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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.

People hold placards as the USAID building sits closed to employees after a memo was issued advising agency personnel to work remotely, in Washington, D.C., U.S., February 3, 2025. Pic: Reuters
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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, from the National Forum of People Living with HIV/AIDS Networks in Uganda
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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


John Sparks - Africa correspondent

John Sparks

International correspondent

@sparkomat

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, director of Ark Wellness Hub in Uganda
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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 , left, with Marco Rubio, during a campaign rally in November. Pic: AP
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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.”

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‘Islamic NATO’ in the making – why Saudi-Pakistan defence deal could be game changing

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'Islamic NATO' in the making - why Saudi-Pakistan defence deal could be game changing

While Britain and America were engrossed in the pageantry and diplomacy of a US presidential visit last week, another event pretty much went unnoticed in most Western capitals – and it could have a profound impact on geopolitics.

The “Strategic Mutual Defence Agreement” was signed by Saudi Crown Prince Mohammed bin Salman and Pakistan Prime Minister Shehbaz Sharif on 17 September.

Seen as an “Islamic NATO” in the making, at its core is the clause that “any aggression against either country, shall be considered an aggression against both”.

Article 5 of NATO states the same, and is the cornerstone principle of collective defence that binds members of the alliance.

If an ally is attacked, each member will consider it an attack against them all and will take action to help. This clause has often been cited since Putin’s war on Ukraine.

Pakistan and Saudi Arabia have a longstanding relationship, with Pakistan willing to defend the holy sites of Mecca and Medina as Shia Iran threatened the Kingdom.

The new pact between Sunni Saudi Arabia, a country considered the heart of the Islamic world, with Pakistan – the only Muslim nuclear nation – is bound to set a new order.

Pakistani defence minister Khawaja Asif said “the deterrence that we get from nuclear weapons, and what we have, and the capabilities we possess, will be made available to Saudi Arabia according to this agreement”.

Pakistan has also not ruled out other Islamic nations joining the coalition and its deputy prime minister, Ishaq Dar, said “other countries have also expressed a desire for similar arrangements”.

Pakistan has not ruled out other Islamic nations joining the coalition. Pic: Reuters
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Pakistan has not ruled out other Islamic nations joining the coalition. Pic: Reuters

The signing took place a week after Israel launched airstrikes against Hamas officials discussing US ceasefire proposals in a Qatari government complex.

The unprecedented attack in Doha has shattered the illusion of American reliability in the region for rich Arab and Gulf countries.

Israel’s menacing military strikes – in Iran, Lebanon, Yemen, Syria and Qatar – have precipitated the idea of a protective nuclear umbrella of their own.

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Impact of Israel’s strike against Hamas in Qatar

Major blow for India

A cash-strapped, politically unstable and quasi-military Pakistan, willing to share its weapons, is a win-win for both countries.

It’s a coup for Pakistan because a client like Saudi Arabia puts it centre stage in the Islamic world, with its credibility sky high and the potential for more patrons.

It has also dealt a major diplomatic and security blow to nuclear arch rival India, against whom it’s fought multiple wars and clashes.

Pakistani navy personnel march at a military parade in Islamabad in March 2019. Pic: Reuters
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Pakistani navy personnel march at a military parade in Islamabad in March 2019. Pic: Reuters

Relations between Saudi Arabia, Gulf nations and India have improved considerably over the years.

But the concern is, would the pact automatically bring these nations into Pakistan’s corner if there was a conflict with India.

After the deadly clashes between the two countries in May, India’s Prime Minister Narendra Modi said “we have merely suspended our retaliatory actions against Pakistan’s terrorist and military targets for now”.

India’s foreign ministry said it would “study the implications for national security and regional and global stability”.

It added: “India and Saudi Arabia have a wide-ranging strategic partnership which has deepened considerably in the last few years. We expect that this strategic partnership will keep in mind mutual interests and sensitivities.”

However, there will be worry and concern in the Indian establishment as its nemesis has prized open a door which they hope does not become a chasm.

The deal will cause concern for Narendra Modi and the Indian establishment. Pic: PA
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The deal will cause concern for Narendra Modi and the Indian establishment. Pic: PA

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The Indians will be hoping the pact remains one of just political solidarity and doesn’t transform into unconditional war guarantees.

India’s diplomacy faces huge challenges; it has been singled out by President Trump for a punitive 25% extra tariff for buying discounted Russian oil, taking the total to 50%, one of the highest in the world.

Relations with China have also been very difficult over the years, while ties between Pakistan and China have strengthened into an all-weather friendship.

The Saudi-Pakistan deal aims to expand military cooperation, joint exercises and intelligence sharing to counter threats, terrorism and cross-border insurgencies.

It also covers the transfer of technology and co-production of military equipment between the countries.

This pact could change the course of the Middle East as Pakistan’s 170 warheads provide the Kingdom with a deterrent that might later expand to cover other countries – an Islamic NATO with potential to reshape the world.

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Thousands flee homes as Super Typhoon Ragasa approaches Hong Kong

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Thousands flee homes as Super Typhoon Ragasa approaches Hong Kong

Flights have been cancelled, schools and businesses have closed, and thousands of people have been forced to leave their homes as one of the strongest typhoons of recent years approaches southern China and Hong Kong.

Super Typhoon Ragasa, with winds near its centre of around 137mph (220kmh), according to Hong Kong’s observatory, is travelling across the South China Sea towards Guangdong province, the southern Chinese economic powerhouse.

At least three people have died and more than 17,500 displaced by flooding and landslides in the Philippines because of the storm, categorised as a “super typhoon” by the observatory because it contains winds of more than 115mph (185kmh).

A river rescue in Salcedo in the Philippines. Pic: Philippines Coast Guard/AP
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A river rescue in Salcedo in the Philippines. Pic: Philippines Coast Guard/AP

A flooded road in Apalit, Pampanga province, Philippines. Pic: Reuters
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A flooded road in Apalit, Pampanga province, Philippines. Pic: Reuters

Ragasa is expected to make landfall in the coastal area between the cities of Zhuhai and Zhanjiang in Guangdong on Wednesday between midday and evening, local time, China’s National Meteorological Centre said.

Sandbags and barriers have been placed by doors to protect homes, and windows and glass doors have been taped ahead of expected high winds.

People in Hong Kong stockpiling supplies. Pic: Reuters
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People in Hong Kong stockpiling supplies. Pic: Reuters

Pic: AP
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Pic: AP

Many people stockpiled food and other supplies on Monday, and some market traders said their goods were selling out fast.

Hurricane-force winds were forecast across a wide area, the observatory said, confirming it will issue the third-highest storm warning signal in its weather alert system, on Tuesday afternoon.

Roads were flooded in Apalit, Philippines. Pic: Reuters
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Roads were flooded in Apalit, Philippines. Pic: Reuters

More damage to the roads in northern Philippines. Pic: AP
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More damage to the roads in northern Philippines. Pic: AP

Winds of 84mph (135kph) were recorded near the ground at a distance of about 75 miles (120km) from the typhoon’s centre, it said.

Water levels may go as high as four to five metres (13ft to 16ft) above the typical lowest sea level, while coastal areas could see rises of up to two metres (6.5ft).

Huge waves seen crashing from Taiwan. Pic: Hana Tsai/Reuters
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Huge waves seen crashing from Taiwan. Pic: Hana Tsai/Reuters

International Space Station flies over the eye of Typhoon Ragasa. Pic: NASA/Reuters
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International Space Station flies over the eye of Typhoon Ragasa. Pic: NASA/Reuters

Schools were closed in Hong Kong and the neighbouring city of Macao, while classes were cancelled in other cities, including the tech hub of Shenzhen.

Hundreds of flights were cancelled in Hong Kong. Shenzhen Airport will halt all flights from Tuesday night.

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The Macao government was evacuating residents and tourists and ordered bridges to close in the evening as it expected Ragasa would pass within 62 miles (100km) to the south of the casino hub on Wednesday morning.

At least six people were injured and over 7,000 people were evacuated in Taiwan when the typhoon swept south of the island, and over 8,000 households lost power, the Central News Agency reported.

As well as the three known to have died, five others are missing in the Philippines because of Ragasa, the most powerful storm to hit the Southeast Asian archipelago this year, the country’s disaster-response agency and provincial officials said.

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Zelenskyy to meet Trump as Russian troops advance towards Ukraine’s ‘fortress belt’

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Zelenskyy to meet Trump as Russian troops advance towards Ukraine's 'fortress belt'

President Volodymyr Zelenskyy will meet President Donald Trump on Tuesday, but Ukraine’s hopes of a tough new sanctions package on Russia appear to be fading.

Despite intense lobbying by Kyiv and its European allies, the US leader has thus far refused to get tough with Vladimir Putin despite a string of alleged airspace violations by Russian aircraft and drones along Europe’s eastern flank.

It comes as the brutal struggle to hold the line in eastern Ukraine continues, where Russian forces exert pressure all along the front including around the crucial city of Pokrovsk.

Meanwhile in Moscow, Russian anti-aircraft units downed 33 Ukrainian drones headed for the capital overnight and into Tuesday morning, officials said.

Zelenskyy to address UN assembly

President Zelenskyy will address a UN General Assembly on Wednesday that has been dominated by discussion of the question of Palestinian statehood.

Beforehand, he will meet President Trump to discuss new sanctions on Russia, which the US leader had hinted at but hopes of which have recently faded.

More on Russia

Ukrainian officials portrayed their work before President Zelenskyy’s arrival as pragmatic diplomacy rather than preparations for a make-or-break trip.

“New York is the platform every September. It’s a super important place to be,” first deputy foreign minister Sergiy Kyslytsya said.

“I wish it were more expedient, but you will never have easy solutions to the conflicts of this magnitude.

“So I think that we will not come back from New York, all of us, with easy solutions. And we will continue to work hard after New York.”

Image released by Sweden apparently showing a Russian jet that violated Estonian airspace. Pic: Reuters
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Image released by Sweden apparently showing a Russian jet that violated Estonian airspace. Pic: Reuters

‘Drone wall’ for Europe

The mood in European capitals has been tense following a series of incursions into their airspace by Russian drones and aircraft – alleged to be deliberate.

British jets flew their first defence mission in Polish skies as part of a NATO mission after one such incident.

The EU’s foreign policy chief – former Estonia prime minister Kaja Kallas – said “every country has the right to defend itself and act accordingly” if Russian planes violate their airspace.

This was echoed by Yvette Cooper, the new UK foreign secretary. She said: “And if we need to confront planes that are operating in NATO airspace without permission then we will do so.

“The United Kingdom stands by our friends.”

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Briton killed in Ukraine war ‘stood up to bullies’

The parents of Callum Tindal-Draper, a British man who died on the battlefield in Ukraine in November, paid tribute to him on Sky News on Tuesday.

They praised him as someone who stood up to bullies, fighting in Ukraine’s foreign volunteer platoon.

Lithuania’s foreign minister called for Ukraine to be fully integrated into a plan to protect NATO’s borders with drones due to its experience pioneering cutting-edge technology in the heat of combat.

The EU is looking at how to create a “drone wall” along the EU’s eastern border – a project that has been infused with urgency following recent incidents.

“We have to bring this technology to the front line and to build it there, build it there so that it will be effective together with Ukrainians,” Kestutis Budrys said.

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Ukraine battlefield: The struggle for Pokrovsk

On the battlefield in Ukraine, Russia has claimed a number of advances as its troops continue to push along the frontline.

Russia’s defence ministry said its forces captured the village of Pereizne in Donetsk, where Moscow has been grinding forward for months at the cost of heavy casualties.

Putin’s armies have long been trying to capture the rest of Donetsk, part of Ukraine’s industrial heartland that Russia claims as its own following a bogus referendum.

A chain of Ukrainian cities nicknamed the “fortress belt” has held the line there for more than a decade, but shortages of troops, supplies and chaotic management are making it increasingly hard to resist Russia’s relentless pressure.

But a Ukrainian commander says he’s confident Russia’s latest attempt to push through there won’t work.

“From a military point of view it looks correct – on the map it looks neat – but after nearly three-and-a-half years of war we all know that such deep manoeuvres and wide flanking operations are not Russia’s forte,” Colonel Pavlo Yurchuk told the Associated Press.

Col Yurchuk, whose troops are defending a small city at the northern end of the fortress belt, added: “They simply won’t be able to control and supply those penetrations, so I’m sure that they will fail.”

Meanwhile Pokrovsk, a crucial logistics hub for Kyiv, remains in Ukrainian hands for now despite its defenders facing months of unrelenting attack.

“Our warriors are marching forward,” the head of Ukraine’s armed forces Oleksandr Syrskyi said of the Pokrovsk front on Monday.

The commander-in-chief said in the previous day 1.3 square kilometres had been taken by Ukraine and Russian forces destroyed in a further 2.1 square kilometres.

Ukrainian soldiers seen in the frontline town of Kostiantynivka. Pic: Reuters
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Ukrainian soldiers seen in the frontline town of Kostiantynivka. Pic: Reuters

Elsewhere, Russian aircraft attacked the southern Ukrainian city of Zaporizhzhia with glide bombs during the night, killing a man, regional head Ivan Fedorov said on Tuesday.

In Odesa, Russian ballistic missiles struck the town centre of Tatarbunary, killing a woman, regional head Oleh Kiper said.

Footage from Ukraine’s state emergency service shows firefighters battling flames in Zaporizhzhia.

Drones shot down on route to Moscow

Across the border, Ukraine’s aim to bring the war to Russia’s population continued overnight, with 33 drones downed as they headed for Moscow, officials claimed.

Kyiv’s drone armies have become a fact of life for Russia, with long-range UAVs causing havoc at oil refineries and airfields as Ukraine attempts to hamper the Kremlin’s war economy.

Flights were delayed and cancelled at Moscow’s Sheremetyevo airport, the country’s largest by passenger numbers, following the drone attacks.

Russia’s Defence Ministry said on Telegram that its anti-aircraft units had destroyed 150 Ukrainian drones overnight and Tuesday morning.

As well as on route to Moscow, drones were reported shot down near Sevastopol in occupied Crimea and Tula region in central Russia.

Ukraine’s military said on Tuesday that it hit two Russian oil distribution facilities in Bryansk and Samara regions.

Autoplay videos credit: AP.

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