‘People will die’: Chaos and mounting fear in Uganda as USAID cuts lead to ‘total panic’ and HIV clinic closures
In what will be seen as a signature act of the new Trump administration, the president and his team have denounced and dismembered the US government’s international assistance arm, USAID, in a matter of three weeks.
It is a decision that will have serious, real-world consequences – and the impact is already being felt in countries such as Uganda.
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The health ministry in Uganda has announced its intention to shut all dedicated HIV/AIDS and tuberculosis (TB) clinics in the country. Stand-alone pharmacies supplying antiretroviral drugs will also be closed.
These facilities provide HIV treatments and preventative therapies to millions of people in Uganda, including an estimated 1.5 million currently living with the virus.
An official said the closure of HIV clinics was a necessary response as the country grapples with the loss of funding from USAID.
The cuts have sparked protests outside USAID’s now-closed building in Washington DC. Pic: Reuters
Directors and staff at the country’s public hospitals have been instructed to offer the same services at their outpatients and chronic care departments.
A USAID initiative called the President’s Emergency Plan For AIDS Relief – or PEPFAR – has bankrolled much of Uganda’s HIV/AIDS relief plan and it’s an initiative that has wielded impressive results.
Specially trained staff and dedicated clinics are credited with bringing infection rates down from 19% in the late 1990s to 5% in 2024.
‘We are still reeling’
Flavia Kyomukama, from the National Forum of People Living with HIV/AIDS Networks Uganda (NAFOPHANU), said she was stunned by Donald Trump’s decision.
“We are still reeling from the shock of what they have done, it is very difficult to understand,” she said. “There was a memorandum of support [between both countries], there was roadmap [towards zero infections] and they make this decision in a day.”
Flavia Kyomukama
Shifting HIV/AIDS-related care to public hospitals is deeply problematic, Ms Kyomukama added.
These facilities are often overwhelmed, and they offer little, or no, privacy. It is a serious issue in a country where those carrying the virus are badly stigmatised.
“Surveys show 30% of health workers have a negative attitude towards people with HIV,” Ms Kyomukama said. “So, we’re going to see [patients] dropping out [of their treatment plans], drug resistance will increase and we will see more violence in hospital as people with HIV get attacked.”
World is worryingly dependent on US – it now faces a major shock and impossible choices
The Trump administration’s destruction of USAID will bring about the virtual collapse of the international aid and development system, experts have warned.
The US government puts far more money into humanitarian assistance than any other country.
In 2023, the most recent year for which data is largely complete, the Americans disbursed $71.9bn (£57bn) in foreign aid, representing 1.2% of total US government spending.
It is a spending commitment that has remained remarkably consistent over the years.
The Americans underwrite programmes in 177 individual countries with Ukraine registering as the biggest recipient in 2023. It received $16.6bn (£12.9bn) to maintain government services after the Russian invasion.
PEPFAR, USAID’s best-known initiative, provides antiretroviral treatments to 20 million people infected with HIV/AIDS.
The initiative supports NGO-run groups with an extended workforce of 350,000 people – with many employed at local clinics.
The US also bankrolls key UN organisations, such as the refugee agency (UNHCR). Its total budget of $4.8bn (£3.8bn) is propped up by the Americans, who put in US$2bn (£1.6bn).
Without this funding, it is difficult to see how UNHCR can continue to support tens of millions of refugees in countries including Sudan, Syria, Turkey and the Democratic Republic of Congo.
If the residents of refugee camps are not supported with basic services, they are likely to move.
The question then is how US funding compares to other donors – and the answer is startling.
According to the UN’s real-time financial tracking service, Germany contributed funds in 2024 representing 8% of total humanitarian aid contributions, as did the European Union, with the United Kingdom at 6%.
The world, then, is worryingly dependent on the United States.
Former international aid worker turned consultant Thomas Byrnes said: “The modern humanitarian system has been shaped by a long-term commitment from the US.
“For decades, organisations like the UN agencies have relied on this predictable funding stream to address global crises.
“The world faces a major shock and I don’t think anyone is prepared for it.”
To alleviate the situation, Mr Byrnes said other donors – such as the UK and Germany – will need to make up the funding shortfall from USAID.
But that is highly unlikely to happen.
The United Kingdom, currently contributing $2.1bn (£1.7bn), would need to contribute an additional $1.5bn (£1.2bn) – representing a 74% increase.
For Germany, the required extra contribution would be $1.8bn (£1.5bn), representing a substantial increase of 70%.
Furthermore, Trump’s move comes at a time when Germany, France, Sweden and others are planning deep cuts to international aid.
The world is looking at a colossal funding gap – and a colossal crisis – as the number of people in need of humanitarian assistance rises to 305 million people, Mr Byrnes added.
“We’re facing a perfect storm,” he said. “The brutal math means we’re heading toward humanitarian aid of just 17 cents per person per day.
“This isn’t a funding dip – it’s a systemic shock that will force impossible choices about who receives help and who doesn’t. People will die as a result of this.”
‘It’s total panic right now’
Brian Aliganyira is the director of Ark Wellness Hub, a busy health clinic for the LGBT+ community in Uganda’s capital, Kampala.
The clinic has sourced supplies – such as antiretroviral drugs, preventative ‘PrEP’ therapies and testing kits – from partners who are underpinned by USAID.
Now, the 37-year-old has got a major problem on his hands.
“It’s total panic right now,” he said. “Our response teams are panicking and there is a lot of panic in the community.
“We are telling people to go home and it’s not just [our clinic]. There is no more medication left – or maybe there’s one refill at the most. But people keep asking us, ‘have you got any extra, any extra’?
“Without the support we need, HIV will surge and people will die.”
Brian Aliganyira
‘Lives will be lost’
There are some still clinging to hope.
On 1 February, US secretary of state Marco Rubio issued a waiver exempting the PEPFAR programme from the new administration’s cuts to foreign aid.
However, President Trump issued a contradictory order banning programmes designed to “advance equality and human rights for lesbian, gay, bisexual, transgender, queer, and intersex people”.
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Donald Trump and Marco Rubio have given contradictory messages about parts of the USAID cuts. Pic: AP
The result in Uganda is chaos – and mounting fear.
“Really, we are grieving about this, we are grieving,” Ms Kyomukama said. “Livelihoods will be lost – and lives will be lost.”
The White House is considering inviting Volodymyr Zelenskyy to a meeting between Donald Trump and Vladimir Putin in Alaska, according to reports in the US.
The reports come a day after Washington and Moscow confirmed the US and Russian presidents will meet on Friday to discuss bringing about an end to the war in Ukraine.
A senior US official and three people briefed on internal discussions have told Sky News’ US partner network NBC News that the Trump administration is now considering inviting the Ukrainian president to the summit.
“It’s being discussed,” one of the people briefed on the talks was quoted as saying.
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For Ukraine – its exhausted, brave soldiers, its thousands of bereaved families mourning their dead, and its beleaguered president – it is exactly what they feared it would be.
They fear the compromise they will be forced to make will be messy, costly, unfair and ultimately beneficial to the invading tyrant who brought death and destruction to their sovereign land.
The sources said a visit by Mr Zelenskyy has not been finalised – and it is unclear whether the Ukrainian leader will be in Alaska.
However, the senior administration official said it is “absolutely” possible.
“Everyone is very hopeful that would happen,” the official said.
Asked whether the US had officially invited Mr Zelenskyy, a senior White House official said: “The president remains open to a trilateral summit with both leaders. Right now, the White House is focusing on planning the bilateral meeting requested by President Putin.”
On Friday – before the summit was confirmed – Mr Trump had told reporters at the White House that “we’re getting very close to a deal” that would end the conflict.
The US president added there will be “some swapping of territories to the betterment of both sides”.
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US diplomacy ‘totally amateur’
Zelenskyy suggests he’s unwilling to give up territory
Yesterday, the Ukrainian president warned that allowing Russia to keep territory it has occupied in Ukraine will result in another invasion.
He said allowing Mr Putin to annex Crimea in 2014 didn’t prevent Russia forces from occupying more parts of Ukraine during the current conflict.
Mr Zelenskyy added: “Now, Putin wants to be forgiven for seizing the south of our Kherson region, Zaporizhzhia, the entire territory of Luhansk and Donetsk regions, and Crimea. We will not allow this second attempt to partition Ukraine.
“Knowing Russia – where there is a second, there will be a third.”
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Zelenskyy: Ukraine will not give land to ‘occupier’
NATO allies say Ukraine must be involved in negotiations
Ukraine and several NATO allies have reportedly been privately concerned Mr Trump might agree to Mr Putin’s proposals for ending the war without taking their positions into account.
In a joint statement last night, UK Prime Minister Sir Keir Starmer and the leaders of France, Italy, Germany, Poland, Finland and the European Commission said Ukraine’s future cannot be decided without Kyiv.
They said: “Ukraine has the freedom of choice over its own destiny. Meaningful negotiations can only take place in the context of a ceasefire or reduction of hostilities.
“The path to peace in Ukraine cannot be decided without Ukraine.
“We remain committed to the principle that international borders must not be changed by force.
“The current line of contact should be the starting point of negotiations.”
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From left: Volodymr Zelenskyy, Donald Trump and Vladimir Putin. Pics: AP
UK hosts Ukrainian officials ahead of summit
Earlier, Foreign Secretary David Lammy hosted a meeting of top Ukrainian officials and European national security advisers alongside US Vice President JD Vance.
The meeting took place at Chevening, the foreign secretary’s official country retreat in Kent, where Mr Vance is staying at the start of a UK holiday.
After the meeting, Mr Lammy said: “The UK’s support for Ukraine remains ironclad as we continue working towards a just and lasting peace.”
From left: Rustem Umerov, David Lammy, JD Vance and Andriy Yermak. Pic: X/David Lammy
It is understood that the meeting had been called at Washington’s request, and included representatives from the US, Ukraine, France, Germany, Italy, Finland and Poland, as well as the UK.
Ukraine was represented by Rustem Umerov, secretary of the country’s national security and defence council, and the head of Mr Zelenskyy’s office, Andriy Yermak.
In a post on social media, Mr Yermak said the allies’ positions were “clear” that “a reliable, lasting peace is only possible with Ukraine at the negotiating table, with full respect for our sovereignty and without recognising the occupation”.
Ahead of the meeting, Sir Keir discussed the talks in a call with Mr Zelenskyy, and also spoke to French President Emmanuel Macron.
A Downing Street spokeswoman said Sir Keir and Mr Macron “discussed the latest developments in Ukraine, reiterating their unwavering support for President Zelenskyy and to securing a just and lasting peace for the Ukrainian people”.
A man who opened fire on the headquarters of America’s national public health agency – leaving a police officer dead – had blamed the COVID vaccine for making him depressed and suicidal.
Patrick Joseph White, a 30-year-old from Georgia, had tried to enter the Centers for Disease Control and Prevention (CDC) headquarters in Atlanta but was stopped by guards, a law enforcement official said.
They added that White then drove to a pharmacy across the street before opening fire late on Friday afternoon.
He was armed with five guns – including at least one long gun.
DeKalb County Police Officer David Rose, who had three children, was shot dead while responding to the incident.
DeKalb County Police Officer David Rose. Pic: Reuters
White also died, but authorities haven’t said whether he was killed by police or if he killed himself.
His father had contacted police and identified his son as the possible gunman.
White’s father also said his son had been upset over the death of his dog and had become fixated on the COVID-19 vaccine.
Health and Human Services Secretary Robert F. Kennedy Jr, whose scepticism of vaccines has been a cornerstone of his career, voiced support for CDC employees yesterday.
But some laid-off CDC employees said Mr Kennedy shares responsibility for the violence and should resign.
An armed police officer at the scene. Pic: AP
Mr Kennedy has a history as a leader in the anti-vaccine movement, but he reached new prominence by spreading distrust of COVID-19 vaccines. For example, he called it “criminal medical malpractice” to give these jabs to children.
He said after the shooting: “We are deeply saddened by the tragic shooting at CDC’s Atlanta campus that took the life of officer David Rose.
“We know how shaken our public health colleagues feel today. No one should face violence while working to protect the health of others.”
Sarah Boim, a former CDC communications staffer who was fired this year during a wave of terminations, said the shooting was the “physical embodiment of the narrative that has taken over, attacking science, and attacking our federal workers”.
The CDC headquarters in Atlanta, Georgia. Pic: AP
White’s ‘distrust of COVID vaccines’
A neighbour of White told The Atlanta Journal-Constitution that the gunman spoke with her multiple times about his distrust of COVID-19 jabs.
Nancy Hoalst, who lives on the same street as White’s family, said he seemed like a “good guy” but he would bring up vaccines even in unrelated conversations.
“He was very unsettled, and he very deeply believed that vaccines hurt him and were hurting other people.” Ms Hoalst told the Atlanta newspaper. “He emphatically believed that.”
However, she said she never believed White would be violent and added: “I had no idea he thought he would take it out on the CDC.”
Donald Trump has announced his “highly anticipated” meeting with Vladimir Putin will take place next Friday in the US state of Alaska.
The two presidents are expected to discuss the war in Ukraine – with the talks potentially leading to a breakthrough in Mr Trump’s effort to end the conflict.
But there’s no guarantee it will stop the fighting since Moscow and Kyiv remain far apart on their conditions for peace.
Earlier, the US president told reporters “we’re getting very close to a deal” that would end the war.
Mr Trump added there will be “some swapping of territories to the betterment of both sides”.
Follow latest: Ukraine war live updates
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‘I’m not against meeting Zelenskyy’
The meeting between the two leaders will be the first US-Russia summit since 2021, when former US President Joe Biden met Mr Putin in Switzerland.
Mr Trump wrote on Truth Social: “The highly anticipated meeting between myself, as President of the United States of America, and President Vladimir Putin, of Russia, will take place next Friday, August 15, 2025, in the Great State of Alaska. Further details to follow. Thank you for your attention to this matter!”
The meeting was also confirmed by Kremlin aide Yury Ushakov, who said the leaders will “focus on discussing options for achieving a long-term peaceful resolution to the Ukrainian crisis”.
He added that the two presidents could meet in Russia in future and that an invitation has already been extended to Mr Trump.
Yesterday, Mr Trump had told reporters at the White House that he couldn’t announce where or when the meeting would take place but he would do so soon.
He also suggested that his meeting with the Russian leader could come before any discussion involving Ukrainian President Volodymyr Zelenskyy.
“We’re going to have a meeting with Russia, start off with Russia. And we’ll announce a location. I think the location will be a very popular one,” Mr Trump said.
The US president added: “President Putin, I believe, wants to see peace, and Zelenskyy wants to see peace … in all fairness to President Zelenskyy, he’s getting everything he needs to, assuming we get something done.”
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Donald Trump, right, and Vladimir Putin at a summit in Vietnam in 2017. Pic: Reuters
Territory to form part of talks
Speaking about the role that territory will play in the peace talks, Mr Trump said: “You’re looking at a territory that’s been fought over for three-and-a-half years. A lot of Russians have died. A lot of Ukrainians have died.
“So we’re looking at that, but we’re actually looking to get some back, and some swapping.
“It’s complicated, actually. Nothing is easy. It’s very complicated. But we’re going to get some back.
“We’re going to get some switched. There’ll be some swapping of territories to the betterment of both.”
Analysts, including some close to the Kremlin, have suggested that Russia could offer to give up territory it controls outside of the four regions it claims to have annexed.
Pressed on if this was the last chance to make a major peace deal, Mr Trump said: “I don’t like using the term last chance … when those guns start going off, it’s awfully tough to get them to stop.”
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Trump says he will meet Putin
Western officials ‘to meet in UK’
Meanwhile, senior officials from the US, Ukraine and several European countries are due to meet in the UK this weekend to try and reach common positions ahead of the Trump-Putin meeting, according to Axios.
Ukraine and several NATO allies are reported to be privately concerned that Mr Trump might agree to Mr Putin’s proposals for ending the war without taking their positions into consideration.
Since his return to the White House in January, Mr Trump has moved to mend relations with Russia and sought to end the war – with public comments veering between admiration and sharp criticism of Mr Putin.
In a sign of his growing frustration with Russia’s refusal to halt its military offensive, Mr Trump had threatened to impose new sanctions and tariffs against Moscow – and countries that buy its exports – unless the Kremlin agreed to end the conflict.
A deadline was set for yesterday, but it is unclear whether these sanctions are taking effect, or if they will be delayed or cancelled in light of the talks.
Ukrainian servicemen of the 148th artillery brigade load ammunition into a M777 howitzer before firing in Zaporizhzhia.
Pic: AP
War grinds on ahead of talks
The meeting has been arranged as Russia’s bigger army is slowly advancing deeper into Ukraine at great cost in troops and armour while it relentlessly bombards Ukrainian cities.
Ukrainian forces are locked in intense battles along the 620-mile frontline that snakes from northeast to southeast Ukraine.
The Pokrovsk area of the eastern Donetsk region is taking the brunt of punishment as Russia seeks to break out into the neighbouring Dnipropetrovsk region.
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