African Countries Still Underfunding Health by as Much as 50 Percent

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Health

Health workers getting ready for duty at an mpox treatment center in Lwiro in DR Congo, a hotspot for the pandemic that CD Africa handled in 2024. Credit: WHO

Health workers getting ready for duty at an mpox treatment center in Lwiro in the Democratic Republic of Congo’, a hotspot for the pandemic that CD Africa handled in 2024. Credit: WHO

NAIROBI, Apr 24 2025 (IPS) – The majority of African countries are yet to commit 15 percent of their GDP to funding the health sector, despite the growing disease burden weighing down the continent and two decades after the coming into force of the Abuja declaration on health sector funding.

Only a few countries, including Rwanda, Botswana, and Cabo Verde, have consistently met the 15 percent target, with some countries allocating less than 10 percent of their budget to the crucial sector.

Under the Abuja Declaration of 2001, African Union (AU) member states made a commitment to end the continent’s health financing crisis, pledging to allocate at least 15 percent of national budgets to the sector. However, more than two decades later, only three countries—Rwanda, Botswana, and Cabo Verde—have consistently met or exceeded this target (WHO, 2023). In contrast, over 30 AU member states remain well below the 10 percent benchmark, with some allocating as little as 5–7 percent of their national budgets to health.

Countries including Nigeria, Chad, and the Central African Republic are allocating as little as 5–7 percent to the sector, thanks to a myriad of political and economic challenges, including a high debt burden and narrow tax base, according to Director General of Africa Centres for Disease Control (Africa CDC), Dr. Jean Kaseya.

Competing demands for security and infrastructure financing and limited coordination between ministries of health and finance, plus the fact that the COVID-19 pandemic “hit national budgets hard,” worsened by global economic instability, haven’t helped matters, he said, while commenting on the latest annual report of the continental health body and the 2025 concept paper on Africa’s Health Financing in a New Era, both released in April.

Wivine M'puranyi, a 30-year-old mother of six,from village of Karanda in D.R Congo's South Kivu reflects on the distressing days when her two daughters were diagnosed with mpox, one of the pandemics that hit Africa in 2024.

Wivine M’puranyi, a 30-year-old mother of six from the village of Karanda in the Democratic Republic of Congo’s South Kivu, reflects on the distressing days when her two daughters were diagnosed with mpox, one of the pandemics that hit Africa in 2024. Credit: WHO

“It also exposes just how costly underinvesting in health can be. The real story here is political will, where leaders prioritize health, and budgets follow,” he noted.

The report finds that only 16-29 percent of African countries currently have updated versions of the National Health Development Plan (NHDP) supported by a National Health Financing Plan (NHFP), the two documents being critical in driving internal resource mobilization.

“Updating National Health Development Plans (NHDPs) and National Health Financing Plans (NHFPs) is not just a matter of paperwork—it’s a heavy lift. Countries need robust data, skilled teams, funding, and strong inter-ministerial coordination,” he said.

Low funding has a consequence: it has led to many health departments being understaffed and overstretched, partly because some governments ‘deprioritize’ updating the two documents because they fear the plans won’t be implemented or be funded. “But without current, credible plans, it’s nearly impossible to make a case for more domestic or external investment. These documents are not bureaucratic checkboxes—they’re investment blueprints,” the DG told IPS.

He noted that countries that have updated and actively used their NHDPs and NHFPs have seen tangible benefits, one such country being Burkina Faso, where an updated NHFP had helped streamline funding and implementation for free healthcare policy.

In Senegal, incorporating macroeconomic forecasting into the NHFP improved budget predictability and donor alignment. “These tools are powerful when they are costly, realistic, and regularly monitored. But let’s be clear; plans must be funded and used—not just filed away—to make a real difference,” Kaseya added.

According to the documents, Africa continues to carry a disproportionate share of the global disease burden—25 percent—but with only 3 percent of the global health workforce, resulting in a “dangerously overstretched workforce,” according to the documents. Should this shortage be prioritized over all other health needs and deficiencies, or what should be addressed first?

The shortage of health workers remains a fundamental challenge, with Africa carrying 25 percent of the global disease burden but a disproportionate 3 percent of the global health workforce—a challenge that cannot be addressed “in isolation.”

Likobiso Posholi, 35, from Ha Sechele village in Mohale's Hoek in Lesotho who is recovering from a recent caesarean section. Many countries in Africa are yet to commit 15% of the national budgets so that women like Posholi can access affordable maternity services.

Likobiso Posholi, 35, from Ha Sechele village in Mohale’s Hoek in Lesotho, recovering from a recent cesarean section. Many countries in Africa are yet to commit 15 percent of the national budgets so that women like Posholi can access affordable maternity services. Credit: WHO

However, recruiting en masse without sustainable financing or strategic deployment can strain the system, and in some countries, trained professionals remain unemployed due to fiscal constraints or wage bill ceilings. “Kenya, for example, is piloting co-financing mechanisms between national and local governments to overcome this. The key is to tackle workforce gaps through integrated, context-specific reforms that link financing, recruitment, and health system needs,” Kaseya said.

The Africa CDC has drafted a three-pronged strategy and placed it at the forefront of a health financing revolution that could potentially represent a paradigm shift from dependency to self-determination. Some aspects of the strategy can be implemented immediately without being subjected to a lot of bureaucracy in view of the emergency brought about by cuts in Overseas Development Assistance (ODA), he added.

Reductions in ODA went down by 70 percent between 2021 and 2025, exposing health systems to deep-rooted structural vulnerabilities and placing immense pressure on Africa’s already fragile health systems, with overseas financing being seen as the backbone of critical health programmes.

These include pandemic preparedness, maternal and child health services, and disease control initiatives, all of which are at risk, threatening Sustainable Development Goal 3 and Universal Health Coverage.

“Some components of our strategy can be rapidly deployed. Health taxes on products like tobacco, sugar, and alcohol are politically sensitive but technically straightforward and yield dual benefits, generating revenue and promoting healthier populations. Strengthening health financing units within ministries is a high-impact, low-cost intervention that can dramatically improve budget execution and efficiency,” Kaseya suggested.

Likewise, deploying digital tools—such as real-time dashboards to track financing flows—can happen quickly and with limited bureaucracy. Countries like Benin, South Africa, and Ethiopia are already implementing such reforms with measurable progress.

He pitched that digitization of the health sector is no longer a luxury, as it is foundational to the much-needed resilient, transparent, and efficient health systems.

On the other hand, the platforms improve decision-making, enable better resource tracking, and enhance service delivery. However, fragmentation of digital solutions remains a challenge, with many platforms developed in ‘silos,’ often “donor-driven and poorly integrated,” he commented.

He singled out Ghana, which offered a strong example of progress, having developed a national platform that integrates health and financing data. “The true value of digitization is realized when countries lead the process, ensure interoperability, and embed digital solutions into broader system reforms,” Kaseya said.

On the positive side, CDC Africa for the first time led an emergency response, putting in place a Joint Continental Incidence Management Support Team (IMST) co-led with the World Health Organization and bringing together over 28 partners to collaborate on the Mpox response. This work was done under the “One team with a One unified plan, One budget, and One monitoring framework.”

“This is a historic first that marked a significant milestone in Africa’s leadership of public health emergencies of continental significance,” the report observed.

It further supported national responses to “multiple major public health emergencies,” including the mpox outbreak in 20 AU member states and the Marburg virus disease outbreak in Rwanda. This was in declaring the former a Public Health Emergency of Continental Security (PHECS) on August 13, 2024, in consultation with the affected countries and relevant stakeholders.

Also on the positive side, the continental health body was advancing a comprehensive three-pillar strategy centered on domestic resource mobilization, innovative financing, and blended finance.

IPS UN Bureau Report

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Children at the Center

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World Creativity & Innovation Day Statement by Education Cannot Wait Director Yasmine Sherif

The ruins of a residential building in northern Gaza following an Israeli airstrike. Credit: UNICEF/Mohammed Nateel

NEW YORK, Apr 21 2025 – Creativity and innovation are essential to finding extraordinary solutions to abnormal problems. Now more than ever we must continue finding creative solutions to protect the world’s most vulnerable children from the excruciating pain of war, dispossession and destruction of their last hope: a quality education. The current humanitarian and development funding levels are falling. However, with creativity we can prevent further deterioration and instead turn towards an upward direction.

With bold, innovative action and connected problem-solving in a world of abundance we can better connect the dots between donors, governments, the private sector, UN agencies, civil society and other key partners to unleash our wealth of humanity towards those in unwanted scarcity: the world’s most vulnerable children whose only wealth is their hope for a quality education.

In 1543, Nicolaus Copernicus published his groundbreaking theory, “On the Revolutions of Heavenly Spheres.” His new ideas sparked a revolution by placing the Sun – rather than the Earth – at the centre of our solar system.

We need a Copernican Revolution of our own today – one guided by data, evidence, creativity and innovation, and the highest of all values: empathy. We can then deliver on the reforms envisioned in the UN80 Initiative, Pact for the Future and other initiatives designed to reimagine the delivery of humanitarian aid. In short, we must place children at the center of our universe and use education as our single most powerful instrument to tap their vast potential. Only then can their hope turn into reality.

Education Cannot Wait (ECW), the global fund for education in emergencies and protracted crises in the United Nations, is embracing evidence-driven reforms to streamline our operations and ensure every donor dollar creates a positive impact on the lives of children caught on the frontlines of conflict, climate change and forced displacement. With the lowest overhead costs, we are lean, agile and fast-acting, and we place children and adolescents in emergencies and protracted crises at the center of everything we do.

Our work – and our value proposition – is driven by data and evidence to achieve optimal results and impact. Let’s start with the growing needs. When ECW became operational in 2017, it was estimated that approximately 75 million crisis-affected children needed education support. Today, with violent conflicts in places like the Democratic Republic of the Congo, Gaza, Sudan and Ukraine, horrific shocks from climate change-related natural disasters, and a unprecedented rise in human displacement and migration, that number has skyrocketed to nearly a quarter of a billion – 234 million to be precise.

Data also tell us that a lack of quality education – especially across the Global South – is costing us trillions of dollars in lost opportunities every year. “Limited educational opportunities and barriers for girls cost the world economy between US$15 trillion and US$30 trillion. In nine countries, the cost of out-of-school children was estimated to be greater than the value of an entire year of GDP growth,” according to the World Bank.

Additionally, investing US$1 in early childhood education can generate returns as high as US$17 for the most disadvantaged children worldwide. Imagine the impact every dollar could have in creating a million more opportunities for the world’s most vulnerable children.

Given the current funding environment, we must embrace our creative problem-solving and solutions orientation. Besides revisiting budgets and finding human-centred solutions to those left furthest behind, another creative approach toward resource mobilization comes from impact investments. Through partnerships with visionary businesses like Swiss Cantonal Banks and Tribe Impact Capital LLP, Education Cannot Wait is able to connect private capital with public goods as a driving force toward long-term economic growth, resilience and security. With the ability to crowd-in resources and expertise, pool funds and broker partnerships, ECW is igniting global reform to deliver on a development sector, such as education, in humanitarian crises with coordination, speed and impact.

Together with our strategic donor partners, ECW is reimagining the way we deliver life-saving education supports on the frontlines of the world’s most severe humanitarian crises. One thing is certain, by following Copernicus’ evidence-based vision – and placing children at the center of our collective efforts – we can make the seemingly impossible possible – provided that we all do our part keeping our eyes on what really matters: those left furthest behind and every child’s right to a quality education – especially when this is their very last hope. By transforming their lives through a quality education, we empower them to arise from their suffering and become creative and innovative contributors to their society and, indeed, all of humanity.

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Funding Crunch Puts Years of Progress at Risk in Fight Against Tuberculosis

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Health

Mycobacterium tuberculosis drug susceptibility test. Credit: CDC

Mycobacterium tuberculosis drug susceptibility test. Credit: CDC

BRATISLAVA, Mar 24 2025 (IPS) – Governments and donors must ensure funding is sustained to fight tuberculosis (TB), organizations working to stop the disease have said, as they warn the recent US pullback on foreign aid is already having a devastating effect on their operations.

NGOs and other groups that play a critical role in national efforts to stop what is the world’s deadliest infectious disease say the US administration’s recent decisions to first freeze and then cancel huge swathes of foreign aid funding have put countless lives at risk around the world.

And they warn that if that funding gap is not filled, years of progress in fighting TB could be lost.

“The impact of these cuts has been massive. There’s a gaping hole in financing, and if we don’t keep the pressure up on TB it will come back,” Dr. Cathy Hewison, Head of Médecins sans Frontières (MSF)’s TB working group, told IPS.

Every year, 10 million people develop TB, and in 2023 1.25 million died from the disease. It disproportionately affects low- and middle-income countries, with the largest TB burdens being among the world’s poorest states.

While in many states government funding accounts for at least the bulk of first-line treatment, community groups play a crucial and outsized role in national efforts to combat the disease, providing vital diagnosis, prevention, advocacy, and support services.

Many such groups rely heavily or exclusively on foreign funding with financing through US schemes, primarily USAID, predominant. USAID is the largest bilateral donor in the fight to end TB, having invested more than USD 4.7 billion to combat the disease since 2000.

In late January, an executive order from US President Donald Trump put a 90-day freeze on all US foreign aid while a review of funded projects was carried out, and then earlier this month, it was announced that 83% of all USAID projects were to be cancelled.

The effects on community groups on the frontlines of the fight against TB have been immediate and severe.

“Many community organizations have suspended outreach services, such as active case finding, contact tracing, treatment adherence, and psychosocial support,” Rodrick Rodrick Mugishagwe, a TB advocate with the Tanzania TB Community Network (TTCN), told IPS.

“Furthermore, transportation allowances for community health workers conducting home visits have been reduced, resulting in lower TB case detection rates. There have also been job losses among community health workers and peer educators, undermining service delivery,” he added.

Mugishagwe recounted how a woman from the city of Arusha in northern Tanzania who was diagnosed with TB last year had relied on a USAID-supported community programme for transport to a clinic for monthly treatment. But following the funding cuts, her programme shut down, and she could not afford the transport costs.

“She has disappeared from her residence and can no longer be traced, putting her at risk of treatment failure and developing drug-resistant TB, while there is a risk of further transmission to the community,” he said.

Bruce Tushabe, regional training and capacity strengthening lead at the AIDS and Rights Alliance for Southern Africa (ARASA), which works with partners in South Africa on TB interventions, most of whom were supported through USAID, said treatment and access to TB medication had been stopped. There had also been a breakdown in community-led monitoring tracking progress in treatment access and availability, he said.

“There is a high burden of TB – an incidence rate of 468 per 100,000 of the population—and we now expect to see an increase in deaths, and in the long term, [rising] multi-drug resistant TB (MDR-TB) among the populace, as well as increased TB cases since contact tracing is now paused in many areas and facilities,” he told IPS.

The spread of drug-resistant (DR-TB) and MDR-TB in the wake of the funding cuts is a particular concern, especially in poorer countries where DR TB is often widespread, as it is much harder and costlier to treat, putting an even greater burden on limited resources.

“There is a lot of DR-TB here and when people don’t have the right information and don’t take the right medicine or don’t have support during lengthy, sometimes very hard treatment, they might not be able to finish their course or treat their TB properly, and then the disease spreads. People with TB who had been going to TB centers may now turn up and find there is no one to answer their questions or give them the right advice on treatment, and so they might just turn away,” Atul Shengde, National Youth Coordinator—Global Coalition of TB Advocates, India, told IPS.

While TB often affects the poorest and most vulnerable communities, even within those communities there are some groups which are especially at risk, such as children.

“Children’s immune systems are less developed, which makes them more vulnerable to TB. Figures show 25% of the world is infected with TB, but just because someone is infected it does not mean they will get sick from it. But if your immune system is less developed or compromised in any way you are more likely to get TB, more likely to get ill with TB, and more likely to have more severe TB,” Hewison said.

“Children at risk of having TB are often overlooked, either going undiagnosed or facing delays in diagnosis. Now, with the recent US funding cuts, these gaps in identifying and treating children with TB will only widen further which threatens to roll back years of progress in TB care,” she added.

The World Health Organization has issued stark warnings of the devastating effects of the abrupt cessation of US global health funding, and affected organizations have pleaded with the US to reverse its decision.

But community groups who spoke to IPS admitted it appeared unlikely funding would resume any time soon.

And because US funding played such a large role in global TB efforts, they worry it will be very difficult to plug the current financing gap, certainly in the short to medium term, and possibly even long term, especially at a time when governments in high-income countries, such as the UK, Germany, and France, among others, are reducing foreign aid.

“I see no high-income donor countries stepping in to fill the gap left by the US funding cuts. Countries are faced with a lot of resource pressures at the moment; for instance, defense is a big issue now, and to pay for that, cuts are going to have to be made elsewhere, and that usually starts with healthcare,” Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, told IPS.

“In future, low and middle income countries, especially, will have to relearn the hard lesson, as they did with Covid, that they are on their own. They will have to think about reducing their reliance on external donors for their health programmes and put the resources in themselves,” she added.

Buy while some governments may be able to up their financing of national TB programmes, poorer countries are likely to struggle to do so, and new forms of financing need to be considered, experts say.

“Of course, raising funding is impossible for some low-income countries. Innovative forms of funding need to be looked at—for example, financing from the different international development banks, debt swaps between countries, and others,” said Ditiu.

However, even if the funding gap is plugged somehow, or there is an unlikely dramatic reversal of US policy in the near future, there are fears the damage has already been done.

“We are going to see a massive spread of TB, and especially DR-TB, whatever happens now because cases have been missed, people have gone undiagnosed, and treatment has been interrupted,” said Ditiu.

IPS UN Bureau Report

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New Survey: US Funding Freeze Triggers Global Crisis in Human Rights and Democracy

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Opinion

Distribution of rice for vulnerable communities in Port-au-Prince, Haiti, by USAID, PICRYL.

THE HAGUE, Netherlands, Mar 19 2025 (IPS) – A new survey carried out by the EU System for an Enabling Environment (EU SEE) network exposes the impact of the US funding freeze on civil society organisations (CSOs) in over 50 countries. With 67% of surveyed organisations directly impacted and 40% of them losing between 25-50% of their budgets, the abrupt halt in funding is disrupting critical human rights, democracy, gender equality and health programs, leaving vulnerable communities without essential support.

Explore the survey in this link

Key Findings:

– The decision by the US to reduce foreign aid funding has become an opportunity to further limit civic space. CSOs are increasingly facing public attacks fuelled by misinformation and negative narratives, along with restrictive regulatory frameworks and heightened scrutiny, according to the new data.

– 67% of surveyed CSOs by EU SEE are directly affected, with 40% of them losing 25-50% of their budgets, forcing them to reduce programs, cut staff or close operations.

– Human rights, democracy and gender equality programs face the most severe disruptions with a real risk of setting the world decades behind.

– Many organisations lack alternative funding sources and risk shutting down permanently.

“Across the world, the immense contributions of civil society to democracy, the rule of law, good governance, policy making and in advancing the rights of excluded voices continue to be undermined by actions that constrain their enabling environment. The time is now for joint action with civil society to push back on these restrictions by advocating for open spaces and progressive laws that promote and protect rights for all,” says David Kode, Global Programme Manager EU SEE.

What Needs to Happen?

The EU SEE network urges governments, donors and policymakers to take immediate action in the following ways:

– Emergency financial support to stabilize affected CSOs
– Stronger donor coordination to ensure sustained support for democracy, human rights, and media freedom programmes.
– Flexible and sustainable funding mechanisms that allow CSOs to adapt.
– Support civil society organisations to develop stronger advocacy & communication strategies to counter narrative backlash.

“If we don’t act now, vital programs which are the direct result of civil society’s impact, supporting democracy, human rights, and communities will disappear,” warns Sarah Strack, Forus Director.

A message echoed by Gina Romero, UN Special Rapporteur on the Rights to Freedoms of Peaceful Assembly and of Association, in an interview with CIVICUS: “These measures are a stake in the heart of the right to freedom of association, especially because of the way the decision is made: radical, surprising, with no possibility of gradual action, with little transparency and zero participation of the affected actors.” CIVICUS has also conducted a survey on the impact of the changing global funding landscape for civil society among its members around the world.

The US funding freeze, along with the insecurities and “unknowns” it is triggering, is already having far-reaching consequences, and its long-term effects could be even more devastating. The data is clear: civil society is at risk, and the time to act is now.

Read the full report here: https://eusee.hivos.org/document/the-impact-of-the-us-funding-freeze-on-civil-society/

Tanja Brok, is EU SEE Communications Lead

IPS UN Bureau

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Human Rights, Healthcare Disrupted in Eastern Europe With USAID Funding Freeze

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Aid

Crowley Logistics in Miami, Florida, was one of three USAID shipping and logistics facilities in the nation. It could, in times of emergency humanitarian relief aid, respond with supplies delivered to aircraft at Miami International Airport within two hours. Credit: USDAID/Lance Cheung

Feb 17 2025 (IPS) – As the full effects of the US decision to freeze foreign aid funding begin to be felt across the world, organizations in Eastern Europe and Central Asia (EECA) are warning years of work in everything from delivering life-saving healthcare to defending human rights and strengthening democracy could be undone.

In many countries in the region, foreign aid is vital for the continued functioning of large parts of civil society and the activities NGOs and other groups carry out.

But since US President Donald Trump’s executive order on January 20 freezing foreign aid for 90 days and a ‘stop work order’ announced four days later, some groups have had to entirely, or partly, shut down their operations—with potentially devastating consequences.

One area that has been heavily affected is the fight against HIV/AIDS.

According to a UN report published in 2024, only half of the 2.1 million people living with HIV in the EECA region have access to treatment, and just 42% of people living with HIV have suppressed viral loads—the lowest rate in the world. In 2023, 140,000 new cases of HIV infection were registered in the region.

US funding has been central to the HIV response in EECA, including through the US President’s Emergency Plan for AIDS Relief (PEPFAR), as well as USAID.

According to UNAIDS, this support has helped fund community-based HIV prevention programmes, provision of antiretroviral therapy (ART), development of laboratory and diagnostic infrastructure, and training of health workers. It has also played a key role in prevention and harm reduction programmes among key populations.

This is critical in a region where 94 percent of new HIV cases occur among key populations and their partners.

While US aid is not the primary source of funds for HIV programmes in some countries in the region, in others it is vital.

In Ukraine, which has Europe’s second worst HIV epidemic, local groups working with key populations and people living with HIV say the aid freeze has had a dramatic impact.

The charity 100% Life provides treatment and prevention services to marginalized communities, including drug users and people with HIV, TB, and other diseases, often operating in frontline areas.

Dmytro Sherembei, head of the Coordination Council of 100% Life, told IPS that up to 25 percent of specialist staff carrying out testing, monitoring and other tasks would have to be laid off, while testing programmes and other assistance for state healthcare projects would be stopped.

“The funding suspensions stopped our whole programme, and it will cause a lot of damage,” he said.

Meanwhile, the Alliance for Public Health (APH), one of the country’s largest healthcare NGOs, said its HIV case-finding operations had been suspended after the aid freeze.

“About 35-40 percent of all HIV-positive cases in Ukraine are found, tested, and referred for treatment by APH and its partners. It will be difficult to find alternative funding,” Andriy Klepikov, Executive Director of APH, told IPS.

APH estimates the halt to testing could mean thousands of cases going undetected during the 90-day suspension of aid.

There are also concerns that treatment for more than 100,000 patients with HIV may be interrupted. Since the beginning of Russia’s full-scale invasion, the Ukrainian government has not had funds to procure antiretroviral drugs (ARVs), and PEPFAR has been procuring ARVs for all patients.

The country has ARV stocks for the next six months, “but a suspension of funding could impact the next delivery of medications planned for March,” Klepikov said.

“This funding stop threatens to turn a manageable epidemic into a deadly crisis,” warned Sherembei.

In Tajikistan, US funding has supported services including treatment and prevention among key populations, training of professionals, strengthening of local organizations, and support for community-led initiatives.

But the funding freeze is threatening to undo years of progress, local HIV activists told IPS.

Pulod Dzhamalov, Director of the Tajik NGO SPIN PLUS, said services for people living with HIV and other key populations in many places had “simply ceased to exist.”

“For many people who sought these services, it was the only place where they felt safe. And staff who worked on these projects have suddenly found themselves unemployed, without any means of livelihood or hope for the future. Significant resources were invested in building a positive image of these services, and now all of that has gone to waste. A considerable portion of the national HIV prevention programme’s budget was covered by PEPFAR funding, and this will inevitably impact the healthcare system as a whole,” he said.

Takhmina Haiderova, head of the Tajik Network of Women Living with HIV, said her organization was “facing serious challenges” and that the freeze on US funds had had a significant impact on all HIV-service NGOs in the country.

“Reduced funding results in fewer HIV prevention and treatment projects, staff reductions, and limited access to life-saving services such as testing, counseling, and treatment. In addition, it negatively affects the achievement of the Sustainable Development Goals, such as reducing the spread of HIV, improving the quality of life of people living with HIV, ensuring gender equality, and upholding human rights,” she said.

The decision to freeze funding, especially in places where the epidemic is not improving, such as EECA, risks doing irreparable harm to global efforts to fight HIV, activists say.

“[The Trump administration’s] efforts are doing irreparable harm to the global HIV response and global health more broadly. These are inefficient, wasteful  and deadly policy moves,” Asia Russell, Executive Director of the Health Gap advocacy organization, told IPS.

But it is far from just efforts to fight HIV/AIDS in the region that have been affected by the pause on US aid.

In many countries, foreign funding is essential to the survival of independent media, keeping a check on autocracies and serving audiences living under repressive regimes.

Press freedom watchdogs say the aid freeze has created confusion, chaos, and uncertainty among media organizations and outlets that rely heavily, or completely, on American funds.

Exiled media reporting for audiences in countries such as Russia, Belarus, and others from outside those states are particularly vulnerable.

“This is very bad news for exiled media that relocated to democratic countries after crackdowns. Some newsrooms from Belarus have reported a complete lack of funding due to the current [US aid] freeze, which may lead to a complete cessation of these projects due to the inability to pay employees. Others have been forced to cut their staff, which is very worrying since they have so far managed to keep their audience in their country, despite being forced into exile. Their efforts made it possible to effectively counter official Belarusian and Kremlin propaganda,” Jeanne Cavelier, Head of Eastern Europe & Central Asia Desk at Reporters Without Borders (RSF), told IPS.

Meanwhile, in Ukraine, where nine out of ten outlets rely on subsidies and USAID is the primary donor, a survey after the aid freeze showed that almost 60% of media professionals surveyed believe that the suspension of US media support programmes could have ‘catastrophic consequences and lead to the closure or significant reduction in the work of many independent media outlets,’ according to RSF.

“Projects funded by American aid, such as USAID, were mostly intended to enable the media to investigate corruption and public spending. This is critical for reliable information, as well as for small media outlets reporting from the frontline,” said Cavelier.

“The freeze has already led a number of newsrooms to cut back on content, lower salaries, increase part-time working and reduce staff numbers,” she added.

Editors at local independent media outlets fear the suspension could lead to publications turning to other sources of funding, which could then look to change editorial stances, influence the independence of these media and, potentially, become tools for Russian propaganda.

There are similar fears in other parts of the region.

“The independent media here relies very much on foreign funding because otherwise they would not be economically viable in a country that is poor and in a market where some media are financed by shady Russian money,” Valeriu Pasha, Programme Manager at Moldovan think tank WatchDog.Md, told IPS.

“I think we could definitely see some deals where some media that are now struggling with funding could be bought by, or would start to be funded through, Russian sources in some way,” he added.

However, he pointed out that it was not just independent media that had been affected by the US aid freeze.

“This will have quite an effect on civil society here; plenty of organizations will feel its impact,” he said, pointing out that groups involved in everything from local election observation to healthcare, rights defense, and even working with the government on judicial reform were reliant to some extent on US aid.

“Even our organization, which has not really been affected by this so far, could well be affected in the future. We don’t know,” he added.

The freezing of US funding may also have had an unexpected, although equally pernicious, effect on civil society in the region.

The US administration’s apparent efforts to effectively shutter USAID have been welcomed by authoritarian leaders who have already been cracking down on NGOs and others they see as critical of their regimes.

In Georgia, USAID is currently investing in scores of programmes across the country with a total value of USD 373 million, according to local media. These initiatives focus on, among others, strengthening democratic institutions and increasing public resilience to disinformation.

Much US funding to the country was stopped last year in response to increasingly authoritarian behavior by the ruling regime—including legislative crackdowns on civil society.

But Prime Minister Irakli Kobakhidze earlier this month told local journalists the stop on USAID activities proved his government’s previous claims that the organization’s funds were used not for humanitarian goals but to “stage revolutions, sow disorder, and destabilize countries, including Georgia.”

Lawmakers appear to have also taken it as confirmation of the hardline approach they have already taken to civil society and the media—including a controversial law on foreign funding of NGOs introduced last year, which forced many to close—and emboldened them to tighten restrictions even further. On February 5, a media regulation law was announced that would ban foreign funding of media, as well as an even more restrictive version of the law on foreign funding for NGOs.

Reports have suggested authorities in Russia, where a swathe of laws and repressive measures have already forced the closure of many key services provided by civil society groups in areas from HIV prevention and help for marginalized groups to rights organizations, may be planning to ask US Congress to share a list of Russian citizens who received US funding with Russia’s Federal Security Service (FSB).

Groups affected by the funding freeze are looking to find alternative sources of finance. Some have called for governments, particularly in Europe, to step in and fill the gap left by the withdrawal of American money.

In a statement, a group of European disability organizations and services called on the European Union and non-governmental donors to provide emergency and long-term funding to disability organizations affected by the cuts in US funding.

They highlighted that organizations were implementing lifesaving programs in countries such as Ukraine, Moldova, Georgia and Albania and that the loss of funding will put at risk organizations and persons with disabilities in the Balkans, Eastern Europe and South Caucasus, leaving hundreds of thousands without support.

While there are hopes that US funding will, sooner or later, resume once the Trump administration finishes its review, whatever US foreign aid is resumed, it is unlikely to be disbursed in the same way as it was previously, said Pasha.

“I expect that some aid will resume in some form after the 90-day freeze, but it will reflect the priorities of the new US administration—in the future it will likely be less connected to values and more to economics,” he said.

IPS UN Bureau Report

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Colombia’s Historic Child Marriage Ban

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Civil Society, Education, Featured, Gender, Gender Violence, Headlines, Health, Human Rights, Indigenous Rights, Latin America & the Caribbean, Sustainable Development Goals, TerraViva United Nations, Women’s Health

Opinion

Credit: Fundación Plan/Instagram

MONTEVIDEO, Uruguay, Jan 8 2025 (IPS) – Colombia has just marked a historic milestone in the global campaign against child marriage, with the Senate passing one of Latin America and the Caribbean’s most comprehensive bans on child marriage and early unions. In a country where one in five girls under 18 and one in 10 under 14 are married or live in marriage-like conditions, the new law raises the minimum age to 18 with no exceptions, eliminating a 137-year-old Civil Code provision that allowed children over 14 to marry with parental consent. This achievement aligns with goal 5 of the Sustainable Development Goals (SDGs), which has a target of eliminating harmful practices like child marriage by 2030. The new law now awaits the signature of President Gustavo Petro to come into effect.

The breakthrough

Child marriage disproportionately affects Colombia’s most vulnerable communities, with rates of between 40 and 65 per cent among rural, Indigenous and Afro-Colombian populations. In some communities, girls as young as 10 are married off. These early unions expose girls to unequal power relations, deny them education, limit their bodily and economic autonomy and lead to higher rates of gender-based violence and health issues linked to early pregnancy.

The passage of the #SonNiñasNoEsposas (‘They are girls, not wives’) bill reflected the power of persistent civil society advocacy. After several failed attempts since 2007, the bill, authored by two congresswomen, passed with unanimous support. This success was driven by a coalition of Colombian civil society organisations as part of the Girls Not Brides global network, including the Foundation for Gender and Family Development, Fundación Plan and Profamilia, working alongside international partners such as Equality Now and Plan International, with Girls Not Brides directly supporting legislative advocacy and media campaigns.

Beyond raising the marriage age, the new law establishes the National Comprehensive Programme for Life Projects for Children and Adolescents. This preventive initiative targets the structural causes of early unions – poverty and lack of education – particularly in remote rural areas. The programme includes the participation of Indigenous communities through their own governance structures, recognising the importance of cultural sensitivity in implementation.

The global landscape

Colombia is by no means alone in having a child marriage problem. Around the world, some 12 million girls are married each year, two million before the age of 15. While child marriage can affect boys as well, girls are six times more likely to be married as children than boys.

According to the Child Marriage Monitoring Mechanism, a collaborative initiative to generate evidence to support efforts to end child marriage, one in five young women worldwide are married before their 18th birthday, with rates highest in sub-Saharan Africa.

To tackle this problem, The Elders, a group of senior public figures, launched the global Girls Not Brides partnership in 2011. With over 1,400 member organisations in more than 100 countries, Girls Not Brides works to prevent under-age marriage, recognising it as both a human rights violation and an obstacle to development. It identifies four main drivers of child marriage: poverty, limited educational and economic opportunities, gender inequality and insecurity in conflict or disaster situations. It tackles the problem with awareness-raising campaigns, national and international policy advocacy and community engagement to challenge social norms that perpetuate child marriage.

Since then, efforts have multiplied. In 2016, the United Nations Population Fund and the United Nations Children’s Fund (UNICEF) launched the Global Programme to End Child Marriage. Now in its third phase, set to run until 2030, the programme operates in 12 high-prevalence countries in Africa, the Middle East and South Asia. Working directly with governments, it has reached millions of adolescent girls, focusing on education, healthcare and economic opportunities.

Regional-level initiatives include the South Asian Initiative to End Violence Against Children, which works in Afghanistan, Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan and Sri Lanka, and the African Union’s Campaign to End Child Marriage in Africa, launched in 2014 in 10 high-prevalence countries and later expanded to 30.

Many more initiatives work at national and local levels. They combine multiple responses, including working with religious and community leaders to change social norms, supporting girls’ education and economic empowerment, engaging with men and boys on gender equality, advocating for stronger laws and their enforcement, providing support services to girls at risk of child marriage, using media and technology to raise awareness and change attitudes and building networks of young advocates and change-makers.

Progress and challenges

These efforts have contributed to a global decline in child marriage rates. According to UNICEF, the proportion of young women married as children has decreased from 25 per cent to 21 per cent over the past decade, meaning that 25 million child marriages have been prevented. However, the global number of child brides is still estimated at 650 million, including girls under 18 who have already married and adult women who married as children.

The average annual rate of reduction has been 0.7 per cent over the past 25 years and 1.9 per cent over the past decade, showing the impact of recent initiatives. But at this rate, the SDG target of eliminating the practice by 2030 won’t be achieved.

Setbacks have been caused by the COVID-19 pandemic, climate change, conflict and economic instability. Wherever insecurity rises, so does child marriage, as parents see early marriage of daughters as a financial and security solution. During Syria’s conflict, for example, the rate of child marriages shot up among refugees in countries such as Jordan and Lebanon.

Looking ahead

Colombia’s new law marks significant progress, but it’s just the beginning, as evidenced by the fact that many of the early marriages that take place in Colombia would have been illegal under the old law.

The real work of implementation begins now. Colombia’s efforts over the next few years will be crucial in demonstrating how legislative change can translate into real protection for vulnerable girls. For Latin America and the Caribbean, it should open up opportunities for strengthened cross-border cooperation and similar legislative reforms.

Colombia’s comprehensive approach could serve as a model for change in a region where many countries still have legal exceptions that allow child marriage under some circumstances, while others have strong laws that aren’t adequately implemented.

While the declining trend in global child marriage rates offers hope, the current pace of change remains far too slow. Colombia’s example shows that significant progress is possible through sustained, multi-stakeholder commitment and comprehensive approaches that change laws but also address underlying social dynamics. The international community must build on this momentum. This means scaling up successful initiatives, increasing funding for civil society organisations and maintaining political pressure.

Inés M. Pousadela is CIVICUS Senior Research Specialist, co-director and writer for CIVICUS Lens and co-author of the State of Civil Society Report.

For interviews or more information, please contact research@civicus.org.

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