‘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.”
A Mexican navy ship has hit the Brooklyn Bridge during a promotional tour in New York City.
The New York Fire Department said authorities were responding to injuries but had no details about how many people might have been hurt or whether they were on the vessel or on the bridge.
Sky’s US partner network NBC News reports that at least three people were seriously injured in the incident.
The Mexican navy said in a post on X that the Cuauhtemoc, an academy training vessel, was damaged in the accident, which has prevented it from continuing its voyage.
Eyewitness video of the collision posted online showed the mast of the ship, which was flying a large Mexican flag, scraping the underneath of the bridge.
Pic: AP
The vessel then drifted toward the edge of the river as onlookers scrambled away from shore.
The Mexican navy said the status of personnel and material was under review by naval and local authorities, which were providing assistance.
The Cuauhtemoc is about 297ft long and 40ft wide, according to the Mexican navy. It sailed for the first time in 1982.
Pic: AP
Each year, it sets out at the end of classes at the naval military school to finish cadets’ training.
It left the Mexican port of Acapulco, on the Pacific coast, on 6 April with 277 people onboard, the navy said at the time.
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One person has died in a bomb explosion near a reproductive health clinic in California, authorities have said.
The incident took place in Palm Springs, a city two hours east of Los Angeles, and is being investigated as a possible car explosion.
The city’s mayor Ron DeHarte said one person died in the blast, adding that the bomb was “either in or near” a vehicle. The deceased’s identity is not known, Palm Springs police said.
Dr Maher Abdallah, who runs the American Reproductive Centers clinic, told the Associated Press his facility was damaged but all staff were safe and accounted for.
The explosion damaged the office space where the practice conducts patient consultations, but the IVF lab and stored embryos were unharmed, he added.
“I really have no clue what happened,” he said. “Thank God today happened to be a day that we have no patients.”
Debris covers the ground after the explosion. Pic: ABC7 Los Angeles/AP
In a statement posted on Facebook the clinic said it was “heartbroken” to learn someone died in the explosion and added: “Our deepest condolences go out to the individuals and families affected.”
It continued: “Our mission has always been to help build families, and in times like these, we are reminded of just how fragile and precious life is.
“In the face of this tragedy, we remain committed to creating hope – because we believe that healing begins with community, compassion, and care.
The clinic will be fully operational on Monday, it added.
“This moment has shaken us – but it has not stopped us. We will continue to serve with strength, love, and the hope that brings new life into the world,” the statement concluded.
Pic: ABC7 Los Angeles/AP
The Palm Springs city government said in a post on Facebook that the explosion happened on North Indian Canyon Drive, near East Tachevah Drive, before 11am local time (6pm GMT).
A burned-out car can be seen in a parking lot behind the building in aerial footage.
The blast caved in the clinic’s roof and blew debris across four lanes of the road.
Another person said he was inside a cannabis dispensary nearby when he felt a massive explosion.
Nima Tabrizi said: “The building just shook, and we go outside and there’s massive cloud smoke.”
Investigators from the FBI and the Bureau of Alcohol, Tobacco, Firearms and Explosives are travelling to the scene to help assess what happened.
California governor Gavin Newsom has been briefed on the explosion, his press office said.
A former FBI director has been interviewed by the US Secret Service over a social media post that Republicans say was a call for violence against President Donald Trump.
James Comey, who led the FBI from 2013 until he was fired in 2017 by Mr Trump during his first term in office, shared a photo of seashells appearing to form the numbers “86 47”.
James Comey later removed the Instagram post. File pic: AP
He captioned the Instagram post: “Cool shell formation on my beach walk.”
Some have interpreted the post as a threat, alleging that 86 47 means to violently remove Mr Trump from office, including by assassination.
Mr Comey later removed the post, saying he thought the numbers “were a political message” and that he was not aware that the numeric arrangement could be associated with violence.
“I didn’t realise some folks associate those numbers with violence. It never occurred to me, but I oppose violence of any kind, so I took the post down,” Mr Comey said.
Mr Trump rejected the former FBI director’s explanation, telling Fox News: “He knew exactly what that meant. A child knows what that meant… that meant assassination.”
Donald Trump Jr accused Mr Comey of “casually calling for my dad to be murdered”.
US Homeland Security Secretary Kristi Noem confirmed in a post on X that Mr Comey had been interviewed as part of “an ongoing investigation” but gave no indication of whether he might face further action.
The Secret Service is part of the Department of Homeland Security.
White House deputy chief of staff Taylor Budowich said Mr Comey had put out “what can clearly be interpreted as a hit on the sitting president of the United States”.
“This is deeply concerning to all of us and is being taken seriously,” Mr Budowich wrote on X.
Another White House official James Blair said the post was a “Clarion Call (…) to terrorists & hostile regimes to kill the President of the United States as he travels in the Middle East”.
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Mr Trump fired Mr Comey in May 2017 for botching an investigation into 2016 democratic presidential nominee Hillary Clinton, the White House said at the time.
While Mr Comey was the director of the FBI, the agency opened an investigation into possible collusion between the Trump 2016 presidential campaign and Russia to help get Mr Trump elected.
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