HIV, malaria treatment may suffer as US moves to cut aid

The United States’ interventions in the prevention and treatment of HIV/AIDS, malaria and other diseases in Nigeria may suffer as the US House of Representatives passed a fiscal year spending bill with provisions seeking to cut foreign assistance to Nigeria over alleged targeted violence against Christians and other vulnerable communities.

The fund cut may also affect humanitarian support such as emergency food aid and protection for displaced persons.

The House passed the fiscal year spending bill on July 15, with a provision requiring the US administration to certify that the Nigerian government is taking adequate steps to protect vulnerable religious communities and prosecute perpetrators of violence before certain categories of assistance can continue.

The development has drawn attention because the United States remains one of Nigeria’s largest bilateral development partners, providing billions of dollars in health, humanitarian, agricultural, education and security assistance.

According to the spending bill, assistance to the Nigerian government could be restricted unless specific conditions relating to accountability and protection of vulnerable groups are met.

The proposal followed sustained lobbying by some US lawmakers and faith-based advocacy organisations that have argued that American taxpayer-funded assistance should be tied to measurable improvements in religious freedom protections.

Although the bill has passed the House of Representatives, it remains part of the wider US appropriations process and still requires further legislative approval before becoming law.

Issues around Christian genocide

The allegation of “Christian genocide” has remained a contentious issue in discussions between Nigerian officials and some US advocacy groups.

Groups promoting the claim argue that Christians in parts of Nigeria face targeted attacks from extremist groups and armed militias. However, Nigerian authorities have consistently rejected the genocide label, maintaining that terrorism, banditry and communal violence affect both Muslims and Christians.

In an interview last year, the spokesperson of the Ministry of Foreign Affairs, Kimiebi Imomotimi Ebienfa, said Nigeria’s security challenges affected citizens across religious and ethnic lines and should not be characterised as a state-sponsored campaign against any faith group.

He said the government remained committed to protecting all Nigerians irrespective of religion or ethnicity.

The issue also featured in a series of engagements between Nigerian and US officials.

Discussions between Nigeria’s National Security Adviser, Malam Nuhu Ribadu and members of a US delegation began in October 2025. A follow-up meeting was held in Washington in December 2025.

The meetings focused on security cooperation, protection of vulnerable communities, counterterrorism efforts and concerns raised by some US lawmakers regarding religious violence in Nigeria.

Major US-supported programmes at risk

The United States has been a major financier of Nigeria’s public health sector for more than two decades.

Under the President’s Emergency Plan for AIDS Relief (PEPFAR), the US has invested more than $7 billion in Nigeria’s HIV response since 2003. Annual support has averaged between $500 million and $600 million in recent years.

The programme funds HIV testing, treatment, prevention, laboratory services, support for people living with HIV, healthcare worker training, community outreach, prevention of mother-to-child transmission, antiretroviral drug procurement and monitoring systems across the country.

Through the President’s Malaria Initiative, the US has provided more than $800 million to Nigeria since 2011.

The assistance covers insecticide-treated nets, antimalarial medicines, indoor spraying campaigns, malaria surveillance, diagnostic kits, treatment support and community-based malaria control programmes.

US funding also supports maternal and child health programmes, immunisation services, reproductive health interventions, child survival programmes, healthcare worker training and tuberculosis diagnosis and treatment initiatives nationwide.

The US has also provided more than $2 billion in humanitarian assistance to Nigeria since the escalation of the North-East crisis.

Programmes that could be affected include emergency food support for conflict-affected populations, protection services for women and children in IDP camps, shelter materials for displaced households and nutrition interventions for vulnerable communities.

The humanitarian assistance also includes food distribution, cash support for vulnerable households, treatment of acute malnutrition, emergency healthcare services, water and sanitation interventions, psychosocial support, child protection services and support for survivors of gender-based violence.

Support for smallholder farmers, climate-resilient agriculture projects, livelihood programmes, basic education initiatives, girls’ education projects and some security cooperation programmes could also face uncertainty if the proposed restrictions eventually become law.

The agricultural and livelihood support has included assistance for improved seeds, farming inputs, climate adaptation programmes, market access initiatives, farmer training and income-generating activities for vulnerable communities.

The US education-related support covers basic education projects, girls’ education initiatives, school rehabilitation, learning materials and community-based education programmes in affected areas.

Its security cooperation assistance includes counterterrorism training, intelligence-sharing support, civilian protection initiatives and capacity-building programmes for Nigerian security institutions.

The proposed restrictions, if retained in the final US appropriations package, would affect assistance programmes that have received billions of dollars in American funding over the years, including HIV treatment, malaria control, emergency food support, protection services for displaced persons, agricultural recovery initiatives, education programmes and selected security cooperation projects.

Previous US aid cut

Recall that President Donald Trump last year suspended the United States Agency for International Development (USAID), freezing funding of key health and humanitarian programmes, especially in developing countries.

Reacting to the development at the time, the Minister of Health and Social Welfare, Prof. Mohammed Ali Pate, assured that the federal government was addressing all funding and policy gaps to tackle the challenges in the healthcare system, especially in the face of the aid cut.

Prof Pate, while speaking at an interactive session with the House Committee on AIDS, Tuberculosis and Malaria, noted that though the US’ decision was sudden and reduced the various measures initially put in place by the federal government, it would make Nigeria look inwards.

“We appreciate the contribution of the US government, the billions of dollars of US government and the US people’s resources that help, but the responsibility to provide for the country is on us immediately.

“And that while we appreciate what has happened in the past, now we have to look at how we orient ourselves to improve and continue so that no Nigerian who is doing technical care will go without treatment for HIV, malaria or other conditions,” he had said.

Nigeria should call America’s bluff —Ex-diplomat

A former Nigerian diplomat, Ambassador Suleiman Dahiru, said the passage of a United States House of Representatives bill seeking to cut foreign assistance to Nigeria should serve as a wake-up call for the country to become more self-reliant.

Dahiru said Nigeria has sufficient human and material resources to sustain itself without depending on foreign aid if its resources are properly managed.

“Under normal circumstances, Nigeria should not even be asking America for aid. And if America should decide to withhold aid to Nigeria, let them withhold it. We have brought ourselves so low in Nigeria that America can talk to us anyhow. If we manage our resources well, and God has endowed us with resources, we don’t need America, we don’t need any country. We can manage ourselves very well,” he said.

The former envoy argued that Nigeria should not allow any country to dictate its internal affairs.

“Nigeria should agree to it. We have got to a state where we should call America’s bluff. We should not reward them with any reply. We should just ignore them,” he said.

Dahiru also dismissed the allegation of targeted killings of Christians in Nigeria, which formed part of the basis for the proposed restrictions.

“Bandits and people who don’t even know religion are the people involved in the killings. The Nigerian government should not be blamed for what some irresponsible people are doing,” he stated.

He also questioned the narrative being presented to the international community, noting that foreign embassies operating in Nigeria were capable of assessing the situation independently.

Dahiru further maintained that Nigeria’s relationship with the United States should be based on mutual respect rather than pressure.

“We want cooperation with all the rest of the world, but we should not accept dictation from any country, whether America or not. What we know in Nigeria is that some bandits and terrorists are terrorising the people of Nigeria, whether they are Muslims, Christians or people who do not believe in any religion. To tie what is happening in Nigeria only to the killing of Christians is most unfortunate,” he added.

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