US restructures health aid to poor nations, millions at risk

The United States is reshaping how it delivers life-saving medical supplies to poorer nations, a move officials and aid sources warn could disrupt treatment for millions battling HIV and malaria, Reuters reports.

For nearly a decade, Washington relied on the Global Health Supply Chain Program, run by contractor Chemonics, to transport critical drugs and prevention tools across developing countries. Between 2016 and 2024, the program delivered over $5 billion in HIV and malaria commodities to 90 nations, primarily in sub-Saharan Africa and Asia.

The system faltered when President Donald Trump froze international aid early in his presidency, leaving shipments stranded in ports and warehouses. While a later waiver allowed some deliveries to resume, stability never fully returned.

Now, a deeper overhaul is underway. An internal State Department email, confirmed by multiple sources, instructs US missions in 17 African countries and Haiti to cease program operations by May 30. The Chemonics contract ends September 30, aligning with a broader wind-down of USAID operations, though it officially runs until November. The email warns of “immediate risks to service continuity” if the transition is rushed, yet provides no detailed roadmap, leaving country offices to plan exit strategies.

Aid experts say the timeline is tight. Five sources told Reuters that accelerated changes could trigger shortages, especially in remote areas where distribution can take up to a year.

Washington is exploring a new model with the Global Fund to Fight AIDS, Tuberculosis and Malaria, leveraging its pooled purchasing and digital platforms. Officials argue the shift, part of the America First Global Health Strategy, moves away from contractor-led programs toward direct funding of frontline services, partnerships with national governments, and private logistics, aiming to cut waste and improve efficiency.

Health workers already report gaps in HIV prevention and malaria treatments, signaling early strain. With millions dependent on consistent access, even brief disruptions could have lasting consequences.

By Vafa Guliyeva