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| A mother and children in a refugee camp in Guatemala in 2005. |
Feb. 8, 2025, 5:00 PM GMT+6
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Malawi Faces HIV Medication Shortages Amid USAID Funding Freeze
Clinics in Malawi may soon run out of essential HIV medication due to a freeze on U.S. foreign aid ordered by the Trump administration. This pause has disrupted HIV programs managed by the U.S. Agency for International Development (USAID), potentially impacting approximately 142,000 girls and young women who received care from one of the agency’s programs last year.
“When you suddenly shut down these programs, I fully expect an exponential rise in new HIV infections,” said a USAID worker specializing in HIV care for women and girls, who was recently laid off and requested anonymity due to fear of retaliation. “People living with HIV depend on daily medication to remain virally suppressed and prevent transmission. Without it, the consequences could be devastating.”
This is just one example of how the 90-day hold on U.S. international aid—and recent efforts to dismantle USAID—are creating serious repercussions for women and girls worldwide.
Court Temporarily Blocks USAID Workforce Cuts
A federal judge, Carl Nichols, issued a temporary restraining order on Friday, delaying USAID’s looming workforce reduction, which would have slashed its personnel from over 5,000 to just a few hundred employees.
Even before the ruling, USAID workers warned of alarming disruptions in lifesaving care. The agency plays a critical role in combating HIV, malaria, and tuberculosis—diseases that disproportionately affect women and girls in some of the world’s most vulnerable regions. USAID also provides vital services related to maternal health and gender-based violence prevention.
“Disrupting these services is catastrophic,” said Sarah Charles Phillips, former head of USAID’s Bureau for Humanitarian Assistance. “For people living with HIV, access to medication is a matter of life and death. Without USAID, getting these medications from supply chains to clinics becomes nearly impossible.”
White House Defends USAID Cuts
In response to concerns over the impact of USAID’s restructuring on women and girls, White House Deputy Press Secretary Anna Kelly stated that “there is no greater advocate for women than Trump.”
“President Trump is ensuring that taxpayer-funded programs at USAID align with the national interests of the United States,” Kelly said. “He will cut programs that do not fit the America First agenda.”
USAID Branded a "Criminal Organization" by Government Official
Elon Musk, the Trump-appointed head of the newly created Department of Government Efficiency, has called USAID a “criminal organization,” echoing conspiracy theories that claim its programs hide biowarfare research or enrich global elites. Critics argue the agency lacks transparency and represents wasteful spending, while supporters highlight its role in saving millions of lives through initiatives like PEPFAR, which has provided HIV/AIDS relief since 2003. Despite accounting for less than 1% of the federal budget, the program is credited with saving over 25 million lives.
HIV Prevention in Africa Under Threat
In sub-Saharan Africa, where USAID runs key HIV prevention and treatment programs, young women ages 15-24 are three times more likely than their male counterparts to contract HIV. Advocates fear that without sustained intervention, these gender disparities will worsen.
While recent waivers will allow many programs in Malawi to resume, they fail to include prevention services such as pre-exposure prophylaxis (PrEP), condom distribution, and behavioral education.
“Education and economic empowerment are critical in reducing young women’s vulnerability to HIV,” the USAID worker said. “Those services are not covered under the waiver and are still suspended.”
Malaria Concerns Rise as Rainy Season Approaches
The impact extends beyond HIV. Anne Linn, a senior adviser for the USAID-led President’s Malaria Initiative (PMI), was laid off amid the agency’s restructuring. She warns that malaria prevention efforts are now at risk as the rainy season begins.
“Essentially all malaria work stopped when contractors were let go,” Linn said. “Countries haven’t had time to develop a backup plan, and pregnant women desperately need protection.”
USAID’s malaria initiatives provide mosquito nets, medication, and preventive treatments to millions. Without these resources, clinics in regions like the Democratic Republic of the Congo could soon face severe shortages. Pregnant women are particularly at risk, as they are three times more likely to develop severe malaria than non-pregnant women, according to the CDC.
“Imagine a pregnant woman expecting to receive a mosquito net at a clinic—if that net was funded by USAID, it won’t be there,” Linn said.
Geopolitical and Domestic Consequences
The USAID shutdown could have broader geopolitical implications, a former agency official warned. In West Africa, where terrorist activity is increasing, USAID has played a role in stabilizing communities through health and education initiatives.
“Pulling USAID resources from these regions means less support for local peacebuilders who counter instability and terrorist threats,” the official said.
The impact of these cuts extends beyond foreign borders. “When women and girls are denied healthcare and education, societies suffer. Economic instability, disease outbreaks, and violence increase—issues that ultimately affect the U.S. as well.”
Despite the uncertainty, advocates like Linn emphasize the need to keep fighting for these services. “This isn’t just about policy changes,” she said. “It’s about people’s lives.”
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