The US withdrawal of financial support from one of the country’s most donor dependent sector threatens essential services such as availability of life-saving antiretroviral drugs and the accessibility of crucial vaccines for children.
A researcher at Kamuzu College of Health Sciences, Lester Kapanda, said vaccines for rotavirus have made a difference.
“Malawi, rotavirus used to kill more than 2,500 young children per year, and just two years after Malawi introduced the rotavirus vaccine, hospital admissions for the disease fell by 43 per cent,” Kapanda said.
Health rights activist Maziko Matemba said the 2024-25 national budget has already indicated a declining commitment to the health sector. Compared to last year, where 12.2 percent of the national budget was allocated to health, this year’s allocation has dropped to just 9.5 percent.
“The reduction comes at a time when demand for healthcare services continues to rise, making the shortfall even more alarming,” Matemba said.
Chairperson for the Parliamentary Health Committee, Mathews Ngwale, acknowledged the severity of the situation, saying that global health financing is largely shaped by major donors like the US government.
“The US plays a crucial role in driving health investments, not just through government agencies like USAID but also through private foundations and individual donors,” he said.
Apart from USAID funding, Malawi also gets support from international organisations such as the Global Fund and WHO.
However, this funding is also at risk due to the Trump administration’s decision to stop funding UN agencies.
The US government was the largest donor by far for the Global Fund and WHO.
USAID has been a dominant force in Malawi’s health sector, injecting about $185 million annually to support various programmes, including HIV/Aids treatment, maternal health, and vaccination campaigns, according to reports.
Malawi is currently benefiting from a $535 million grant from the Global Fund, covering the period from 2024 to 2027. This funding ensures that some critical health initiatives, particularly those targeting malaria, tuberculosis (TB), and HIV/Aids, continue to operate without immediate disruptions.
Principal Secretary in the Ministry of Health Sam Mndolo said the issue is not much about filling the gap but rather ensuring that the essential services that were previously supported by the resources that have been withdrawn continue.
“This distinction is important because not all of the quoted amount—whatever the precise figure may be— was directly allocated to service delivery.
“Additionally, even for funds that were used for service delivery, it is crucial to assess whether they supported cost-effective interventions and whether they were utilised through cost-effective delivery channels,” he said.
To address this challenge, he said, the ministry has taken several strategic steps including re-prioritization of services, improving efficiency in resource utilisation and exploring financial health reforms.
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