By guest contributor Angelo Katumba
First things first: no one is arguing that low- and middle-income countries (LMICs) should continue to receive foreign aid in perpetuity. LMICs must take greater ownership of their development by committing more financial resources toward healthcare, food security, climate change mitigation, education, security, and other essential services. Although slow in many cases, sustainability conversations are ongoing in nearly every country and must be prioritized. Encouragingly, some African governments have stepped up since newly elected U.S. President Trump issued an Executive Order to freeze foreign aid. In recent weeks, Nigerian lawmakers approved $200 million for the health sector, the South African government announced plans to fill the gaps left by the U.S. President’s Plan for AIDS Relief (PEPFAR) freeze, and several African countries have made public commitments to ensure critical services continue to prevent loss of life during this crisis.
However, the ongoing foreign aid freeze imposed by the U.S. government is a stark reminder of the fragile and imbalanced nature of the donor-recipient relationship. More than just a policy decision, such actions reveal entrenched neocolonial dynamics, where partnerships remain subject to the whims of former colonial powers rather than the priorities of LMICs. While calls for more domestic investment by LMICs are valid, these colonial imbalances must also be acknowledged and addressed.
The fragility and dishonesty of “partnership” in foreign aid
U.S. foreign aid, estimated at around $72 billion a year, makes up less than 1% of the total U.S. gross domestic product, yet its implications for LMICs, particularly in Africa, are profound. When a so-called partner can unilaterally withdraw from an agreement ensuring that more than 20 million people living with HIV (PLHIV) receive antiretroviral therapy (ART), can they truly be considered a partner? Authentic partnerships require mutual respect, accountability, shared decision-making, and transparency. Additionally, good global leadership demands adherence to certain norms, values, and identities, as recognized in constructivist international relations theory (Mccourt, 2022). The issue here is not the withdrawal of aid itself, but the way it has been executed – abruptly, with little to no planning for a transition to domestic funding and management.
Although the impacts of the aid freeze extend across multiple sectors, the HIV/AIDS response provides a particularly stark example. UNAIDS estimates that by December 2024, U.S. foreign aid supported over 20 million people on life-saving antiretroviral treatment, including approximately 560,000 children (0-14 years). A few weeks after the freeze took effect, in February 2025, there were an estimated 2,000 new HIV infections among adults – all preventable had funding been maintained (Lankiewicz et al., 2025). If PEPFAR were permanently halted, UNAIDS projects an additional 6.3 million AIDS-related deaths, 3.4 million AIDS orphans, and 8.7 million new adult HIV infections by 2029 (Impact of US Funding Cuts on the Global AIDS Response — Weekly Update – 17 March 2025, 2025). Given the massive grant/contract terminations observed in recent weeks, it is difficult to see how these numbers will be reversed.
These statistics are not just numbers; they represent lives, communities, and decades of progress toward ending AIDS, and if things continue, most – if not all – gains we have made in recent decades will likely be lost Several advocacy groups have already sued the new administration, challenging the legality of these abrupt funding cuts. Furthermore, the growing transactional approach to humanitarian aid, as seen in conflicts in the Democratic Republic of Congo (DRC) and Ukraine – where the U.S. government is demanding access to natural resources in exchange for support – is inhumane and deeply troubling.
Aid: A matter of shared global responsibility
Critics of international aid often question whether developed nations have any obligation to support developing countries. While no legally enforceable mandate exists, compelling reasons based on equity, historical responsibility, and mutual benefit create a clear imperative for continued support. The United Nations Charter of 1945 laid the foundation for international cooperation to address economic, social, and humanitarian challenges worldwide. This framework explicitly acknowledges that developed nations have a role in assisting less developed countries to foster global stability, peace, and prosperity.
Ignoring this responsibility is shortsighted. In today’s interconnected world, no country can truly thrive in isolation when neighboring regions experience economic and social hardship. Our global village is more interdependent than ever before, with effective global trade linked to widespread prosperity. The Sustainable Development Goals (SDGs), particularly SDG 17, emphasize the importance of partnerships between developed and developing nations. This goal specifically calls for increased Official Development Assistance (ODA) and equitable trade policies that benefit all participants in the global economy.
Aid is not merely a charitable act; it also benefits donor countries. As UNAIDS Executive Director Winnie Byanyima aptly put it,“We have the diseases, they [the Global North] have the profits.” The structured relationship between developed and developing nations has been deliberately maintained to ensure continued economic dominance by the Global North over the Global South. This was evident during the COVID-19 pandemic, when vaccine production technology was withheld from developing countries, prolonging dependency and restricting access to life-saving medical interventions. The pharmaceutical industry thrives on LMICs’ dependence on foreign drugs (Sell, 2009; ’T Hoen, 2009), while donor nations leverage aid as a geopolitical tool rather than a humanitarian effort (Alesina & Dollar, 2000; Moyo, 2009; Sell, 2009). This, too, must stop.
Toward self-sufficiency: A new African strategy
For far too long, African countries have conditioned themselves to view donor funding as indispensable. Conversations about transitioning to domestic funding sources have been slow and insufficient. While aid has saved lives, relying on it indefinitely is neither strategic nor sustainable. Some countries, such as South Africa, have already begun transitioning toward self-sufficiency. South Africa funds more than 80% of its HIV response domestically, reducing its vulnerability to external funding cuts. Other countries must follow suit, though transitioning away from a donor-funded model cannot happen overnight, particularly for large-scale programs such as the $6.5 billion a year PEPFAR.
To build resilience and reduce dependency on foreign aid, African governments and institutions should consider the following strategies:
Strengthening Domestic Resource Mobilization (DRM): Governments should increase domestic budget allocations for health and social services, engage local philanthropists and corporate social responsibility programs, and encourage community contributions through crowdfunding and social enterprises.
Expanding and diversifying funding sources: African nations should seek grants from regional institutions, non-Western donors such as BRICS and China, and mobilize diaspora contributions. Remittance flows to Africa have doubled in the past decade, reaching $100 billion since 2022 – a potential resource for sustainable funding.
Enhancing efficiency and reducing waste: African governments and institutions should conduct rigorous monitoring and evaluation to optimize resource allocation, pool resources among organizations with overlapping mandates, and explore South-South partnerships such as the COMPASS Africa Program and India’s Aravind Eye Care System, which center communities and emphasize homegrown solutions.
Advocating for sustainable funding policies: Governments should push for continent-wide policies prioritizing domestic funding and lobby for multi-year donor commitments rather than short-term grants.
Investing in local talent and capacity development: Reducing reliance on expatriate expertise and leveraging African experts in program management, fundraising, and technical fields will strengthen local ownership and sustainability.
Beyond aid: Toward a decolonized future
While the U.S. government’s funding cuts are devastating, they serve as a necessary wake-up call. African countries must transition from a model of dependency to one of self-sufficiency. The Global South has enormous collective bargaining power, particularly given its large and growing population. The current crisis should prompt not just reactionary survival strategies but a complete recalibration of Africa’s relationship with donor nations. Aid should not be a tool of coercion. African nations must negotiate from a position of strength rather than desperation.
This transition will be challenging, but with strategic financial planning, policy advocacy, and a commitment to domestic resource mobilization, it is achievable. As the world approaches 2030, the goal of ending AIDS remains within reach – but only if Africa takes ownership of its destiny. True partnerships must be equitable and based on shared responsibility, not dependency.
About the author:
Angelo Katumba is a doctoral candidate at the University of Illinois Chicago’s School of Public Health; and an associate of the Global Health Decolonization Movement (GHDM) Africa and the African Institute of Child Studies (AICS).
Disclaimer: Views expressed by contributors are solely those of individual contributors, and not necessarily those of PLOS.