– As U.S. Aid Freeze Hits Liberia
Image Credit: Novusacs.com
Montserrado-Liberia — In a cramped room in Monrovia’s outskirts, Johnson (not real name), who has lived with HIV for 24 years, contemplates an uncertain future. His current antiretroviral medication will last another five months, but after that, like thousands of others in Liberia, he faces a precarious reality following USAID’s sudden suspension of aid to the country.
“If the government doesn’t come in to find other alternatives, then maybe some of us may live for another two or three years,” Johnson said.
The suspension, part of a broader pause in U.S. assistance to Liberia, has sent shockwaves through the country’s healthcare system, particularly affecting HIV/AIDS services that have been heavily dependent on American support since the end of Liberia’s civil war in 2003.
At ELWA Hospital, one of Liberia’s primary HIV treatment centers, the impact was immediate. By early February, the facility reported critical shortages of medications, particularly for infants and children, while viral load testing and peer counseling services ground to a halt.
The crisis threatens to unravel two decades of progress in fighting HIV/AIDS in Liberia, where approximately 39,000 people live with the virus. USAID, through the President’s Emergency Plan for AIDS Relief (PEPFAR), has been the cornerstone of the country’s HIV/AIDS infrastructure, supporting a network of 70 treatment centers across all 15 counties.
“When you were to get six months of treatment, they cut it down to three months,” Johnson said, describing the immediate rationing measures implemented by treatment centers. The reduction in medication supply represents more than just a medical challenge – it’s a potential public health crisis in waiting.
Healthcare workers and advocates fear the disruption could increase virus resistance and new infections. “what the treatment does is suppress the virus to a level that it cannot be detected in the blood. Without it, you can easily infect anybody,” Johnson said.
The suspension affects not just medication distribution but an entire ecosystem of HIV support services. Organizations like FHI 360, which implements USAID’s programs, have had to suspend operations, leaving peer educators, program managers, and healthcare workers unemployed.
However, amid the crisis, some see an opportunity for African nations to reduce their dependence on foreign aid. Gabriel Starks, Executive Director of the Starks Foundation, a civil society representative on Liberia’s Global Fund board, views the suspension as a wake-up call.
“Donald Trump has no responsibility to us. We never elected Donald Trump,” Mr. Starks said, arguing that African nations must take control of their healthcare destiny. “We have the gold, the diamond, the minerals. These resources are not benefiting the people of Africa, and that’s the reason why we are there begging.”
Starks points to Burkina Faso as an example of African self-sufficiency, where recent policy changes have prioritized domestic funding for social services. He estimates that Liberia would need about $14 million annually to replace USAID’s HIV/AIDS support, with actual medication costs around $1.3 to $1.4 million – figures he believes the Liberian government could manage with proper prioritization.
Yet for people living with HIV, such political and economic calculations offer little immediate comfort. The human cost of the suspension is already evident in treatment centers across the country, where healthcare workers struggle to maintain services with dwindling resources.
The crisis particularly affects vulnerable populations, including sex workers and young people living with HIV. Support organizations report that some beneficiaries might resort to desperate measures to survive, potentially increasing HIV transmission risks.
At ELWA Hospital, staff members and former FHI 360 personnel have continued working as volunteers, trying to maintain essential services. But without a systematic solution, these stopgap measures may prove insufficient.
For Johnson, who has raised seven children while living with HIV, the situation resurrects memories of earlier, darker days when treatment was scarce and stigma was rampant. “The first time I went public, it was a difficult thing,” he recalled. “They used to put my children out of school. Even quite recently, people got behind them and called them AIDS children.”
As Liberia grapples with this healthcare crisis, the broader question of African nations’ dependence on foreign aid has come to the forefront. Ghana’s government has already announced plans to bridge the gap left by USAID’s suspension, but smaller nations like Liberia face steeper challenges.
The suspension’s initial 90-day period may be extended, leaving Liberia’s HIV/AIDS services in prolonged uncertainty. Healthcare workers and advocates are calling on the government to develop sustainable domestic funding solutions, but in a country still recovering from civil war and economic challenges, quick fixes seem unlikely.
Meanwhile, in treatment centers across Liberia, healthcare workers continue their daily struggle to maintain services with diminishing resources. For thousands of Liberians living with HIV, each day brings them closer to potential treatment interruptions, while they wait for either international aid to resume or domestic solutions to emerge.
“If we don’t have treatment available,” Johnson said, “it becomes a difficult thing for me to survive.” His words echo the fears of thousands of others caught between international politics and the basic human right to healthcare.
