One of President Donald Trump’s first moves in office was to suspend all foreign aid for 90 days to assess whether it aligns with the ‘America First’ agenda. However, this sweeping order was later softened when Secretary of State Marco Rubio announced exemptions for certain programs, such as life-saving humanitarian aid and military assistance to Israel and Egypt, and partially, Ukraine.
Despite these exemptions, USAID projects across the world came to an abrupt halt, including those that should have qualified as life-saving. The suspension created widespread confusion due to unclear exemption criteria, staff dismissals and a funding freeze.
As the world’s largest single foreign aid donor, the United States’ withdrawal is expected to exacerbate humanitarian crises across the globe. This decision is also unlikely to benefit US businesses or the US international standing. This article focuses on the four likely consequences of the US foreign aid suspension in sub-Saharan Africa, where key USAID recipients include Ethiopia, Somalia, Nigeria, DR Congo, Kenya, South Sudan, Uganda, Mozambique and Tanzania.
Rise in deaths and illnesses. Health assistance accounts for the largest share of US foreign aid to Africa, with HIV/AIDS prevention and treatment programs receiving the most funding. The suspension of the US President’s Emergency Plan for AIDS Relief (PEPFAR) puts millions of lives at risk. Without this support, fewer HIV-infected individuals will receive antiretroviral treatment, more HIV-positive pregnant women will transmit the virus to their unborn children, and preventive treatments and testing will decline – leading to increased infections. In South Africa alone, over 8 million people are living with HIV.
Beyond HIV/AIDS, the suspension of US health programs will result in higher death rates from malaria, tuberculosis, poor maternal care, and inadequate water and sanitation infrastructure.
The economic and business impact will also be significant. Rising illness and mortality rates will lead to increased business costs due to more sick leaves, greater demand for hiring and training new workers, and potential operational disruptions due to a lack of skilled workforce in certain sectors.
Decline in US soft power.
More than the military assistance – Russia is Africa’s largest arms supplier – the US has relied on soft power to maintain its influence on the continent. Apart from the health sector, the US foreign aid to Africa has focused on promoting economic growth (particularly by supporting agriculture, clean energy and environmental initiatives) and peace and security.
By abruptly cutting aid, the Trump administration has undercut one of its main tools for projecting US soft power across the globe, including Africa. This move erodes US’s claim to moral superiority vis-à-vis Russia’s and China’s arguably more transactional approach. It also signals to African nations that the US is an unreliable partner.
These factors will decrease the US’s attractiveness to follow it (for instance, in the way of UN votes to support American interests) or do business with.
The opportunity for China and Russia to increase their influence in Africa and their access to critical minerals.
The withdrawal of US foreign aid will force African countries to seek alternative sources of funding. However, the rise of populist and nationalist movements across Europe and plans by several major European countries – including France and Germany – to cut foreign assistance, suggest this extra help is unlikely to come from the old continent.
China and Russia are likely to use this funding gap as an opportunity to strengthen ties with certain African governments through targeted increases in foreign aid. This threatens to solidify China’s dominance over Africa’s critical minerals and bolster Russia’s influence in resource-rich, politically unstable states.
Rise in anti-US and anti-Western sentiment.
Military juntas in Mali, Burkina Faso and Niger have denounced Western influence, particularly French, and forged stronger ties with Russia. In Niger, General Abdourahamane Tchiani’s government ended military cooperation with the US in March 2024, leading to the closure of an American airbase used for counterterrorism surveillance operations.
The suspension of US foreign aid threatens to fuel further resentment against Western powers, especially amid rising living costs and worsening humanitarian conditions. This could trigger disruptive protests, destruction of US and Western-owned assets, and increased risks for Western nationals living in the region.
Some aid programs may eventually be restored, provided they align with the Trump administration’s ‘America First’ agenda. Nevertheless, the abrupt nature of the suspension that left recipient nations with no time to adjust will result in severe consequences: preventable deaths and strained US-Africa relations that Russia and China will likely skillfully use to their advantage.