US Aid Cuts Threaten Hepatitis Fight in Africa
Cuts to foreign aid enacted by the United States government are severely impacting the fight against hepatitis in Africa. The reductions have led to the closure of specialized clinics, the dismissal of healthcare workers, and disruptions in the supply of essential medications, jeopardizing the health of the 72.5 million people in Africa living with hepatitis B and C.
The Intertwined Funding Streams
While the United States Agency for International Development (USAID) did not allocate a specific budget dedicated solely to hepatitis, resources reached organizations through programs focused on HIV/AIDS. This is due to the shared transmission routes – blood and sexual contact – between the two viruses. When the Trump administration paused USAID programs and the US President’s Emergency Plan for AIDS Relief (Pepfar) in early 2025, organizations addressing hepatitis experienced significant setbacks.
Impact Assessment: A 40% Disruption
A survey conducted between March and October 2025 by the Coalition for Global Hepatitis Elimination (CGHE), the World Hepatitis Alliance (WHA), and the Hepatitis Elimination Laboratory team revealed the extent of the damage. The survey, which included responses from 240 researchers, healthcare workers, and organizations, found that 40% of organizations experienced serious problems continuing research and clinical trials, while 30% reported a “high impact” on clinical care for their patients. Some respondents requested anonymity, fearing further loss of funding.
On-the-Ground Consequences
Reports from African countries paint a grim picture. In Malawi, over 1,500 testing assistants were laid off at the end of 2025, halting community testing initiatives and forcing clinic closures, leaving individuals without access to care or preventative measures. Shortages of antiviral medications have been reported across multiple countries, and community-based support groups have been severely affected by funding cuts.
A Fragile Foundation
Even before the cuts, hepatitis care in Africa was critically under-resourced. Less than 5% of individuals with hepatitis B had been diagnosed, and of those diagnosed, only 5% received treatment. Vaccination coverage for hepatitis B at birth was also low, at just 8% across the continent, significantly lower than rates in countries like Spain, where it is part of the standard childhood immunization schedule.
Shifting US Health Policy
The deterioration of hepatitis care coincides with broader changes in US health policy. In December 2025, the Advisory Committee on Immunization Practices, comprised of experts appointed by Health Secretary Robert F. Kennedy Jr., advised against universal hepatitis B vaccination for newborns. The government also supported a controversial study in Guinea-Bissau that proposed withholding vaccinations from some infants, a proposal ultimately blocked due to ethical concerns raised by the World Health Organization (WHO).
Potential Repercussions
Organizations warn that reduced screening, interrupted treatment, and decreased vaccination rates could lead to an increase in hepatitis cases, more severe liver disease, the development of drug resistance, and increased mortality. Interrupting chronic hepatitis B treatment can cause viral rebound, liver inflammation, and potentially liver failure or death. Reduced vaccination rates increase the risk of mother-to-child transmission, the primary route of hepatitis B infection in sub-Saharan Africa.
Adapting with Limited Resources
Non-governmental organizations (NGOs) are struggling to adapt. Kiraay, an NGO operating in Senegal, relied on funding from larger coalitions addressing HIV to provide care for hepatitis patients. With the cuts, its ability to continue operations is threatened. Similarly, Bekwarra Hepatitis B Support in Nigeria, which has been conducting awareness campaigns and free testing in Cross River State, has faced challenges in maintaining its programs. They had planned 12,000 tests but could only complete 6,000 due to funding limitations.
Advocacy and Future Challenges
The African Hepatitis B Advocacy Coalition (ABAC) has provided grants to some community organizations, but the scale of the problem demands greater intervention. With the shift in US health policy towards bilateral agreements, there are concerns that hepatitis may not be prioritized. As Prince B. Okinedo, co-founder of ABAC, stated, “I don’t know how we are going to solve this, it will be a big challenge if things continue like this.”