By Job Allan Wefwafwa and Bob Wekesa

On his first day in office, January 20, 2025, President Donald J. Trump signed an executive order pausing US development assistance for 90 days. This was meant to allow for the re-evaluation of foreign aid in alignment with the America First foreign policy. This meant the end of the United States Agency for International Development (USAID). Indeed, much of the USAID, as we knew it, has been merged into the State Department, and many of the programs it supported monetarily and in non-monetary resources have been terminated. The impact has been felt almost instantly.

Voices of discontent in the new move rose almost immediately, with African leaders and opinion shapers raising concern over the potentially devastating impact of the anti-philanthropy US move. These responses are understandable. The USAID was the largest bilateral and multilateral state-led foreign assistance entity. In the 2024 fiscal year, it set a budget of about $23 billion. Africa was the largest recipient, with $12 billion going to sub-Saharan Africa alone, even without factoring in northern Africa.

The initial consternation was, however, rapidly followed by pragmatic responses from African leaders and governments. A quick media-based survey we conducted on the health dimensions of the policy shift shows that most African governments were proactive. We focused on the health dimensions in Washington’s aid funding cuts towards Africa based on the heavy coverage of the issue, relative to other equally affected sectors.

African leaders, governments, and public figures talked about taking responsibility for the health of their people. There are debates among the African people about how African governments need to raise resources internally and from alternative external sources to fund their health budget deficit. The survey shows that governments are taking full responsibility to mitigate the impact of Trump’s withdrawal of aid, which has largely funded the health budgets of many African countries.

To undertake the survey, we used the framing theory and delineated four frames, namely: conflict, morality, impact, and responsibility. Drawing on scholarship, we defined conflict frames as dealing with the issues and areas of difference and disagreement between the Trump administration and African opinion shapers. We defined morality as the emotive responses questioning the humanity of US decision makers. We saw the impact frame as revolving around what the likely effects on diverse segments of the African population would be. We set up the responsibility frames as who should be obligated, who should be in charge, and accountable for the emergent situation.

We used these frames to analyse African newspapers’ coverage of how African governments are responding to the aid withdrawal. The frames indicate that most of the newspapers in English-speaking Africa reported on the health-related funding cuts from a responsibility frame perspective. This suggests that African governments and opinion shapers see the new development more as their responsibility rather than that of the US government.

An assumption we had before doing the survey was that African people would be more inclined towards the moral frame for several reasons. The first would be because Trump’s order was immediate, leaving African governments and people ill-prepared to take on the funding of their health budgets. Secondly, African people may have become too comfortable with the situation where the US is funding a large part of their health budget. They would have wanted the funding taps to continue flowing. However, there are two conclusions to be drawn from the African countries’ readiness to take the blame for the withdrawal of aid.

The first is that it may be easy for African countries to take a responsibility frame on funding their health budgets because this framing can be used for manipulation purposes to gain political mileage. For example, we see that African leaders may want to look stronger in the eyes of their people to gain political favour, even if they have no immediate intention of funding their health budgets. This is mainly because they do not have the structures and capacity to immediately raise funds for health budgets to make up for the aid that has been withdrawn.

The issue of corruption is key here. Corruption is endemic in many African countries that are trying to take responsibility for their health budgets. Institutional philanthropists, such as foundations, and corporate philanthropists may have the resources to somewhat fund African governments’ budget deficits.  The high levels of corruption and the reluctance of African leaders to tame it, however, discourage such potential donors.

Secondly, even as governments took responsibility for the funding cuts, the questions of how and why the many African countries abdicated the important duty of caring for the health of their people remained unanswered. Why and how did the governments entrust the health of the African people to the US, another country on another continent?

The answer takes us back to the immediate aftermath of the Second World War. The Union of Soviet Socialist Republics (USSR) and the USA wanted to assert their influence in Africa. We see that at the end of the war, the USSR proposed to help African countries develop the capacity for self-sufficiency in health by setting up vocational training centres. However, the US, through USAID, was quick to lure African people with ready medical supplies and manpower. Other smaller European countries, such as the Scandinavians, followed suit because they wanted alliances with the US to protect them from possible invasions by the USSR. As a result, African countries fell prey to the US and abandoned the USSR’s proposed course of health self-sufficiency. At that time, the overriding intention was to win the Cold War between the US and the USSR.

Therefore, Trump’s order to stop USAID funding health budgets in all countries of the world, including Africa, should have come immediately after the Second World War in the 1990s. It can be argued that the US feared the resurgence of the USSR if it had stopped aid in the 1990s, or that the US was a little more obsessed with other programmes it wanted to implement in Africa, including economic structural adjustment programmes and democratisation.

Arguably, the US needed the goodwill of the African people to implement these. What we are seeing is that democratisation does not seem to be working at the moment, even in the US. As a result, there is disillusionment about it, and hence less enthusiasm to sell it to the African people. In any case, the USSR and China are not democratic and have either maintained global power status (in the case of Russia) or grown steadily over the years to become global powers (China). This leads the African people to doubt the style of leadership and to pay lip service to it to get the US aid to which they have been accustomed for decades.

Based on the response of African governments to the order, we can say that governments realise that they have been duped into a false deal with the US. They realise now it is time to wake up to the opportunity to build their internal capacity and mobilise resources to build their health structures.