lives if the US government doesn’t change its mind and maintain its leadership… people are going to die because lifesaving tools have been taken away from them,” Byanyima was quoted as saying in Uganda.
Trump’s decision to also withdraw the US from the World Health Organization (WHO) came at a time of growing global health inequalities, experts said. The move will undermine international health solidarity and leave the most vulnerable parts of the world, particularly Africa, at even graver risk, they warned.
In addition, some programmes and entities run under the US-funded Centres for Disease Control and Prevention have long supported public health initiatives and medical research linked to universities across the African continent.
Uganda, a country that hosts 1.8 million refugees and asylum-seeking population — Africa’s largest and the world’s fourth-largest — was already struggling with this growing burden amid dwindling budget and the US aid freeze has only worsened the crisis.
In 2024, the US contributed more than $86 million towards Uganda’s humanitarian refugee programmes. These programmes, however, were already strained due to dwindling funding. For example, in 2017, the United Nations High Commissioner for Refugees operated on a budget of almost $220 million for 1.4 million refugees in Uganda alone, according to a 2024 policy brief published by Brussels-based think tank, the Egmont Royal Institute for International Relations. But by the end of 2023, the agency’s budget for Uganda had plummeted to $141 million, despite an increase in refugee numbers.
Less than half the agency’s budget of $360 million for refugee support in Uganda had been secured, even as the number of people in need increased to some 1.7 million, a UNHCR report from late 2024 showed. As of January 31, 2025, the UN agency had raised a mere nine per cent of its required amount.
This is the scenario across many other countries that are hosts to the continent’s nearly 10 million refugees. Nine out of 10 refugee crises occur in Africa, destabilising peace and development on the continent, according to the Institute for Security Studies (ISS).
In 2024, some 37 per cent (45.9 million) of the world’s forcibly displaced people were in Africa, comprising around 8.9 million refugees, 1.1 million asylum seekers, 35 million internally displaced persons and about a million stateless persons, UNHCR said. Most of these cases have relied heavily on US aid and the freeze has left most of them in the lurch.
Over the years, the biggest chunk of US aid has gone towards economic development programmes for African countries. But now the US is not just withdrawing foreign aid, but going further to seek to maximise cash inflows from abroad. Under his America First Trade Policy, Trump announced plans to establish an External Revenue Service with a broader plan of using it to collect tariffs, duties and other foreign trade-related revenue.
Experts fear that in addition to further complicating the already complex global tax system, Trump’s move to explore the use of a global supplemental tariff to close US trade deficits and the imposition of broad-based tariffs would impact the types of goods Africa exports to the US.
At least 40 African countries have benefited from the Africa Growth and Opportunity Act (AGOA), which has allowed duty-free export of selected products from these countries into the US for 25 years. This programme is now under threat. South Africa’s citrus and automotive industries, for instance, have benefited from this tariff-free access.
South Africa exports 110,415 tonnes of citrus fruit to the US annually, creating jobs for 140,000 people, many of them in rural communities that have no alternative employment opportunities. Its automotive industry — which also exports duty-free to the US — employs some 112,000 people directly and another 350,000 indirectly, making it a vital contributor to the South African economy.
The similar benefits have been spread in various sectors of the 40 countries that are beneficiaries of AGOA.
There are also concerns that by pushing for greater fossil fuel exploration and development at home under its new National Energy Policy, the US may become an even more forceful competitor in global energy markets, potentially driving down oil and gas prices. For energy-exporting countries in Africa, such as Nigeria and Angola, cheaper American production could challenge their market share, throwing their economies into turmoil.
The non-profit sector is a major contributor to employment in Africa, with the tens of thousands of the non-profits employing millions directly, while indirectly benefiting even more others. In Kenya alone, more than 30,000 people work in US-funded health projects, so the mass layoffs resulting from the withdrawal of US funding would have serious effects on the economies of all African countries.
While a number of NGOs that do not receive funding from America are still on the ground, there is always a symbiotic relationship among the various non-profits operating in a country or a region. The resultant ecosystem is severely disturbed when a behemoth like USAID suddenly pulls out.
“Like many small non-profits operating in countries where USAID has a presence, we benefit indirectly from the broader humanitarian and economic stability the agency can help create,” Operation Broken Silence wrote in their report. “Humanitarian work is incredibly complex and requires a network of organisations working alongside local heroes to tackle difficult challenges. No single group can do it all; but, when a powerhouse like USAID is suddenly removed from the situation, everyone suffers.”