The disappearance of USAID raises questions about the future of Africa's healthcare and health technology sector.
The suspension of USAID-funded programs, including PEPFAR, has had far-reaching consequences for Africa's healthcare ecosystem, particularly in areas such as HIV/AIDS prevention and treatment, maternal and child health, and infectious disease control.
Potential Impacts ------------------
The withdrawal of USAID's support has led to healthcare service disruptions and workforce challenges, with clinics and community organizations delivering HIV/AIDS services closing or reducing operations. This has resulted in service gaps, especially in high-burden areas like South Africa and Nigeria, where over 8,000 healthcare workers lost their jobs following funding cuts.
Vulnerable groups, including men who have sex with men (MSM), transgender populations, and rural communities, are disproportionately affected due to reduced access and heightened stigmatization. The discontinuation or interruption of antiretroviral therapy can lead to drug resistance and increased HIV transmission, threatening to reverse years of progress made by PEPFAR and other programs.
Beyond HIV, other disease programs like malaria control have lost significant funding, endangering initiatives such as bed net distributions and treatment programs. This could result in surges in child mortality. Essential supplies like antiretroviral drugs, testing kits, and malaria diagnostics are in short supply, escalating the risk of untreated infections and outbreaks. Maternal and child health programs, including midwifery and mobile clinics, face suspension, increasing maternal and infant mortality.
Strategies for Pivoting -----------------------
To mitigate these impacts, several strategies are being considered. African governments are reallocating national treasury funds to stabilize critical programs and maintain essential healthcare worker employment and service continuity. To reduce dependence on any single external donor, African healthcare systems are cultivating multiple funding streams such as private sector partnerships, multilateral development banks, and philanthropic organizations.
Building robust healthcare infrastructure and workforce through investment in local training, supply chain management, and community engagement is vital for creating resilient systems less vulnerable to external shocks. Collaborating within African Union frameworks or regional bodies can help in pooling resources, sharing best practices, and negotiating better terms with donors or suppliers.
Adoption of health insurance schemes, social impact bonds, or leveraging technology for cost-effective service delivery could support sustainability. Programs that integrate HIV/AIDS, malaria, tuberculosis, and maternal-child health services can maximize resource use and improve overall health outcomes even amid funding constraints.
The sector must reimagine its playbook, with governments leading with policy instead of platitudes and aggressive domestic investment in digital infrastructure. VCs and impact investors are encouraged to step into USAID's role, using development impact bonds or revenue-based financing for investments in electronic health records or telemedicine.
Innovative solutions are also emerging from local and regional partnerships between the private sector and health tech startups. For example, Ghana's mPharma has acquired distressed pharmacies to stabilise drug access, while Maisha Meds, a leading healthtech startup in Africa, received funding from USAID's Development Innovation Ventures (DIV) to expand their mobile software platform and provide affordable malaria care across Africa.
Despite the challenges, there are glimmers of hope. The African Union is urging global institutions to commit to African-led healthcare frameworks, and platforms like AfriGadget are proving that the model for de-risking investments in healthtech works. Damilola Adelekan, a Product Manager with 5+ years of experience, is leading product management at Remedial Health Solutions and is passionate about mentorship, having helped over 50 individuals transition into tech.
USAID played a significant role as a catalyst in Africa's health ecosystem, investing in bridges between governments, NGOs, and innovators like Remedial Health Solutions. However, USAID's exit poses a seismic shock to systems that relied on its expertise to optimise last-mile delivery, train frontline workers, and scale digital tools.
In summary, the suspension of USAID-funded programs has created a critical juncture for Africa, risking setbacks in major public health achievements but also spurring efforts for greater self-reliance and strategic shifts in healthcare delivery and financing. Strengthening national commitment and fostering innovative partnerships will be key to navigating this transition.
- With the closure or reduction of operations for clinics delivering HIV/AIDS services due to the withdrawal of USAID's support, there is an increase in service gaps, particularly in high-burden areas like South Africa and Nigeria, where the discontinuation of funding has led to over 8,000 healthcare workers losing their jobs.
- Innovative solutions are emerging from local and regional partnerships between the private sector and health tech startups, such as Ghana's mPharma's acquisition of distressed pharmacies to stabilize drug access and Maisha Meds' expansion of their mobile software platform through funding from USAID's Development Innovation Ventures (DIV) for affordable malaria care across Africa.
- To reduce dependence on any single external donor and maintain essential healthcare worker employment and service continuity, African governments are reallocating national treasury funds and are cultivating multiple funding streams like private sector partnerships, multilateral development banks, and philanthropic organizations.
- The African Union is urging global institutions to commit to African-led healthcare frameworks, and initiatives like Damilola Adelekan, a Product Manager with experience in mentorship, leading product management at Remedial Health Solutions, are playing a crucial role in fostering innovation in the healthtech sector, even amid the challenges posed by USAID's exit from the African health ecosystem.
