Trump’s aid funding cuts are already affecting African women

Zimbabwean mother Getrude Mucheri walked kilometres in the rain to get her expired contraceptive implant removed and have a Depo-Provera birth control injection instead.

The 35-year-old mother, who relies on free family planning services, was out of luck when she arrived at the Chitakatira health clinic in eastern Zimbabwe.

Nurses at the public health facility, outside the city of Mutare and supported by charities including Population Services Zimbabwe, said they had run out of stock for that day.

“I am stressed. I do not have money to buy birth control pills,” said Mucheri, an unemployed mother of four. “I cannot have more children. I am struggling to feed the ones I have.”

Mucheri is among millions of women worldwide who rely on free contraceptives from aid programmes that have been plunged into turmoil since President Donald Trump gutted the US Agency for International Development (USAID), a key global donor.

Lydia Zigomo, regional director for the UN sexual and reproductive health agency UNFPA, said the cuts would have “severe consequences” with hundreds of thousands in East and Southern Africa losing access to contraception.

“Many countries in the region are expected to run out of contraceptives and life-saving maternal medicines within the next three to six months,” Zigomo said by email.

“Given that countries such as South Sudan, the Democratic Republic of Congo (DRC) and Madagascar already have high maternal mortality rates, the withdrawal of funding will have catastrophic consequences.”

The immediate loss of US funding for UNFPA in the DRC, South Sudan and Ethiopia came to about $4m (R72.5m), she said, noting many local health providers had also lost US funding.

“With the US freeze, the ecosystem for improving sexual, reproductive, maternal, neonatal, child and adolescent health has been compromised.”

Violence against women, maternal mortality and unplanned pregnancies would all increase, while menstrual hygiene and pregnancy-related care would suffer, she added.

Longer term, there would be more sexually transmitted infections and unsafe abortions. Child marriage and teen pregnancies could also rise as families fall into poverty.

There would also be major disruptions in the supply chain for contraceptives and reproductive health medicines, Zigomo said.

Pester Siraha, a country director at Population Services Zimbabwe, an affiliate of Marie Stopes International, said the USAID cuts violated women’s rights.

‘Cruel decision’

“This is a cruel decision,” she said. “The sudden suspension created a lot of chaos and uncertainty. Sudden stoppage of services without notice is not ethically right.”

In 2024, USAID provided up to $360m for health and agriculture programmes in Zimbabwe, whose own government has underfunded healthcare for decades.

Each year, the health budget falls far short of the target set in the 2001 Abuja Declaration, in which AU governments committed to spend at least 15% of national budgets on health services.

Zimbabwe’s deputy health minister, Sleiman Kwidini, said the government had been buying its own family planning supplies through the National Pharmaceutical Company, a government agency, with funding from donors.

“We have enough supplies and stock to provide family planning services around the country,” he said, without giving further details.

Siraha said more than half of all funding for sexual and reproductive health services in Zimbabwe came from USAID, so the cuts would inevitably boost unplanned pregnancies.

“[This leads] to unsafe abortions and maternal mortality. Teenage pregnancies lead to school dropouts and worsen the higher percentage of teenagers dying during delivery,” she said.

In January Trump also recommitted to two international anti-abortion pacts, cutting all US family planning funds for foreign organisations that provide or promote abortions.

The fallout from the aid cuts is already rippling through Zimbabwe: thousands of health workers were told via WhatsApp to vacate work premises in late January after Trump’s executive orders kicked in, according to some of those affected.

A 29-year-old single mother of two, who did not want to give her name for fear of reprisals, said on the eve of January 28, she was told not to report for work the next day at a USAID-funded NPO providing sexual health services to young girls in Gokwe, Midlands province.

“I signed for unpaid leave. The last salary and savings is the one I am using for all expenses and upkeep of my family,” she said. “I am trying to find ways to get income. I am buying and selling clothes and food, but it is not yielding much.”

Ekenia Chifamba, director of Shamwari Yemwanasikana, a community-based organisation that promotes girls’ rights, said the cuts were “unbearable” as they affected whole families.

“It is devastating and disturbing,” she said.

Zigomo said UNFPA was seeking alternate funding, be it engaging national governments, asking more of other donors or tapping the private sector and philanthropic organisations. It was also trying to mobilise civil society and grassroots organisations to push for local solutions and funding.

“Despite these efforts, it appears unlikely that most [East and Southern African] countries will mobilise resources to fill in the gaps in the short term,” she said.

“There remains an urgent need for sustainable and predictable funding to prevent a devastating rollback in progress on women’s health and rights.”

Thomson Reuters Foundation