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A Crisis or a Turning Point? The Effect of USAID Cut on Ethiopia

Updated: Mar 9

Imagine a young mother living in rural Ethiopia, her child burning with fever in the dead of night. The nearest clinic, once supplied with USAID-funded malaria medications, now stands empty. She watches helplessly as her child convulses. The treatment that could save her is now out of reach.

Imagine a woman living with HIV who dreams of starting a family. The life-saving antiretroviral therapy she is reliant on is currently inaccessible. Imagine her fear and desperation. The decision to have a child is not simple anymore. Will she sentence her child to a short lifetime with HIV?  Or will she choose not to become a mother?


For millions like them, the recent USAID aid suspension is not just a bureaucratic policy shift—it is a matter of life and death.


The recent cut in USAID has sent shockwaves through the country. USAID has been the largest development partner in Ethiopia over the years. Hence its withdrawal affects multiple sectors, but none more devastatingly than healthcare.


The question now is: Will this cut push Ethiopia into a deeper crisis, or will it ignite a movement toward self-reliance?


A Blow to Global Health

In his speech at the Geneve conference Dr. Tedros Adhanom, the Director-General of the World Health Organization (WHO) spoke of the alarming consequences of the USAID funding cut.  He noted that HIV treatments and other essential health services have been disrupted in 50 countries. In particular, the suspension of PEPFAR (the President’s Emergency Plan for AIDS Relief) has halted HIV treatment, testing, and prevention services. This has left Ethiopia among the hardest-hit countries. Only time will tell if this results in a possible resurgence- but the likelihood is alarmingly High.


A Legacy of Assistance: History of USAID in Ethiopia


USAID has played an integral role in Ethiopia’s development since 1961. Its initial focus was on agriculture and natural resources. The 1973-74 drought in Ethiopia that affected multiple regions necessitated a transition of USAID focus to emergency food aid and drought recovery programs. This helped address the ensuing famine. However, the rise of the Derg regime in 1974 led to a significant reduction in US development assistance, due to the Marxist politics presiding then. The reestablishment of diplomatic relations with the U.S. government in 1992, enabled USAID to resume broader development initiatives that targeted health, education, and governance. The recent Focus of USAID in Ethiopia included enhancing food security, strengthening health and education systems, promoting democratic governance, and responding to humanitarian crises exacerbated by conflict and climate shocks.

Since 2020 the USAID has provided an estimated $3.6 billion in humanitarian assistance as a response to conflict and climate-related challenges. In the Fiscal Year 2022, USAID has provided $1.93 billion in an attempt to address drought-related issues, including agriculture, food assistance, nutrition, water, sanitation, hygiene, and health activities.


USAID and Health Sector: Lifeline at Risk

Specifically in the health sector, USAID invested over $154 million annually to enhance Ethiopia's national health system and improve health service quality. This has created resilience and improved accessibility and quality of care throughout Ethiopia. It has collaborated with the Ministry of Health to significantly reduce maternal and child mortality rates, improve infectious disease surveillance, and expand access to family planning services.  Before the aid cut, USAID has been working with the ministry through the following NGOs: Amref, Jhpigo, DHA, JSI, QHA, PSI, Core Group, World Vision, CHI, MSI, MFF, and Plan International.


Through this collaborative effort, tuberculosis deaths have decreased by 35 percent from 2015 to 2020, and HIV deaths fell by over 50 percent from 2010 to 2023. Most notable in this achievement is PEPFAR, which had a transformative impact in Ethiopia. It has provided nearly $3 billion to support the HIV/AIDS response. After this fund, over half a million people living with HIV in Ethiopia received treatment at over 1,000 sites. As a result, HIV deaths have declined from 4.4% in 2003 to 0.9% in 2022. Similarly, the U.S. President’s Malaria Initiative (PMI) has allocated around $544 million to combat malaria since 2008. Subsequently, 50 million mosquito nets were distributed, and rapid diagnostic tests and malaria treatments were readily available. This has enabled the Ethiopian health sector to achieve significant strides. Some people are living their healthiest lives today—perhaps without even realizing they owe it to this vital support.


So, with this sudden suspension, what comes next? Will it unravel these decades of progress?


The effects of USAID’s withdrawal are already being felt across Ethiopia. Hospitals and clinics that relied on USAID funding now struggle to function. Essential medicines, from antiretrovirals to malaria treatments, are running out. Around 5000 workers working under the Ministry of Health have been laid off. The potential for an HIV resurgence looms large. Disrupted malaria and tuberculosis programs are feared to lead to outbreaks.


Multiple organizations have ceased operations. Plan International, MSI, and CHI are working partly on these life-saving projects at reduced capacity. Thousands of malnourished children are without aid. Malnutrition rates are expected to rise as food security programs collapse. This could not have come at worse times. The country is currently going through cycles of civil war, with natural disasters, droughts famine displacing millions of people out of their homes.


The abrupt halt in funding jeopardizes the health sector which is mostly reliant on foreign aid. Prior experience tells us that the effect of this cut can be significant. In 2023 when USAID temporarily minimized its funding, the health sector was severely impacted.  It led to shortages of essential medications, halted maternal health programs, and caused a spike in preventable deaths. Today, with the country grappling with multiple crises, the impact is poised to be even more severe.


Crisis or Opportunity? A Call for Self-Reliance


As devastating as the aid cut is, could it also serve as a turning point for Ethiopia?  Can we only see this as a purely negative blow? For a country where health priority has been sidelined, is this a wake-up call? Can this serve as a reminder for the government and policymakers to prioritize the health sector?  Will this provide private partners an opportunity to take the lead in ensuring the health sector?


While the immediate challenges are overwhelming, this moment offers an opportunity for Ethiopia to reassess its approach to health and development. Ethiopia can learn valuable lessons from nations like Rwanda and Vietnam, which have successfully reduced their dependence on foreign aid by leveraging domestic industries and fostering strategic global partnerships. In this regard, the Ministry of Health and its partners already looking for increased funding from other partners. They have been working tirelessly to keep some of the essential projects to keep running.


There is the possibility that this cut charts a sustainable path toward development. However, this requires bold moves and grand investments. To make the health system sustainable and resilient, Ethiopia should prioritize local pharmaceutical production, invest in agricultural innovation, strengthen the private sector, and build transparent governance to enhance self-sufficiency and reduce reliance on external aid.


This vision is within reach—but it requires bold action and collaborative measures from policymakers, citizens, and the international community. If geared in the right way, this can create a shift from aid-driven assistance to investment-driven partnership.


These statistics are more than numbers. The loss of funding doesn’t just mean a drop in aid—it means empty hospital shelves, closed clinics, and families left without hope.


This is a Crossroads for Ethiopia’s Future. Will this moment mark a descent into crisis, or will it spark a new era of resilience and self-reliance?


So, what do you think? Join the conversation and share your vision!



 

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