PEPFAR Withdrawal: Blame Nigerian leaders and not Trump for the coming health crisis
Once again, Nigerians have taken to outrage, reacting with shock and anger to Donald Trump’s decision to suspend PEPFAR—the United States’ multi-billion-dollar HIV/AIDS relief programme. This knee-jerk reaction, however, is as shameful as it is hypocritical.
Why?
Because Nigeria, as rich as it is, has no business depending solely on foreign handouts to manage its public health crisis in the first place.
Nigeria’s annual health budget tells a disgraceful story. We consistently allocate a meagre portion of the national budget—just about 5%—to the healthcare sector. Despite signing the Abuja Declaration in 2001, which mandates African governments to allocate at least 15% of their budgets to health, Nigeria has failed to meet this commitment for over two decades.
If you think I am exaggerating, go and explore the public healthcare system and you will see how this gross underfunding is reflected in the crumbling hospitals, frequent drug shortages, and the dire doctor-to-patient ratio.
How then can we act blindsided when a pragmatic leader like Donald Trump decides that the USA will no longer foot our medical bills? Why is it surprising that he would rather put American taxpayers’ money into domestic issues rather than fund the failures of the Nigerian government?
The real scandal here is not Trump’s decision—it is Nigeria’s refusal to take responsibility for its citizens.
The Nigerian government’s track record with donor funds is abysmal. Transparency and accountability are foreign concepts to many of our public officials. Over the years, there have been numerous reports of corruption within agencies tasked with managing foreign aid.
From inflated contracts to outright embezzlement, millions of dollars meant for critical health interventions have vanished without a trace. Why should the US continue to bankroll a system that refuses to reform itself?
Trump’s withdrawal of $390 million in annual HIV/AIDS funding will undoubtedly have serious implications. Nigeria is home to approximately 1.8 million people living with HIV, many of whom rely on PEPFAR-funded medication.
The number of people living with HIV is also likely to increase with the fund withdrawal because PEPFAR also pays for medicines that minimize the risk of contracting HIV.
Experts say that patients whose infections are currently suppressed could see them flare in a matter of days to weeks without access to their drugs.
They could also be left vulnerable to other illnesses like tuberculosis and be more likely to spread the virus to others. Pregnant mothers with uncontrolled infections could pass HIV to their babies. All of these point to the fact that there is a medical crisis coming and we are not making the moves to prepare for this. Instead of holding our leaders accountable for failing to plan for this reality, we direct our outrage at a foreign president.
Perhaps the most damning indictment of Nigeria’s negligence is how heavily our HIV/AIDS response has relied on external donors.
Between 2004 and 2018, PEPFAR contributed nearly $6 billion to Nigeria’s HIV programmes.
As of 2024, international donors still fund over 90% of our HIV response efforts. These numbers are not just embarrassing; they highlight a national failure to prioritise healthcare for our people.
PEPFAR’s intervention was always meant to be a lifeline, not a permanent crutch.
But instead of gradually building our capacity, we became complacent. Year after year, the government failed to increase its funding, content to let foreign donors shoulder the burden.
Nigeria can no longer afford to be a nation that begs while sitting on vast resources. It is a disgrace that an oil-rich country must depend on external donors to keep its citizens alive. The uproar over Trump’s decision should serve as a wake-up call: our reliance on foreign aid is not just unsustainable—it is shameful.
Rather than whining about US policy, we should be demanding that our government allocates sufficient funds to health care. We should be fighting to end corruption in donor-funded programmes. We should be holding our leaders accountable for years of negligence.
The lesson here is clear: No country owes Nigeria a free pass. If we fail to fund our own future, we have only ourselves to blame. And if we continue to rely on foreign aid to keep our healthcare system afloat, then the real shame is not in Trump’s actions—it is in ours.
