The suspension of nearly all U.S. foreign aid has forced a number of programs that the President’s Emergency Plan for AIDS Relief funds in Africa to shut down.

Secretary of State Marco Rubio on Jan. 24 directed State Department personnel to stop nearly all U.S. foreign aid spending for 90 days in response to an executive order that President Donald Trump signed after his inauguration. Rubio later issued a waiver that allows PEPFAR and other “life-saving humanitarian assistance” programs to continue operating after bowing to pressure.

A message on the U.S. Agency for International Development’s website notes “all USAID direct hire personnel will be placed on administrative leave globally, with the exception of designated personnel responsible for mission-critical functions, core leadership, and specially designated programs.” The announcement is scheduled to take place on Friday at 11:59 p.m. ET.

One of the PEPFAR-funded healthcare programs in Kenya still impacted by the funding freeze, despite Rubio’s waiver, is the Fahari ya Jamii (“joy of the community” in Swahili) initiative that began in 2022. The University of Nairobi was jointly implementing the project.

The Sh4.2 billion ($32,558,139.52) project sought to coordinate and manage high quality, cost-effective, and accessible HIV services in Nairobi, neighboring Kajiado County, and other parts of Kenya. Fahari ya Jamii was scheduled to end in May 2026, but it has closed indefinitely because of a lack of U.S. funding.

More than 700 staff, mostly healthcare workers, on Jan. 31 were placed on unpaid leave for three months, or until Washington decides whether to unfreeze funding. More than 150 Fahari ya Jamii clinics that offer HIV treatment to at least 72,000 people on antiretroviral drugs have also shut down.

The initiative’s target groups include children, adolescents, and adults living with HIV; young people, men, and women at risk of HIV; and key populations that include men who have sex with men and female sex workers.  Fahari ya Jamii since 2022 has offered HIV tests to more than 257,500 people, connected 94 percent of those who tested positive to treatment, distributed condoms and lubricants, and disseminated safter sex messages to their target groups.

Faith Ndung’u, advocacy manager for Kenya’s Health NGOs’ Network (HENNET) said the Trump-Vance administration should have used a humane approach to engage with countries that benefit from U.S. funding, instead of abruptly suspending it.

“We are feeling the magnitude of the suspension in the health sector because these are lives; these are people,” said Ndung’u. “When such an abrupt decision is made, we are talking about more than one million people living with HIV being affected.”

HENNET is an umbrella group with 112 members from local and international NGOs, faith-based organizations, and research institutions that focus on health-related issues in Kenya’s 47 local governments.

“This is now a wakeup call for Kenya and Africa to invest in the health sector by funding it more not to be in a similar crisis when a donor pulls out or forfeits his commitment,” Ndung’u said.  

Local governments that also rely on USAID to run PEPFAR programs have suspended their U.S.-funded activities and phased out the stand-alone comprehensive HIV care centers by integrating treatment and care into general health care services. This move has forced hundreds of health care workers to go onto unpaid leave and wait for further guidance.

Pema Kenya, a Mombasa-based queer lobby group, said the decision to suspend funding means “uncertain times” for the LGBTQ community and Kenyans at large who depend upon U.S.-funded groups for their health care.

“Many queer organizations rely heavily on USAID funding for vital services such as HIV/AIDS prevention and treatment, mental health support, and legal aid,” Pema Kenya stated.

Pema Kenya noted the suspension of U.S. aid could severely cripple queer organizations and leave vulnerable people with limited access to crucial resources.

“This would be a significant setback in the fight against HIV/AIDS and other health crises disproportionately affecting the LGBTQ+ community,” Pema Kenya stated.   

GALCK, a coalition of 16 Kenyan LGBTQ rights groups, was even more blunt.

“This isn’t just a policy decision; it’s a matter of life and death,” it said in a statement.

OUT and Engage Man’s Health — two South African organizations that provide HIV services to MSM, transgender people, sex workers, and other vulnerable groups through PEPFAR — have also been impacted by the U.S. funding freeze.

OUT and Engage Man’s Health, which provides HIV services to MSM, announced on Jan. 27 that it will stop offering services “until further notice” due to a lack of funding. The organization asked its clients to seek services from the nearest public health facilities.

“We deeply value our clients and remain committed to safeguarding your health,” said the announcement. “We sincerely apologize for the inconvenience and disruption this may cause. Unfortunately, we are unable to provide further details at this time.”

Kenya and most other African countries have said a permanent suspension of U.S. aid will adversely impact progress made in the health sector, particularly the fight against HIV/AIDS. Botswana and some other nations on the continent that use their national budgets to purchase antiretroviral drugs, have assured their citizens the supply of these medications will not be interrupted.

As mpox cases continue to surge in Uganda, LGBTQ rights organizations have raised concerns over its “troubling increase” among the queer community and have advised it to be on high alert.  

The Uganda Key Populations Consortium, an LGBTQ rights organization, working closely with the Health Ministry and Kampala Capital City Authority and other government bodies to stem the spread of mpox, has warned that queer people in semi-urban areas are the most affected.   

“These communities have expressed valid concerns regarding stigma and discrimination which may deter individuals from seeking necessary medical attention,” UKPC Director General Richard Lusimbo said.  

Uganda has recorded 512 new mpox cases in the last two weeks, bringing the total number of cases to 2,127 and 12 deaths, as the Health Ministry confirmed on Tuesday. The World Health Organization’s latest multi-country report on the mpox outbreak, released on Jan. 11, indicates that Uganda has recorded 1,552 cases and 12 deaths since the disease was first reported last July..      

The WHO report places the capital Kampala with the highest number of mpox diseases spread through community transmission with an infection incidence of 45 cases per 100,000 people, followed by the Wakiso and Nakasongola districts.

“Cases have been reported in at least 49 percent (71 out of 146) of districts in the country, but the epidemic remains largely concentrated in and around Kampala,” the WHO report reads. “So far, only clade Ib MPXV, linked to the outbreak in the eastern Democratic Republic of the Congo, has been detected in the country, and current evidence indicates that transmission of the virus is occurring exclusively through close, physical human-to-human contact.” 

People between 20-29 are the most affected group, with sexual contact as a major mode of transmission among sex workers and men who have sex with men.

The UKPC has issued an urgent health advisory to the queer community as it collaborates with the Health Ministry and KCCA in responding to the mpox transmission through immediate and long-term actions, including integrating its response with ongoing HIV prevention and care strategies. 

Lusimbo, whose organization has also partnered with WHO and the Most At Risk Populations Initiative, a local health NGO, to stem the spread of mpox stated a unified preventive approach that is inclusive and effective is vital for the health and safety of all Ugandans.   

“The fear of stigma and discrimination can exacerbate the situation by hindering effective response and treatment efforts,” Lusimbo said. 

He noted that the fight against mpox in Uganda is not just limited to managing a health crisis. It also offers the queer community an opportunity to advocate for the rights and dignity of the marginalized groups. 

The UKPC last week unveiled an online survey on the mpox epidemic targeting queer people in Uganda to reliably understand its impact on them and their knowledge about the disease. 

“Mpox continues to disproportionately affect mostly our community, especially female sex workers and their clients, and men who have sex with men,” the survey reads. “As the national secretariat and coordinating body for key populations, UKPC, in partnership with KCCA, has been leading important discussions on the disease’s public health implications in areas where the impact is most notable.”

The report states the survey data will help develop tailored, inclusive, and equitable interventions for the LGBTQ community. The survey also seeks to provide specific numbers of queer people who have contracted mpox and those who have died from the disease.

Uganda Minority Shelters Consortium Coordinator John Grace attributed the lack of data about queer people affected by mpox to privacy concerns, stigma, and discrimination against the community by the homophobic public and state authorities tasked with enforcing anti-homosexuality laws. He said the Anti-Homosexuality Law has created a significant barrier for queer people to report such abuses.

“This makes it difficult to ascertain the true extent of stigma and discrimination or the impact of misinformation about transmission methods,” Grace said.  

Grace also noted the collaboration between LGBTQ organizations and healthcare providers in tackling mpox has been “inconsistent.” 

“While some providers have been welcoming and supportive, others demonstrate a lack of awareness or sensitivity regarding the specific needs of the LGBTQ+ community,” he said.

Despite the homophobic climate in Uganda amid the fight against mpox, Grace noted many LGBTQ organizations have proactively disseminated accurate information to educate queer people about the disease’s prevention within their communities through educational campaigns and safer sex practices.   

Advocacy groups in Ghana have welcomed the demise of a bill that would have further criminalized LGBTQ people and outlawed allyship.

President John Mahama on Jan. 14 said the Promotion of Proper Human Sexual Rights and Ghanaian Family Values Bill that MP Sam George of Ningo-Prampram co-sponsored in 2021 was essentially dead. Mahama made the remarks to a delegation of bishops from the Ghana Catholic Bishop’s Conference.

“If we are teaching our values in schools, we wouldn’t need to pass a bill to enforce family values,” said Mahama. “More than just passing the Family Values Bill, we need to agree on a curriculum that instills these values in our children as they grow.”

The president also said that although MPs passed the bill last February, parliament dissolved before former President Nana Akufo-Ado, whose term ended earlier this month, signed it.

“I don’t know what the promoters of the bill intend to do, but I think we should have a conversation about it again,” said Mahama. “As far as I know, the bill did not get to the president. So, the convention is that all bills that are not assented to law before the expiration of the life of parliament, expire. So that bill effectively is dead.”

LGBT+ Rights Ghana Communications Director Berinyuy Burinyuy said the president’s remarks offer a glimmer of hope for LGBTQ Ghanaians who have long been subjected to systemic discrimination, fear, and violence.

“For many, the mere suggestion that LGBT+ issues could be addressed through education rather than criminalization represents a significant departure from the traditional legislative path championed by the bill’s proponents,” said Burinyuy. “This shift implies a possible opening for dialogue and a more inclusive approach, one that recognizes the need for respect and understanding of diverse sexual identities within Ghanaian society.”

Burinyuy, however, asked about how family values will be incorporated into the educational curriculum.

“Will the curriculum provide a comprehensive, nuanced understanding of human sexuality that respects diversity, or will it risk reinforcing discriminatory attitudes under the guise of cultural preservation?” said Burinyuy. “The fear, particularly among LGBT+ activists is that the emphasis on education could inadvertently foster homophobia in Ghanaian children. If the content is not carefully structured, it could perpetuate harmful stereotypes and deepen existing prejudices.”

“While Mahama may not yet be fully committing to a clear policy direction, his statement leaves open the possibility of a more balanced approach, one that allows for a national conversation on sexual rights without rushing into divisive legislation,” added Burinyuy.

We Are All Ghana said Mahama’s comments are a welcomed approach in addressing anti-LGBTQ sentiments and negative stereotyping.

“We need a holistic educational curriculum for our schools,” said We Are All Ghana. “The children at least deserve to know the truth. There is nothing worse than half baked information.”

Yaw Mensah, an LGBTQ activist, said Mahama is teaching Ghanaians to be tolerant of everyone, regardless of their sexual orientation.

“Mahama is indirectly saying LGBT persons are not Ghana’s problems. Let’s teach families values that accept and respect everyone. Ghanaian values should be tolerance, respect, honesty, hardworking, hospitality, and integrity,” said Mensah. “Those need to be taught and not the hate, discrimination, barbarism, greediness, and hypocrisy that we are seeing in many leaders which transcends into the young ones.”

George has yet to comment on Mensah’s comments about his bill.