United States foreign aid freeze: An urgent call to action for support for African national laboratory programmes

Abstract

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The United States government, under the Trump Administration, imposed a freeze on foreign aid by means of an Executive Order on 20 January 2025 (EO 14169. Reevaluation and Realigning United States Foreign Aid), initiating a 90-day pause on all foreign aid programmes. The United States Agency for International Development, established under the Foreign Aid Act of 1961 (22 USC Ch. 32: Foreign Assistance),^1^ is an independent agency responsible for implementing United States foreign programmes and managing Congressionally allocated funds.

The President’s Emergency Plan for AIDS Relief is the largest aid initiative managed by the United States Agency for International Development, and is supported by the United States Centers for Disease Control and Prevention (CDC), Department of Defense, and State Department, significantly enhancing laboratory capacity in clinical diagnosis, disease surveillance and pandemic preparedness. The dismantling of the United States Agency for International Development’s operations will significantly affect laboratory services in many countries that rely on its health programmes. This opinion presents key historical contributions of the President’s Emergency Plan for AIDS Relief in strengthening the diagnostics landscape in Africa and makes the case that, if immediate action is not taken, the continent is on the verge of losing this progress, thereby reversing decades of success:

Given the uncertainty surrounding the future of United States foreign aid, it is imperative for African leaders to take immediate action by mobilising resources to advance the continent’s laboratory programmes. Key considerations for immediate and sustainable laboratory programme resolutions are provided below: