On April 19, the US government is expected to announce the way forward after a recent temporary closure of U.S. Agency for International Development (USAID) operations globally.
The temporary closure of the operations would have widespread and significant impacts across numerous sectors, particularly in developing countries and especially come with a significant setback in health initiatives, including those related to girl’s and women’s health especially in sexual reproductive health and rights (SRHR).
African youths have shown lack of implementation of existing policy and outdated legal frameworks continue to impede improved sexual reproductive health which is already threatened by low budget funding and possible closure of support from the US Government.
This was raised at the recent 2025 Africa Health Agenda International Conference (AHAIC) held in Kigali from March 2-6, bringing together health experts, political leaders, innovators, researchers, policymakers to discuss the future of health funding at a time when the health program funding are under threat of closure.
Based on these facts, youth participants at a session dubbed- “Reclaiming Control: Let’s talk about sexual reproductive health and rights” youth participants from across the continent showed that the above challenges will further widen gaps in access to SRH information and services if no action is taken.
Steve Ougo, the Team Lead at YouthSpaces Africa, said that Kenya, like many countries has very good and progressive SRHR policies but their implementation remains lacking especially when they don’t address the priorities and needs on ground.
“We don’t need to have more policies. We need to start by checking the policies that are there and see if they address the priorities and needs of young people,” Ougo said.
Ougo stated that there is need to address the political and legal barriers in the implementation of these policies that allegedly hinders access to SRH information and services.
“That is where the problem is. If we don’t have the political good will, how will we be able to increase and ensure that young people access SRHR information and services,” Ougo said.
With the threat of halting USAID funding Ougo called on governments to start refocusing their healthcare priorities and allocating 15% of their health budgets to the SRH programs as required by the Maputo declaration of which only a handful of countries have tried to implement with of these policies
Rwanda’s SRH champ, Grace Uwicyeza says that who has contributed the creating awareness among fellow youths through the European Union-funded tSolutions for Supporting Healthy Adolescents and Rights Protection(SHARP) project implemented in six countries, including Rwanda; says that banking on youth-led efforts will enable existing programs navigate through any outcomes.
“We have been able to create impact by empowering young teenagers to know more information about sexual reproductive health, changing mindsets. It is about them knowing their rights, their body, and taking a decision about their health,” Uwicyeza says.
With minimum resources at hand to bring health services to many Africans, Constantin Gasasira Irakoze, a Rwandan Women Deliver Emerging Leader and digital health champ, suggests that to sustain health activities, Africans can leverage existing technologies to sustain health outreach programs.
“We don’t have the resources to reach all youth on SRH awareness, however tech is there and anyone can have access to but we are not harnessing it. We are using it at the minimum level,” Irakoze says.
He stated that it is by leveraging this technology (such as tiktok), Africans can reach many that this is where ‘tech guardians’ come in to enable the transitioning world to address issues of SRH among youths with providing the right information.
He also noted that unlike investors who want short term solutions and effects, Africans should look for long term solutions by creating models that are sustainable.
“Without funding sources, we can still use tech, leverage on artificial intelligence to come up with solutions that can easily be deployed. Without the policies we can still change our mindsets. We need to create models that have vast information filtered for specific groups,” he said.
These youths and health financing experts believe that African countries need to implement the 15% allocation of health budget required by the Maputo protocol.
Lioka Lioka, the Executive Director Medicines Research and Access Platform (MedRAP) in Zambia says that the Maputo protocols have been ratified but need to be contextualised especially within the changing funding landscape where funders want to pull out.
Lioka stated that this shift in funding is very critical to Zambians and many African countries that will be affected thus a need to change strategies in implementation of health systems.
“We need to rely on our own locally produced medicines and look at how our local funding process corresponds to the international system, for example our procurement systems have to align with others, the health system has to also become robust so that we have the budgets at district levels to improve services availability,” Lioka said.
According to Diane Gichengo, the Executive Director at Institute for Social Accountability (TISA) says that only Botswana, Kenya, Malawi, Uganda, Tanzania among others have improved budgets but these are not sustainable as they depend on pay cheques to cover the health system financing.
Denis Eliasaph Bwana, the SRHR Officer at the Eastern Africa National Networks Of AIDS And Health Services Organisation (EANNASO) says that the withdrawal of funding will affect health programs in Africa and this calls for domestic health financing in Africa but an innovative approach.
“For example in Tanzania every litre of petrol bought there is a small amount of money that goes to infrastructure but not to the health sector. If this works for the roads and electricity financing, then it has to work for health,” Bwana said.
However, Bwana said that governments need to have an integrated health system where every health service is provided so that when you go for a malaria test, you can also have an HIV test and SRH services in one facility.
Rwanda is one of the countries that has taken in this threat as eminent and despite the funding gaps that will be dented into the health sector, Health Minister Dr. Sabin Nsanzimana says there are already existing planning for Rwanda to not totally depend on aid.
For example, Nsanzimana says that a five-day event could be reduced to three days to save money, and some short training programs can be held virtually using IT tools and there are plans to use traffic offense fines to increase local funding.
“Over-speeding in Rwanda will earn you a speed ticket but a good chunk of the fine will go to financing cancer treatment in the country,” Nsanzimana revealed at a AHAIC session on Bridging Disparities: Advancing Breast Cancer Care for African Women.
Dr. Githinji Gitahi, Group CEO of Amref Health Africa suggests that there is a need to shift the mindset from relying on external resources to safeguarding vulnerable populations.
“If we shift our mindset to say, ‘how do we protect the vulnerable communities that were the recipients of this promise,’ that should be our first step,”Gitahi said.