‘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.”
Footage geolocated by Sky News showed Russian soldiers walking through the Shakhtarskyi neighbourhood on the outskirts of Pokrovsk on Thursday.
The video sheds light on the situation in this key frontline area, as Russian forces slowly encroach on Myrnohrad, the satellite town to Pokrovsk, and one of its last remaining outposts.
Videos geolocated by Sky News show fighting intensifying in recent weeks, as Russian forces attempt to gain control of the towns and their network of road and rail intersections.
Gaining control here would give Russia a base from which to access key cities further north that form part of Ukraine’s “fortress belt”.
Russian forces are advancing from all directions, according to the Institute for the Study of War (ISW), with only one small opening to the northwest of Myrnohrad remaining.
Estimated to be only 3km wide by military experts, this withdrawal corridor is patrolled by Russian drone units which monitor the area for moving vehicles and those who may attempt to leave on foot.
Russian forces have been advancing on Myrnohrad since late October.
Video from a Ukrainian unit in Myrnohad, posted on 29 October, shows a Russian vehicle attempting to enter the town from the northeast. The tank is attacked and soldiers attempting to enter on foot are targeted.
Video posted on 3 November shows Russian forces on the ground in the south of the town.
By 8 November, Russian strikes begin to pummel the northeast of Myrnohrad, the location of many of the town’s high-rise buildings, at that time, held by Ukrainian forces.
George Barros, Russia Team & Geospatial Intelligence Team Lead at ISW, told Sky News that Russian strategy in Pokrovsk has been to erode Ukrainian logistical capacity using drones and artillery over the course of several months.
“After denying supply lines and degrading the frontline forces by essentially cutting them off from behind and starving them out in their positions, then the Russians move forward with their infantry and frontal assaults,” Barros explained.
Capture the flag
For a brief period, it looked as though Russian forces had captured Myrnohrad.
Videos posted on 13 November appeared to show a Russian flag flying over the Myrnohrad mine.
However, video posted the following day showed a Ukrainian drone shooting it down.
Both Russian and Ukrainian forces continue to fight for control of Myrnohrad, with videos posted on the 19 and 20 November showing Russian airstrikes on Ukrainian positions in the town, and Ukrainian drone strikes targeting Russian forces on foot.
While the exact numbers of Russian and Ukrainian forces in the area remains unclear, reports indicate that three key Russian units are active in Pokrovsk and Myrnohrad, and are advancing on the towns from the north and south.
A number of Ukrainian units remain inside the towns, including the 145th Assault regiment and the 32nd, 35th, 38th and 155th Brigades. Reports indicate that more Ukrainian units have been moved into surrounding areas to hold the withdrawal corridor open.
Sky News reached out to the Ukrainian brigades still in Myrnohrad, but they declined to comment, citing military regulations.
Strategic significance
Natia Seskuria, associate international security fellow at the Royal United Services Institute (RUSI), explained that the area is important for the Ukrainians to keep and the Russians to take because of its strategic position.
“Situated at a major road and rail intersection in Donetsk Oblast, Pokrovsk has functioned as a central artery for moving troops, equipment, and supplies to Ukrainian units deployed along the surrounding front.”
Russia “would gain a platform to redirect its offensive efforts toward Ukraine’s principal defensive urban centres… including Kramatorsk and Slovyansk,” Seskuria said.
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Ukrainian and Russian soldiers in Pokrovsk have fought intensely and at close quarters over the last month.
In late October US-made Black Hawk helicopters containing specialist troops directed by Ukrainian military intelligence entered Pokrovsk to try to keep the town.
But as Russian troops advance, Myrnohrad is becoming the last stronghold of Ukrainian forces in the area.
Uncertain future
At least up until 12 November, there were still civilians living in Pokrovsk and Myrnohrad, despite strikes on buildings in both cities.
Residents sit in an armoured vehicle as Ukrainian police officers evacuate them from Pokrovske on 11 November. Source: Reuters
A post made on that day by the Donetsk state regional administration estimated 1,200 people remain living in Pokrovsk and 900 in Myrnohrad.
Evacuation is only possible with the help of the military or police, and it is not clear how many have evacuated in the 11 days since.
Barros of ISW says gaining Pokrovsk would increase Russia’s leverage at the negotiating table.
“If the Russians can successfully convince enough international leaders that, okay, the Russians took Pokrovsk, they’re going to take the next thing, and they’re going take the thing, so now let’s negotiate, then that is a strategic victory for the Russians.”
Production by Michelle Inez Simon, Visual Investigations Producer.
The Data x Forensics team is a multi-skilled unit dedicated to providing transparent journalism from Sky News. We gather, analyse and visualise data to tell data-driven stories. We combine traditional reporting skills with advanced analysis of satellite images, social media and other open source information. Through multimedia storytelling we aim to better explain the world while also showing how our journalism is done.
Torrential rain, flooding and landslides has left more than 100 people dead or missing in Vietnam.
Rainfall has exceeded 74.8in (1.9 metres) in some parts of central Vietnam over the past week.
The region is a major coffee production belt and home to popular beaches, but it is also prone to storms and floods.
Fatalities have been reported in Dak Lak province and the neighbouring Khanh Hoa province.
Parts of Quy Nhon has been under several feet of water. Pic: picture-alliance/dpa/AP
Footage has been released by local police of a dramatic rescue, involving a drone which airlifted a stranded man to safety from an island in the middle of the Serepok River, Dak Lak province.
The government estimates the flooding has cost the economy around 8.98 trillion dong (£260m).
More than 235,000 houses were flooded and nearly 80,000 hectares of crops were damaged, Vietnam’s disaster agency said.
On Thursday, VietnamNet newspaper said that a suspension bridge on Da Nhim River in Lam Dong province had been swept away.
Video footage posted online showed the bridge being swallowed by the river in just a few seconds.
Naval forces have been deployed to help stranded citizens in Khanh Hoa, the Vietnam News Agency reported, adding that floodwaters had reached record highs in many areas.
Photos shared in state media reports showed residents, including children, sitting on the roofs of flooded houses in Khanh Hoa, Gia Lai and Dak Lak provinces.
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A seven-year-old girl was rescued late on Wednesday in Da Lat, the capital of Lam Dong province, after being buried by a landslide, the Nhan Dan newspaper reported.
The landslide, triggered by heavy rain, knocked down and buried part of the house where the girl was staying.
She was pulled out after an hour and a half and was taken to hospital with a broken leg, according to the report.
Three international airlines have cancelled flights departing from Venezuela after a “potentially hazardous situation” warning.
The US Federal Aviation Administration (FAA) on Saturday issued an alert to airlines flying over the country, citing the “worsening security situation and heightened military activity in or around Venezuela“.
The US is poised to launch a new phase of operations related to the South American nation in the coming days, four US officials said.
The exact timing or scope of the operations, as well as whether President Donald Trump has made the final decision to act, have not yet been established.
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Venezuela claims Trump creating ‘fables’ to justify ‘war’
Brazil’s Gol, Colombia’s Avianca and TAP Air Portugal cancelled their flights from the capital, Caracas, in north Venezuela, on Saturday, according to Flightradar24 and the official website of Simon Bolivar Maiquetia International Airport.
TAP Air Portugal confirmed it cancelled flights scheduled for Saturday and next Tuesday.
“This decision follows information issued by the United States aviation authorities, which indicates that safety conditions in Venezuelan airspace are not guaranteed,” the airline said.
The Trump administration has been considering Venezuela-related options to tackle what it has portrayed as President Nicolas Maduro’s role in supplying illegal drugs that have killed Americans.
Venezuela’s president has denied having any links to the illegal drug trade.
Mr Maduro, who is celebrating his 63rd birthday on Sunday and has been in power since 2013, has claimed Mr Trump is looking to oust him and that Venezuelan citizens and the military will rally against any such attempt.
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Aeronautica Civil de Colombia said in a statement there were “potential risks” of flying in the Maiquetia area “due to the deterioration of security conditions and increased military activity in the region”.
Spain’s Iberia also said it was cancelling its flights to Caracas from Monday until further notice.
Reports of looming action have been growing in recent weeks as the US military has deployed forces to the Caribbean, amid heightened tensions with Venezuela. The Pentagon referred questions to the White House and the CIA declined to comment.
There has been a huge US military build-up in the region, including the US Navy’s largest aircraft carrier, USS Gerald R Ford, at least eight other warships, and F-35 aircraft.
USS Gerald R Ford. Pic: Reuters
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The build-up in the Caribbean has been rumbling on for months, and Mr Trump has authorised covert CIA operations in Venezuela.
The US plans on Monday to designate the Cartel de los Soles, a Venezuela-based alleged criminal group, a foreign terrorist organisation for what the US sees as its role in importing illegal drugs into America, officials said.
A coastguard boat of the Venezuelan Navy operates off the Caribbean coast. File pic: Reuters
The Trump administration has accused Mr Maduro of leading the cartel, which he denies.
US forces in the region so far have concentrated on counter-narcotics operations.
US troops have carried out at least 21 strikes on alleged drug boats in the Caribbean and Pacific since September, killing at least 83 people.
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