Allan Olingo
On January 20, President Donald Trump signed an executive order imposing a 90-day suspension on all U.S. foreign development assistance programs. These included critical programs in countries funded by the U.S. Agency for International Development (USAID), including those supporting reproductive and maternal healthcare.
Just two weeks in, the devastating consequences are already unfolding. The sudden halt in funding — with the possibility looming of a total shutdown of USAID — has forced clinic closures, stalled life-saving projects, and cut off essential aid to communities in dire need.
The fallout is especially severe for African women, many of whom rely on donor-funded healthcare services for maternal care, contraception, and HIV prevention.
On Friday, a judge blocked Trump’s executive order, providing temporary relief. If the move ends up going ahead, here are five ways experts predict this move could profoundly affect women in countries that receive this funding:
Preventable deaths of women and children will increase
Africa accounts for over 70 percent of global maternal deaths, with rates remaining alarmingly high. The USAID funding cut threatens vital maternal healthcare programs, putting more lives at risk — especially in rural and underserved areas where access to safe childbirth services is already limited.
“The immediate impact on vulnerable individuals in the world’s poorest regions cannot be overstated,” says Pio Smith, the United Nations’ sexual and reproductive health agency’s (UNFPA) Regional Director for Asia and the Pacific. “Women are being forced to give birth alone in unsanitary conditions, increasing the risk of obstetric fistula while newborns are dying from preventable causes.”
Smith fears that the loss of funding may also disrupt training for healthcare workers, community outreach programs, and access to emergency obstetric care. He highlighted African countries and war-torn countries like Afghanistan as especially vulnerable.
“Every two hours, a mother dies from preventable pregnancy complications, making Afghanistan one of the deadliest countries in the world for women to give birth. Without UNFPA’s support, even more lives will be lost at a time when the rights of Afghan women and girls are already being torn to pieces,” Smith said.
More women will get infected with HIV
According to the U.N.’s HIV/AIDS program, women and girls accounted for 62 percent of new HIV infections in Africa in 2024. On top of this, many African countries rely on USAID funding tied to HIV programs to provide essential reproductive health services. Trump’s USAID freeze — together with the reinstatement of the global gag rule, which prohibits recipients of U.S. government funding from providing abortion services — effectively cuts off reproductive healthcare funding. Clinics dependent on USAID funding will either be forced to scale back operations or shut down, resulting in unmet contraceptive needs, unplanned pregnancies, and unsafe abortions. Advocates say Trump’s last administration triggered a spike in pregnancy-related deaths.
“We can longer work in silos,” says Nelly Munyasia, the executive director at Reproductive Health Network Kenya. “We must stand up boldly for sexual and reproductive health rights and gender equity.”
Women in refugee camps and conflict zones will be at greater risk
With aid cut off, women in marginalized communities — especially refugees and those in conflict zones — face heightened risks of sexual violence, as well as maternal mortality and severe health complications.
In 2024, the U.S. provided over $3.7 billion in humanitarian aid, covering half of all support for Uganda’s 1.7 million refugees. U.S. funding assisted more than 8 million refugees and 30 million displaced individuals across Sub-Saharan Africa, and has been vital in addressing crises in the Horn of Africa, the Sahel, and the Democratic Republic of Congo. The majority of these populations are women and children — they now face a deeply uncertain future.
“USAID has supported over 1,200 gender-based violence centers across Kenya, including in refugee camps — but now, that support is at risk,” says Dr. Stella Bosire, Executive Director of the Africa Centre for Health Systems and Gender Justice.
These centers, she said, could simply disappear.
Frontline health workers — mostly women — will lose their jobs
Across the world, community health workers (CHWs), who are mostly rural or poor women, have been an instrumental force in fighting the COVID-19 pandemic, reducing maternal mortality, providing HIV care and reproductive services, and delivering immunizations to millions. The women are at the center of an effort to provide holistic, integrated healthcare services that will improve access to healthcare to the urban and rural poor of the global South. These services have already been disrupted, with many CHWs getting laid off.
This puts in jeopardy the Africa Centers for Disease Control and Prevention’s goal to increase its CHW workforce to 500,000 by 2027.
“Funding cuts don’t just disrupt reproductive health—they unravel entire healthcare systems,” says Dr. Bosire. “These policy shifts widen funding gaps, putting millions at risk of losing access to essential healthcare services and jeopardizing vital work done by CHWs that has taken years to build.”
Unprepared governments could further endanger women’s lives
Experts predict governments and non-governmental organizations (NGOs) will struggle to fill the funding gap left by USAID. Many lack the resources or capacity to maintain services at anywhere near the same scale.
For instance, USAID funding has supported the supply of oxytocics across Africa — critical for preventing postpartum bleeding, which claims the lives of over 70,000 annually. This funding had ensured a steady supply of oxytocics to public health facilities through Chemonics International for decades.
This responsibility now falls entirely on local governments, raising serious concerns about access to these life-saving medications by women.
Essentially, the funding freeze disproportionately affects the world’s most vulnerable women and girls, undermining years of progress. It also highlights the critical need for alternative funding sources and increased local investment in healthcare systems to mitigate the damage caused by such external policy shifts.
Former Kenyan President Uhuru Kenyatta urged the African continent to rethink how it secures funding for its needs.
“It is time we channel our resources toward the right priorities,” he said.
*Correction: The article originally stated that a judge had blocked President Trump’s USAID funding freeze. Instead, the judge blocked the effort to fire 2,200 USAID workers.
*Correction: The article referred to the U.S. policy of blocking funding for non-governmental organizations providing abortion or abortion-related services as “the global gag rule”. The official term for the policy is The Mexico City policy.
