US Shifts Malaria and HIV Supply Program, Sparking Shortage Fears in Africa

The US government is overhauling its approach to delivering medical supplies for HIV and malaria to low-income countries, potentially causing major disruptions just a year after previous aid freezes.

Since 2016, the Global Health Supply Chain Program - Procurement and Supply Management, operated by contractor Chemonics, has supplied over $5 billion worth of essential products like HIV drugs and insecticide-treated bed nets to 90 countries, primarily in sub-Saharan Africa and Asia.

President Trump’s administration halted the program last year on his first day in office, stranding supplies in ports. Operations partially resumed via waivers, but now face termination amid broader foreign aid reforms, including the dismantling of USAID and a shift to bilateral deals.

An internal email from the US State Department, verified by sources, instructed staff in 17 African countries and Haiti to stop implementation by May 30, despite the contract officially ending in September. It highlighted risks to service continuity without a clear handover plan, leaving country offices to devise their own transitions.

Experts from five sources caution that the rapid pace could create shortages of vital products, with severe consequences in malaria-endemic regions where the disease claims around 400,000 lives annually, mostly children.

The US is exploring partnerships with the Global Fund to Fight AIDS, Tuberculosis and Malaria for future procurement, but sources say the proposed timeline—far short of the year needed for complex orders—is unrealistic.

Under the ‘America First Global Health Strategy,’ the administration criticizes contractors for inefficiency and plans to fund frontline supplies directly via bilateral pacts with countries like Kenya, Rwanda, and Uganda, using private logistics. However, some agreements face delays or legal hurdles.

This article is based on reporting from Daily Monitor (Uganda).