Africa relies too heavily on foreign aid for health – 4 ways to fix this

There’s been a global trend in the reduction of aid to Africa since 2018. Donors are shifting their funding priorities in response to domestic and international agendas. Germany, France and Norway, for instance, have all reduced their aid to Africa in the past five years. And, in 2020, the UK government reduced its Overseas Development Aid from 0.7% of gross national income to 0.5%.

Many health services across the African continent rely heavily on overseas aid to provide essential care. International funding supports everything from vaccines and HIV treatment to maternal health programmes.

Cuts to aid, particularly unilateral ones, can have widespread implications. For instance, about 72 million people missed out on treatment for neglected tropical diseases between 2021 and 2022 due to UK aid cuts.

The freeze of US aid to Africa in January 2025 is the latest in this trend. It’s already having significant and wide-ranging impacts across the African continent. For example, vaccination campaigns for polio eradication and HIV/Aids treatment through the President’s Emergency Plan for AIDS Relief (Pepfar) have been stopped. This puts millions of lives at risk. In South Africa alone, the cut of Pepfar’s US$400 million a year to HIV programmes risks patients defaulting on treatment, infection rates going up and eventually a rise in deaths.

President Donald Trump’s actions have highlighted Africa’s reliance on foreign aid for health funding. I’m a global health expert who sits on various funding and advisory boards, including those of the World Health Organization (WHO), the UK government and boards of global resource mobilisation organisations. I am well aware of the competing funding priorities for international funders and have long advocated for local, sustainable health funding mechanisms.

Long-term strategies to reduce aid dependency are critical. Breaking away from this current funding status requires concerted efforts building on proven best practice.