NGOs warn that at least two million people worldwide will be affected by the cancellation of US grants. In Kenya, access to HIV pre-exposure prophylaxis and community-led surveillance programmes has already come to a halt. Approximately three percent of the population is HIV positive and is now facing a shortage of medicines.
Jeffrey Okoro is the executive director of the NGO CFK Africa in Kenya. He said that since the decision of the US government to freeze US Agency for International Development (USAID) spending in January, Kenyans working in healthcare are directly affected.
The decision has already disrupted efforts to stop the spread of diseases like HIV and tuberculosis.
"A sizeable portion of the Kenyan government funding for health counselling comes from international organisations from foreign governments," Okoro told RFI from his office in Kenya.
And this has affected a huge portion of the health workforce, mainly through the 'stop work' order.
"A number of healthcare workers and other personnel were put on stop, meaning that they could not go to work. And even despite the order being rescinded, we have had a huge number of healthcare workers reporting low morale and basically being afraid for their jobs."
Closed clinics, lost jobs
CFK Africa is an international nonprofit dedicated to empowering youth in informal settlements across Kenya, through public health and youth leadership programmes.
They have already reported severe impacts on the communities they serve after US President Donald Trump decided the abrupt withdrawal of support through USAID.
Since January, tens of thousands of Kenyans received notification that they would be laid off, disrupting long-standing efforts to stop the spread of diseases such as tuberculosis (TB) and HIV.
Okoro says he works with really good health care people who give a lot of time.
"The morale is low now," he continues, "and seeing that they fear for their jobs, seeing that some of them have already lost their work, it's not a good place where our health care workers are currently."
He confirms that the NGOs can already feel the effect of the US decision, as the UK has also announced it would cut aid spending.
"Even to maintain the supply lines on the fight against HIV has been disrupted by this," he adds. "We've had hospitals that have been closed. We have had specialists who have also had to be stopped. And so this has definitely dented the efforts made in fighting HIV and TB."
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Patients afraid to die
With cuts to USAID-funded projects, the nonprofit is facing uncertainty around its critical care clinic for HIV/AIDS and tuberculosis, staff are unclear what to share with patients, and access to data has become limited.
In addition, CFK's clinics are experiencing an influx of patients and requests from community members who previously received care from organisations that were grant recipients of USAID and now have nowhere to turn.
“Some patients are now coming into our healthcare clinics asking us if they are going to die,” according to Eddah Ogogo, CFK Africa Programme Lead for Clinical Services. “They are asking for longer refills for prescription drugs and making plans for what might happen if they cannot continue to get care.”
Officials with CFK Africa noted that the sudden drop in funding has upended Kenya’s health care system, which was supported directly and indirectly through USAID in several ways.
This is leading to new discussions about how the Kenyan government and other NGOs should respond to ensure life-saving care continues.
New approach
For NGOs like CFK, the situation shows that it is time to rethink how they approach development work and how aid is delivered.
The health workers advocate for localisation, local financing and even "changing the look around all the challenges that exist in these communities", Okoro told RFI.
"For example, we work in Kibera, which is one of the most disenfranchised places in Nairobi, but at the same time, it has resources. And so we need to think about breaking barriers and investing in community assets. So it's not constantly just about bridging the gap, but enabling the local communities to address the challenges."
CFK is deeply committed to supporting people despite the current challenges, but there is also a lot of misunderstanding on what aid or development work is, according to Okoro.
"To me, it restores dignity, brings out the best in humanity, and lessens suffering, and I think that is missed from a lot of the current news stories on the pullback of aid,” he said.
“We don’t know what will happen next, but we are turning to our partners, reassuring our patients, and staying focused on our mission. At CFK Africa, our communities come first.”
