In January, Donald Trump, the President of the United States, froze foreign aid immediately upon taking office, for 90 days. As a result, Africa is particularly set to suffer severe damage. ChosunBiz examines the impact of budget cuts and possible solutions in Malawi, one of the main beneficiaries of international organization foreign aid, while assessing the sustainable potential of Africa and diagnosing Africa's future.
I had a child who suffered from malaria. The body is burning hot like a fireball and shivering with chills, and unfortunately, it rained heavily during the rainy season. I ultimately could not go to the hospital, and the biggest concern is whether such a situation will occur again in the future since children can get sick at any time.
Tindai Gausi, 22, who is raising a 4-year-old, said with a weak smile. Gausi lives in Mulanje District in southern Malawi, about 75 km from the former capital, Blantyre. The area, more than three times the size of Seoul, has a population of just about 850,000. Although there are 164 scattered villages, there are only 23 medical facilities. The nearest hospital is about 11 km away, a roughly 2-hour walk, making it realistically difficult to take a child there.
On the 22nd, when the reporter visited Musa village in Mulanje District, residents gathered with lively faces as two ambulances and medical personnel arrived. The gathering place was an open building of about 10 pyeong. It had three windows and seven rows of cement chairs, but once a month, it transforms into the hospital for Musa village. Thanks to the professionals affiliated with public hospitals in Mulanje through the MOMENTUM program, a five-year support program by USAID, mobile clinic services have been provided monthly.
On that day, the medical personnel met the residents and greeted them warmly before quickly checking their health conditions. They checked the leg condition of an elderly man using crutches and placed a hand on the forehead of a baby clinging to a mother to check the temperature. With about 30 patients gathered, the hospital became quite busy.
MOMENTUM is a five-year health support program that started in 2022, in line with the development plan 'Malawi Vision 2063' set forth by the Malawi government. Operating under the name 'Tikweze Umoyo,' which means 'let's boost our health' in Chichewa, it has provided equipment and personnel to medically vulnerable areas across Malawi. Due to this program, over 8,000 newborns were born in a safe medical environment over the course of a year, and medical equipment and supplies worth more than $470,000 (approximately 653 million won) were distributed.
However, the situation changed rapidly with the disbandment of USAID in February. The MOMENTUM program was suddenly halted, and mobile clinics ceased operations. The area most affected is the Maternal and Newborn Health (MNH) project. Earlier, at the end of January, President Trump ordered a freeze on foreign aid and issued a 'limited exemption' for the MNH program, but from February, related projects were indiscriminately suspended, raising red flags locally. This is especially concerning as Malawi has one of the highest maternal mortality rates in the world (225 deaths per 100,000 live births, compared to an OECD average of 6) and a youth pregnancy rate of 31.5%, indicating a potential for even greater shock.
In Nsanje District near Mulanje, there were women worried about the suspension of medical support. During the flooding of the village by Cyclone Freddy in 2023, Annie Musa, 22, was a nine-month pregnant woman about to give birth. At that time, with support from the United Nations Population Fund (UNFPA), she could receive assistance for shelter, prenatal checks, and postnatal care, but as budget cuts became reality, medical diagnosis is now practically severed. Notably, Nsanje District is a low-lying area that repeatedly suffers from cyclones and flooding, placing an even heavier burden on Musa.
There are concerns that Malawi may revert to its pre-aid state due to these budget cuts. Approximately 58.6% of Malawi's health budget depends on international aid. In fact, since the 2010s, Malawi has steadily reduced maternal mortality, youth pregnancy rates, HIV infection rates, and instances of gender-based violence due to support from the international community. Particularly for maternal mortality rates, which had received intensive budget support, there has been a decline of over half compared to 517 deaths per 100,000 live births in 2010; however, with support ending before the infrastructure stabilized, continuing this trend is realistically impossible.
Flora Pandazola, the Director in charge of health budget, stated, "Now is a critical time for the international community to provide sustained and responsible support." He emphasized, "As donor countries lock their doors and national budgets remain insufficient, women in vulnerable areas are regressing to the past, and interest and solidarity are needed for countries like Malawi and others in Africa to pursue self-sufficiency and growth."