Aid Withheld: One Year without US Global Health Assistance

Panel Presentation with Frontline Workers

Reductions in international aid are hindering the achievement of sustainable development goals worldwide. Global aid cuts—most notably from the United States—have had far-reaching consequences. At worst, it leads to needless deaths and severely stalls progress in providing health care services and protecting sexual and reproductive health and rights (SRHR).

In collaboration with our sister organization, Population Connection Action Fund, we hosted a discussion with community organizers whose work has been impacted by the U.S. foreign aid “freeze” and the dissolution of USAID (the US Agency for International Development). Speakers shared their firsthand experiences dealing with funding cuts to community-led programs that were working to improve essential healthcare services, combat gender-based violence, and protect reproductive freedom.

Date: January 22nd, 2026

Bridget Diana Ndagire, Public Health Specialist and Program Director, National Forum of People Living with HIV/AIDS Networks in Uganda

Ndagire Diana Bridget is an expert in HIV programming with over eight years of experience in HIV, SRHR, Gender, and Youth programming, working at the National Forum of People Living with HIV/AIDS Networks in Uganda (NAFOPHANU).

She holds a Bachelor’s degree in Development Studies. With expertise in system strengthening, advocacy, community engagement, resource mobilization, and partnership development, Bridget sits on several committees that guide the national HIV/AIDS response.

Through technical leadership, dialogues, and public platforms on policy, programs, and health services, she has modeled successful working partnerships with communities affected.

Leshan Kereto, Founder and Executive Director, Tareto Africa

Leshan Kereto is an award-winning sexual and reproductive health and rights (SRHR) champion. He serves as the chairperson of the United Nations Population Fund (UNFPA) and the Kenya Youth Advisory Panel (YAP). He is also the founder of Tareto Africa, a community-based organization in Narok County in Kenya that is widely involved in sexual and reproductive health rights advocacy, mainly focusing on advocating against Female Genital Mutilation (FGM) and Gender Based Violence.

Leshan was awarded the Presidential Recognition Award for outstanding efforts in ending Female Genital Mutilation in Kenya. Furthermore, he was recognized by the World Health Organization as a champion for vaccine equity and access in Africa.

He was enlisted among the top 60 men in Kenya who have exemplarily advocated for gender equality. Leshan was awarded the title of National Hero and officially received the HSC-Head of State Commendation by President William Ruto. He was also awarded the Top 40 under 40 Leadership Award in Kenya.

Leshan also served at the African Union Youth Reference Committee, representing the country in ending global inequalities among young people in the office of the African Union Special Youth Envoy. He continues to champion young people from diverse backgrounds to join and make the world better, and is known for the quote, “Young people are the custodians and designers of the practices that they would like in their generation.”

Willis Mulaa, Former Programs Officer and Service Delivery Coordinator, USAID 4TheChild

Willis holds a Bachelor’s degree in International Relations and Diplomacy with a proficiency certificate in project management and training in engaging young people on emerging issues.

Willis has worked with USAID-funded mechanisms for the last seven years in various capacities, both at the implementing level and the managerial level. He worked as the Programs Officer for 5 years and then spent 2 years at the management level as the Service Delivery Coordinator.

The programs focused on the prevention of HIV, especially for adolescents and mothers to children. As the Service Delivery Coordinator, Willis witnessed HIV infection rates drop over the years. With the recent funding cuts for HIV programs, there has been a surge in new infections in Kenya, and specifically in Busia County.

Martha Clara Nakato, Public Health Specialist and Community Action Facilitator, Uganda CSO Task Team on Accountability, Efficiency, and Diplomacy

Martha Clara Nakato is a Public Health Specialist and Community Development Facilitator honed in Adolescent and Youth Health with a focus on Sexual Reproductive Health and Rights (SRHR), HIV/AIDs, Gender and Social Justice.

She has shaped health policy agendas across the UN, African Union, East African Community, and at various Ministerial levels. Martha Clara bridges grassroots realities with global decision-making, ensuring young people and communities experiencing marginalization move from being “consulted” to becoming powerful co-creators of solutions.

Dr. Jallicia Jolly, Founder and Director, Black Feminist Reproductive Justice, Equity, and HIV/AIDS Activism (BREHA) Collective

Dr. Jallicia Jolly is a writer and reproductive justice organizer, serving as an Assistant Professor in American Studies and Black Studies at Amherst College. During her sabbatical/research leave for 2025-2026, Dr. Jolly is a Visiting Scholar at Princeton University’s Center on Transnational Policing and the Effron Center for the Study of America.

A 2025 National Academy of Sciences U.S. Kavli Fellow, she merges community-based research on Black women’s health, grassroots activism, and transnational political leadership with reproductive justice organizing and practice in the United States and the Caribbean. Dr. Jolly is the founder and director of the Black Feminist Reproductive Justice, Equity, and HIV/AIDS Activism (BREHA) Collective. This is an interdisciplinary medical humanities lab that bridges research, advocacy, student collaborations, and high-impact learning experiences focused on the health and movement-building of Afro-diasporic girls, women, and gender-diverse individuals.

A public scholar invested in research-informed political action, Dr. Jolly is Co-Chair of Birth Equity and Justice Massachusetts (BEJMA). This multisectoral reproductive justice group brings together clinicians, researchers, community organizations, advocates, and legislators to implement evidence-based interventions to improve outcomes for Black birthing people and advance equity in maternal health policy in the Commonwealth. Her work has been featured in various media outlets, including Forbes, The Washington Post, USA Today, The Boston Globe, and The Huffington Post.

Additionally, Dr. Jolly has been awarded recognition and supported by grants/fellowships such as The Ford Foundation, Fulbright Scholar Program, The Mellon Mays Foundation, National Women’s Studies Association, Yale University’s Center for Interdisciplinary Research on AIDS (CIRA) and LGBT Studies, and Brown University’s Pembroke Center for Teaching and Research on Women.

Q&A

Learning from what has been experienced in the last 12 months, how can rights-based programming be sustained despite the shocks that can knock anytime?

Response from Martha Cole, Uganda Perspective:
  • Legitimize Community leadership to recognise the critical role CSOs and Networks of affected communities play in promoting service delivery, social inclusion, and social accountability.
  • Safeguard already existing community-led Service delivery mechanisms, i.e., Peer Supports, Drop-In-Centres/Outreach spots, etc., and forge their alignment to the National health system. (Eases transition, ensures continuity of service delivery & enhances local ownership).

A practical approach for these two points: Development of a Meaningful Partnership Framework between the Ministry of Health & Civil Society to legitimize community leadership in service delivery, Social Contracting, and alignment to the National Health Plan and system.

  • Continuous assessment of the legal and social environment to ensure laws and policies protect and promote the right to health for all, and equitable access to healthcare.
  • Strengthen localised Private Partnerships for increased domestic financing, and as a way to reduce reliance on foreign donors.
Response from Leshan Kereto, Kenya Perspective:

Anchor programs in community ownership and rights education, not only service delivery

  • Invest in peer leaders, girls’ groups, and community facilitators who can continue work even when services pause
  • Design programs to flex between service linkage, advocacy, and community protection during disruptions

How have changes in global aid funding influenced community trust in health systems?

Response from Martha Cole, Uganda Perspective:
  • For long, most communities experiencing marginalisation and discrimination, esp. mostly Sex workers, Gay men, Transgender women, don’t feel safe, seen or heard at public health facilities.
  • Without safe spaces, trusted and friendly health workers, most of these communities are left out of care. OR some with the capacity to manage their healthcare have moved to private care, with huge cost implications.
  • Even with that, the government hasn’t stepped up to own the national Key Population programming, but rather moving ahead with Facility-based Health Integration to ensure continuity of service access.
Response from Leshan Kereto, Kenya Perspective:

Sudden service interruptions (reduced clinic hours, halted outreach) led to confusion and frustration

  • Loss of familiar health workers weakened confidence in facilities
  • Increased reliance on self-medication and informal care
  • Trust erosion affected both government facilities and community-based organizations

What strategies have local organizations and health workers developed to cope with funding instability? Can any of these adaptations provide lessons for future crises or shifts in international support?

Response from Martha Cole, Uganda Perspective:
  • Move towards alignment within the National Health System and plans for stability and sustainability. (Current funding models from USG & Global Fund are now funding through a system-based approach, not parallel to ensure harmonisation and country ownership.
  • More partners are increasingly advocating for and implementing integrated service delivery models where rights-based components are woven into routine primary health care systems. (Enhance health security and resource sharing).
  • Documentation of impact and engagement in stronger advocacy with national government, bilateral partners and CSOs to secure ongoing support for rights-based programming.
Response from Leshan Kereto, Kenya Perspective:
  • Role blending: facilitators and peer educators took on multiple informal roles
  • Targeted prioritization: focus on girls, pregnant women, and high-risk households
  • Use of informal networks: schools, women’s groups, local leaders-maintained outreach

Local organizations function as shock absorbers and should be strengthened for future crises.