Nigeria after USAID

A few years ago I worked for an organisation that collected donations for large humanitarian agencies such as Médecins Sans Frontières, Amnesty International and Save the Children. My job was to approach passers-by – students milling around campus, office workers heading to lunch – and encourage them to contribute to these causes. Most conversations followed a predictable pattern: a polite decline or a brief acknowledgment of the importance of the work.

One exchange stood out though. A woman stopped me in my tracks to let me know that my job was useless: humanitarian aid was ineffective. She argued that aid organisations fostered dependency rather than self-sufficiency and that her hard-earned money would be nothing more than a bandage over a gaping wound. She refused to donate. I thought of her when the Trump administration announced that 90 per cent of USAID funding would be cut.

Nigeria has been a recipient of USAID funding for decades. The agency has invested billions of dollars in healthcare, agriculture, education and democratic governance. One of its most significant contributions has been in the fight against HIV/Aids. Through PEPFAR (the President’s Emergency Plan for Aids Relief, established by the Bush administration in 2003), USAID has funded lifesaving antiretroviral therapy for 89 per cent of the nearly two million Nigerians living with HIV.

USAID-backed initiatives have also protected 68 million Nigerians from malaria through mosquito net donations and treatment programmes, reducing child death rates from the disease by 16 per cent between 2010 and 2020. These interventions have been vital in a country where hospitals frequently lack electricity, and maternal mortality rates remain among the highest in the world. More broadly, the sudden loss of aid threatens to cripple epidemic preparedness, immunisation programmes and overall public health efforts.

Nigeria already struggles with inadequate healthcare funding. This year’s budget allocates only 5.18 per cent of the total (2.48 trillion naira) to health – which is up from 1.23 trillion naira last year but still far below the 15 per cent target set by the Abuja Declaration in 2001. Without USAID, an already fragile system is weakened.

This crisis forces a cruel reckoning: what happens when a nation accustomed to foreign aid is left to fend for itself? The abrupt withdrawal has revived debates among development economists. Critics argue that foreign aid fosters dependency and corruption, enriching elites while leaving ordinary citizens in poverty.

Trump’s cuts have spurred urgent calls for Nigeria’s government to take responsibility for its citizens’ well-being. In October 2023, within two months of taking office, President Bola Ahmed Tinubu launched the Presidential Initiative for Unlocking the Healthcare Value Chain. Its aim is to reduce Nigeria’s reliance on imports by strengthening its pharmaceutical sector and domestic medical production. Each year, Nigerians spend $1 billion on medical tourism because of inadequate domestic healthcare facilities. The new initiative, led by Dr Abdu Mukhtar, seeks to reverse these trends by stimulating local and international private investment in healthcare infrastructure through strategic partnerships.

It is unlikely that these efforts will be enough. The private sector alone cannot fill the void left by USAID’s departure. It is unclear what measures will be put in place to protect citizens from disastrous health outcomes.

Foreign aid has long been both a lifeline and a crutch. It compels the receiving nation to adhere to the rules set by the donor country. In the foreign aid matrix, the priorities and interests of the wealthier nation always take precedence. Despite this, the absence of aid will be keenly felt, with the burden falling on ordinary Nigerians, who will be forced to endure the consequences of Trump’s policy shift.

USAID’s sudden withdrawal prompts the question: what will Nigeria do without it? Or, perhaps more important, can the country finally build the self-sufficiency that aid, for all its benefits, has arguably delayed? A faint hope remains that the aid vacuum might spell an end to Nigeria’s bureaucratic pitfalls and endemic corruption. As one commentator on X wrote, ‘we’re about to find out just how much our government doesn’t give a damn about investing in public goods.’