‘People will die,’ says Canadian charity in Kenya as Trump’s USAID cuts threaten HIV medications

In Nanyuki, a market town just northwest of Mount Kenya, some foreign aid workers and volunteers are worried what U.S. President Donald Trump’s dismantling of the U.S. Agency for International Development will mean for the people there.

“It’s a concern. It’s a real issue,” said Rex Taylor, co-founder and president of The Small Project, a registered Canadian charity that helps send kids to school in rural Kenya. 

“In my judgment, it will mean people will die unnecessarily,” he told CBC News while on an annual visit to Nanyuki.

Kenya has one of the highest rates of HIV in the world, ranking 11th with a prevalence of 3.7 per cent in 2022, according to the World Health Organization. About 1.4 million Kenyans are HIV-positive, according to the non-profit Be in the Know. Amfar, the Foundation for AIDS Research, notes that about 1.3 million people are on HIV/AIDS treatment in the country.

Kenya relies on direct U.S. funding for 29 per cent of its HIV-related spending, according to UNAIDS — the 10th most reliant country in the world.

Taylor says his concern is that Trump’s foreign aid freeze could sever their access to antiretroviral medication (ARV), which stops HIV from replicating in the body. 

But in particular, Taylor says he’s worried about Joseph Awoi, a 20-year-old aspiring culinary student in Nanyuki. Taylor, who lives in Newmarket, Ont., has been supporting Awoi’s education through The Small Project since Awoi was a child.

In May, Awoi, an orphan who was born deaf and HIV-positive, will attend a culinary program in Nairobi through this continued funding. While his educational funding is unrelated to USAID, like so many other Kenyans, Awoi is reliant on ARVs.

And Taylor says he’s sharing Awoi’s story to put a face on the potential impact of the USAID cuts.

“It’s a situation that’s still unfolding here. It’s under the radar, people don’t think about it,” Taylor said.

“People need to know there are real people who are without the resources, because of the circumstances of their country and their birth, who, if the threats pan out the way we fear they will, will mean they start getting sick.”

Humanitarian relief efforts in chaos

The Trump administration announced last week that it was cancelling nearly 10,000 foreign aid grants and contracts worth almost $60 billion US, ending about 90 per cent of USAID’s global work.

The shuttering of USAID is part of an unprecedented downsizing of the federal government by Elon Musk’s Department of Government Efficiency. The aid agency’s sudden demise has thrown global humanitarian relief efforts into chaos. 

Last Friday, United Nations Secretary-General António Guterres said he was deeply concerned about severe cuts in U.S. foreign assistance, in a strong rebuke of the move that he said would be “especially devastating” for the world’s vulnerable people.

“Going through with these cuts will make the world less healthy, less safe and less prosperous. The reduction of America’s humanitarian role and influence will run counter to American interests globally,” Guterres said in a statement to reporters at the UN.

Funding for programs combating HIV/AIDS, tuberculosis, malaria and other programs has stopped, he said.

Humanitarian aid through the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, to combat HIV in Kenya was funded largely by USAID. Over the last two decades, the U.S government, through PEPFAR, has spent more than $8 billion US on HIV/AIDS treatment for close to 1.3 million people in Kenya, reports the Associated Press.

Last month, Margaret Odera, a community health worker who lives in Nairobi, wrote a plea on LinkedIn, expressing her fears that the U.S. was “retreating from aiding countries like mine from supplies of ARVs.” 

“Many are looking up to you as a lead country and superpower. Saving lives does not make you poorer,” Odera wrote.

“We are praying for you.”

‘What happens when the drug supply runs out?’

At the end of January, Kenya’s Ministry of Health released a statement reiterating its commitment to sustaining HIV/AIDS treatment and prevention programs.

“The ministry is actively engaging with other development partners and investing in local pharmaceutical manufacturing to prevent treatment disruptions,” said Dr. Patrick Amoth, the director general for health.

But without a strong contingency plan, “the abrupt end to PEPFAR funding will have devastating consequences,” wrote three professors of medical microbiology and infectious diseases from the University of Manitoba in an article published in The Conversation Feb. 24.

The University of Manitoba has been partnering with the Sex Worker Outreach Program (SWOP) and a local agency in Nairobi for 45 years, wrote assistant Prof. Julie Lajoie, Prof. Keith Fowke, and PhD candidate Toby Le.

The partnership with SWOP has been funded by PEPFAR since 2003.

If this funding ends, “this would mean no more HIV testing, preventive treatment and antiretroviral therapy — which would increase the risk of transmission, leading to an increase in cases and even a greater number of deaths in people living with HIV,” the professors wrote.

In Nanyuki, no one really knows what will happen next, and there’s a great deal of worry, says Taylor. He’ll continue to support Awoi, including “absolutely” paying for his medications through the charity if that becomes necessary, Taylor said.

But he worries as well about all the other people in Kenya who may not be able to afford antiretrovirals.

“There are lots of kids — and lots of adults — who are like him,” Taylor said.

“What happens when the drug supply runs out?”