‘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.
Trump latest: President doubles down on Gaza plan
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”.
Read more:
What is USAID?
Funding gap leaves South Africans in turmoil
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.”
World
At least 100 people killed in Israeli strikes on Gaza – ‘complete families wiped out’ says health ministry
At least 100 people have been killed in Israeli strikes on Gaza overnight and into Sunday, according to Gaza’s health ministry.
Local medics also report that women and children were among the dead – as Israel launches an escalation of its war in Gaza to ramp up pressure on Hamas.
“Complete families were wiped off the civil registration record by Israeli bombardment,” Khalil Al-Deqran, Gaza health ministry spokesperson, told the Reuters news agency.
Nasser hospital, in the southern city of Khan Younis, said it received the bodies of 20 people killed in strikes that hit houses and tents in the Muwasi area. Hamas described that as a “new brutal crime”.
Smoking debris after an airstrike at a tent camp in Khan Younis, southern Gaza on Sunday. Pic: Reuters
Saleh Zenati carries the body of his nephew killed in Khan Younis on Sunday. Pic: AP
In central Gaza, at least 10 people were killed in two separate strikes, according to the Al-Aqsa Martyrs hospital in the town of Deir al Balah.
Meanwhile, first responders from the health ministry and the civil defence reported at least 36 people were killed in multiple strikes in Jabalia, northern Gaza.
The Israeli military had no immediate comment on the latest strikes.
Israel has blocked the entry of medical, food and fuel supplies into Gaza since the start of March. It is attempting to pressurise Hamas into freeing Israeli hostages and has approved plans that could involve seizing the whole of Gaza and controlling aid.
It comes as peace talks between Israel and Hamas take place in Qatar this weekend, although sources told Reuters there had been no breakthrough.
Sky News Arabia reported that Hamas had proposed freeing about half its Israeli hostages in exchange for a two-month ceasefire and the release of Palestinian prisoners held by Israel.
A Palestinian official close to the talks said: “Hamas is flexible about the number of hostages it can free, but the problem has always been over Israel’s commitment to end the war.”
Please use Chrome browser for a more accessible video player
On Saturday, Israel ramped up attacks on Gaza
Earlier on Sunday, Gaza’s health ministry issued a statement accusing Israel of “intensifying its systematic campaign to target hospitals”.
“After putting the European Gaza Hospital out of service a few days ago, the Israeli occupation has intensified its targeting and siege of the Indonesian Hospital in the northern Gaza Strip since dawn today,” it added.
Israel has previously denied deliberately targeting civilians and accused Hamas of using hospitals for military purposes.
This week, Israel said it had bombed the European Hospital because it was home to an underground Hamas base, but Sky News analysis has cast doubt on its evidence.
Please use Chrome browser for a more accessible video player
Mass protests on Saturday mark 77 years since the Nakba
Separately, the Israeli military said on Sunday it had intercepted a missile launched from Yemen toward Israel.
Yemen’s Iran-aligned Houthis said they had targeted Ben Gurion Airport near Tel Aviv with two ballistic missiles.
The Houthis have fired at Israel because of the plight of Palestinians in Gaza, while Israel has carried out airstrikes in response, including one on 6 May that damaged Yemen’s main airport in Sanaa and killed several people.
The conflict began on 7 October 2023, when Hamas-led militants attacked southern Israel, killing 1,200 people and abducting 251 others.
Israel’s military response has seen the deaths of more than 53,000 people, according to the Hamas-run health ministry in Gaza, which doesn’t differentiate between civilians and combatants.
This breaking news story is being updated and more details will be published shortly.
Please refresh the page for the fullest version.
You can receive breaking news alerts on a smartphone or tablet via the Sky News app. You can also follow us on WhatsApp and subscribe to our YouTube channel to keep up with the latest news.
Donald Trump has said he will speak to Vladimir Putin and Volodymyr Zelenskyy separately on Monday in a bid to secure a ceasefire deal between Russia and Ukraine.
The US president made the announcement on Truth Social – shortly after the Ukrainian president condemned Russia for the “deliberate killing of civilians” after a drone hit a bus in north-eastern Ukraine.
Mr Trump said he will speak to Mr Putin over the phone. He will then talk with Mr Zelenskyy and “various members of NATO”, he wrote.
In an all-caps post, he said: “HOPEFULLY IT WILL BE A PRODUCTIVE DAY, A CEASEFIRE WILL TAKE PLACE, AND THIS VERY VIOLENT WAR, A WAR THAT SHOULD HAVE NEVER HAPPENED, WILL END. GOD BLESS US ALL!!!”
The Ukrainian town of Bilopillia today declared a period of mourning lasting until Monday after nine people were killed in a Russian drone attack – which occurred just hours after Kyiv and Moscow held peace talks.
Seven others were injured, Ukrainian authorities said. The bus was evacuating civilians from a frontline area when the drone hit, the country’s national police said.
Please use Chrome browser for a more accessible video player
Nine killed in Russian strike on bus
A “father, mother and daughter” were among the dead, Mr Zelenskyy said, writing on Telegram: “All the deceased were civilians. And the Russians could not have failed to understand what kind of vehicle they were targeting.”
The attack has also been condemned by British Foreign Secretary David Lammy, who said he was “appalled”.
“If Putin is serious about peace, Russia must agree to a full and immediate ceasefire, as Ukraine has done,” he wrote on X.
Representatives for Kyiv and Moscow met for direct peace talks in Istanbul, Turkey, just hours before the drone attack.
While the discussions – which were not attended by the Mr Putin or Mr Zelenskyy – did not result in a truce, both countries agreed to exchange 1,000 prisoners in their biggest swap yet.
Ukraine’s intelligence chief, Kyrylo Budanov, said on national television the exchange could happen as early as next week.
Please use Chrome browser for a more accessible video player
What happened at Ukraine talks?
Russia ‘threatened eternal war’ at peace talks
After a Ukrainian official yesterday said Russia made “unacceptable” demands during the discussions, a source from the Kyiv delegation has now told Sky News that Moscow threatened “eternal war”.
Separately, a senior Kyiv official said Russia’s proposed ceasefire terms included the full withdrawal of troops from four regions of Ukraine: Donetsk, Zaporizhzhia, Kherson and Luhansk.
Moscow also called for international recognition that those regions and Crimea – annexed in 2014 – are Russian and for Ukraine to become a neutral state, with no allied troops stationed there, they said.
The Kremlin declined to comment on the matter.
Read more:
What happened last time Putin and Zelenskyy met?
Ukrainians tortured and killed in Russian jails
Analysis: the chilling moment in Russia-Ukraine talks
Listen to The World with Richard Engel and Yalda Hakim every Wednesday
Ukraine has rallied support from its allies following the talks, and a number have spoken out.
French President Emmanuel Macron said: “Today, what do we have? Nothing. And so I tell you, faced with President Putin’s cynicism, I am sure that President Trump, mindful of the credibility of the United States, will react.”
The EU is working on a new package of sanctions against Moscow, European Commission President Ursula von der Leyen said.
Israel and Hamas said ceasefire talks have resumed in Qatar – even as Israeli forces ramped up a bombing campaign and mobilised for a massive new ground assault.
Earlier, the Israeli military said it had been “conducting extensive strikes and mobilising troops” as part of preparations to expand operations in Gaza.
Israel’s defence minister Israel Katz said Hamas had “refused to discuss negotiations without a cessation of the war”, but after the airstrikes and the mobilisation of forces the militant group’s representatives “have agreed to sit in a room and seriously discuss the deal”.
“Israel emphasises that if the talks do not progress, the [military] operation will continue,” he added.
A Hamas source told Sky News that ceasefire talks began in Doha on Saturday morning.
Palestinians inspect the site of an Israeli strike on a house in Jabalia. Pic: Reuters
Tents were targeted in an airstrike on Saturday at al Aqsa Hospital in Deir al Balah in central Gaza. Pic: AP
Hamas official Taher al-Nono told Reuters news agency that the two sides were involved in discussions without “pre-conditions”.
He added Hamas was “keen to exert all the effort needed” to help mediators make the negotiations a success.
More than 150 people have been killed in Israeli strikes in the last 24 hours, according to the Hamas-run health ministry in Gaza.
This week has been one of the deadliest phases of bombardment since a truce collapsed in March and marked a significant escalation in Israel’s offensive.
The Israeli military’s preparations to expand operations in Gaza have included the build-up of tanks and troops along the border.
It is part of “Operation Gideon Chariot”, which Israel says is aimed at defeating Hamas and getting its hostages back.
Israeli tanks near the Israel-Gaza border on Saturday. Pic: Reuters
An Israeli tank being relocated to a position near the Gaza border on Friday. Pic: AP
An Israeli defence official said earlier this month that the operation would not be launched before Donald Trump concluded his visit to the Middle East.
The US president ended his trip on Friday, with no apparent progress towards a new peace deal.
Please use Chrome browser for a more accessible video player
Forensic look at Israel’s escalation
Meanwhile, on Saturday, leaders at the annual summit of the Arab League in Baghdad said they were trying to reach a ceasefire between Israel and Hamas in Gaza.
They also promised to contribute to the reconstruction of the territory once the war stops.
The meeting comes two months after Israel ended a ceasefire reached with the Hamas militant group.
A man carrying the body of a child killed in Israeli airstrikes on Friday in Jabalia, northern Gaza. Pic: Reuters
Parts of northern Gaza have been completely destroyed in the bombing campaign. Pic: Reuters
Israel’s Prime Minister Benjamin Netanyahu said on 5 May that Israel was planning an expanded, intensive offensive against Hamas as his security cabinet approved plans that could involve seizing Gaza and controlling aid.
This week, Israel said it had bombed the European Hospital because it was home to an underground Hamas base, but Sky News analysis has cast doubt on its evidence.
Listen to The World with Richard Engel and Yalda Hakim every Wednesday
Israel’s goal is the elimination of Hamas, which attacked southern Israel on 7 October 2023, killing around 1,200 people and seizing about 250 hostages.
Its military response has killed more than 53,000 people, according to the Hamas-run health ministry in Gaza, which does not differentiate between civilians and combatants.
-
Sports3 years ago‘Storybook stuff’: Inside the night Bryce Harper sent the Phillies to the World Series
-
Sports1 year agoStory injured on diving stop, exits Red Sox game
-
Sports2 years agoGame 1 of WS least-watched in recorded history
-
Sports2 years agoMLB Rank 2023: Ranking baseball’s top 100 players
-
Sports4 years ago
Team Europe easily wins 4th straight Laver Cup
-
Environment2 years agoJapan and South Korea have a lot at stake in a free and open South China Sea
-
Environment2 years agoGame-changing Lectric XPedition launched as affordable electric cargo bike
-
Business3 years agoBank of England’s extraordinary response to government policy is almost unthinkable | Ed Conway