U. S. Aid Shift Sparks Risk of Medicine Shortages in Africa and Asia

The United States is changing how it sends life‑saving medicines for HIV and malaria to poorer nations, a move that could leave many countries without essential drugs. Until now, the U. S. ran its donations through a program called the Global Health Supply Chain, managed by private company Chemonics. Since 2016, that system shipped more than $5 billion worth of medicines to 90 countries, mainly in sub‑Saharan Africa and Asia. When President Trump began his term in January last year, he halted all international aid. This freeze left millions of dollars’ worth of supplies stuck in ports and warehouses, from HIV treatments to insecticide‑treated bed nets. A later waiver allowed some products back into circulation, but the program’s future has been uncertain as the administration cuts and reshapes aid. Sources say the rapid changes could create gaps in medicine delivery. The State Department sent an email to U. S. staff in 17 African countries and Haiti, telling them to stop the current supply program by May 30. The contract with Chemonics was set to end on September 30, even though the official termination is in November. The email warned of “immediate risks to service continuity” if the transition is rushed or incomplete, yet it offered no clear plan.In separate discussions, U. S. officials are talking with the Global Fund to Fight AIDS, Tuberculosis and Malaria about using its supply platform for future deliveries. The Global Fund already purchases around $2 billion a year of health products and operates an online procurement system. Some experts say the proposed November 2027 transition is unrealistic, given that ordering and delivering medicines to remote areas can take up to a year. The Trump administration’s “America First” health strategy aimed to cut contractor use, arguing that such firms add waste. Instead, it has moved toward bilateral agreements with recipient governments and private logistics companies. While Washington promises direct funding to countries like Kenya, Rwanda, Uganda, and Zambia, negotiations are still in flux. In Kenya, a court challenge over data privacy is delaying the deal; talks with Zambia have stalled. Overall, the U. S. shift toward a new aid model risks disrupting access to critical HIV and malaria treatments for millions of people in low‑income regions.