The malaria season has begun across much of Africa, bringing renewed fears about the continent’s deadliest disease, which disproportionately affects children.
However, this year, the fight against malaria faces an additional challenge: the Trump administration’s decision to slash 90% of USAID’s foreign aid contracts. The move has sparked alarm among health officials in Uganda, who warn of severe consequences for some of the world’s poorest communities.
Dr. Jimmy Opigo, head of Uganda’s malaria control program said that the stop-work orders issued by USAID in late January have left his team scrambling to prepare for a looming health crisis.
The United States has long been the leading bilateral supporter of anti-malaria programs in Africa, providing critical resources such as insecticide-treated bed nets and life-saving medications.
Opigo likened their necessity to basic supplies, saying, “There needs to be a continuous supply.” With these resources suddenly cut, he fears a surge in severe malaria cases, leading to complications such as organ failure.
While malaria vaccines are being distributed in parts of Africa, they are not yet a perfect solution. Nevertheless, they continue to receive support from a global vaccine alliance.
According to Malaria No More, a Washington-based organization, new projections indicate that even a single year of disruption in malaria-control efforts could result in nearly 15 million additional cases and 107,000 more deaths worldwide. The organization has urged the Trump administration to restore these vital programs before outbreaks spiral out of control.
Africa accounted for 95% of the estimated 597,000 malaria deaths worldwide in 2023, according to the World Health Organization (WHO). Among the hardest-hit nations are Nigeria, Congo, and Uganda. Health workers in these countries have reported worsening conditions due to the sudden reduction in U.S. government support.
For years, the U.S. has allocated hundreds of millions of dollars annually to these three countries through the President’s Malaria Initiative, led by USAID. This funding is channeled through non-governmental organizations, medical charities, and faith-based groups, ensuring that malaria prevention and treatment services remain accessible, especially in rural communities.
In Uganda alone, 12.6 million malaria cases and nearly 16,000 deaths were reported in 2023, with the majority being children under five and pregnant women, according to WHO data. Dr. Opigo noted that the U.S. has been contributing between $30 million and $35 million annually to Uganda’s malaria control efforts.
Although Opigo did not specify which contracts were canceled, he acknowledged that field research has also been significantly impacted.
Halted Mosquito Spraying Raises Concerns
Some USAID funds in Uganda were earmarked for large-scale mosquito-spraying campaigns in remote regions, planned to begin in February — just before the rainy season when stagnant water creates ideal breeding conditions for malaria-carrying anopheles mosquitoes.
These efforts have now been put on hold.“We need to spray the houses before the rains when the mosquitoes come to multiply,” Opigo explained.
Every year, long queues of malaria patients line up outside clinics across Uganda, highlighting the scale of the public health challenge. Malaria accounts for 30% to 50% of outpatient visits to health facilities nationwide, according to the Uganda National Institute of Public Health.
Opigo suggested that other U.S. agencies, such as the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), could step in to provide assistance. However, he warned that the situation remains precarious. “We need to manage the relationship with the U.S. very carefully,” he cautioned.
With malaria season underway and USAID funding slashed, health officials fear the worst. Unless urgent action is taken, millions of vulnerable people across Africa could face an even deadlier fight against malaria in the coming months.
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