US Aid Cuts Leave Kebbi Communities Struggling For Malaria Treatment
A Child’s Illness, A Costly Delay
WHEN 14-year-old Safiyanu Idris developed mild malaria symptoms, his guardian, Kabir Abubakar, hoped the fever would pass. For years, anti-malaria drugs were freely available at the primary healthcare centre in Yabo, Yauri Local Government Area of Kebbi State. But by early 2025, that assurance had faded.
Mr. Abubakar had heard that medicines were no longer reliably free. Afraid of costs he could not afford, he delayed seeking care. Within days, the boy’s condition deteriorated. At the clinic, there was another shock: the drugs were out of stock. He was told to buy them from a private pharmacy.
“I had to borrow money,” Mr. Abubakar said. “And I still worry about the other boys under my care.”
Like many facilities in Kebbi, the Yabo clinic once depended on the US-funded Presidential Malaria Initiative (PMI), implemented through the now-dissolved United States Agency for International Development. The crisis followed a January 2025 executive order by former US President Donald Trump suspending aid to several countries, including Nigeria.
Shrinking Supplies, Rising Cases
Officials at the Kebbi State Primary Healthcare Development Agency say they are rationing remaining stocks. Nasir Zagga, the state malaria elimination programme officer, confirmed that facilities now rely on dwindling reserves.
But frontline workers paint a grimmer picture. Mariya Liman, a senior extension worker in Yabo, said drugs often run out within two weeks of supply. “When it finishes, we buy and sell to patients. When there’s nothing, they must go outside,” she said.
Data reviewed across facilities show steep declines in Artemisinin-based Combination Therapy (ACT) and Rapid Diagnostic Test (RDT) kits since March 2025. ACTs — the standard malaria treatment endorsed by the World Health Organization — are distributed in age-specific doses, yet several clinics reported receiving incomplete batches or none at all.
In some months, facilities received drugs without test kits. Others got test kits without sufficient drugs. By late 2025, some clinics had neither.
Health workers in Argungu and Birnin Kebbi described inconsistent deliveries and unexplained gaps. In Nabame community, a maternal clinic went months without supply. “We’ve been diagnosing malaria clinically because we can’t ask patients to buy test kits,” said extension worker Fatimah Isah.
Nigeria bears the world’s highest malaria burden, recording an estimated 68 million cases and 194,000 deaths in 2021, according to WHO data. In endemic states like Kebbi, transmission persists year-round.
IDPs and the Human Toll
The impact extends beyond Kebbi. In Benue State, a USAID-supported clinic near the Dauda II Internally Displaced Persons camp shut down for months after funding stopped. The facility, established through UNICEF support backed by USAID, had served over 500 displaced persons.
When it closed, residents like Joy Aondongu had to pay out of pocket. She could not afford full malaria treatment for her toddler at once and bought drugs gradually from a pharmacy.
Even after reopening, services remain strained. Only one doctor returned. Patients now queue for hours.
Health worker Israel Wasem warned that sustainability is uncertain. “Before, drugs and staff payments were funded. Now we depend on government supply, and it’s not enough,” he said.
Rising Prices, Uncertain Future
USAID’s withdrawal also removed subsidies that had kept malaria drugs affordable in private pharmacies. Prices have since risen sharply.
State officials admit the government cannot fully replace the scale of foreign funding. Over five years before the cuts, Nigeria received trillions of naira in US health assistance.
Though Nigeria and the US signed a five-year health cooperation agreement valued at $5.1 billion in late 2025, implementation has yet to begin, and details remain unclear.
For Kebbi, the consequences are immediate. Mr. Zagga warned that drug reserves may run out before year’s end without alternatives.
For families like Mr. Abubakar’s, the crisis is not abstract policy — it is a daily gamble between illness and debt. As shelves empty and queues lengthen, vulnerable communities continue to pay the price of aid decisions made far away.
