A new fund that aims to prevent 300,000 health-related avoidable deaths in Africa has been launched with the support of a coalition of global philanthropies that have stepped in to bridge the gap left by the withdrawal of United States Agency for International Development (USAID) programmes. With a joint commitment of nearly US$600 million, the Beginnings Fund aims to accelerate maternal and newborn survival in Africa by enhancing access to quality care for 34 million mothers and babies by 2030.
In a press statement released on April 29, the Beginnings Fund indicated that it plans to work in partnership with African governments, national organizations, and experts. Over the next five years, it will partner with up to 10 African countries: Ethiopia, Ghana, Kenya, Lesotho, Malawi, Nigeria, Rwanda, Tanzania, Uganda, and Zimbabwe.
"The Fund will partner with African countries to make targeted investments in the products, people, and systems required to improve and scale maternal and newborn health. These investments will advance maternal and newborn survival in high-burden hospitals, health centers, and referral networks, in which most maternal and newborn deaths – the majority of which are preventable – occur," stated the Fund, which is head-quartered in Nairobi, Kenya.
Alice Kang’ethe, CEO of the Beginnings Fund, noted that the project has been in development for at least a year, but its role has become more critical as governments worldwide, led by the US, reduce international aid.
In January 2025, President Donald Trump issued a 90-day pause on new foreign aid spending and issued a stop-work order for existing grants and contracts under USAID, pending a review of programmatic efficiencies and alignment with US foreign policy.
The repercussions for Africa are wide and deep. "Overnight, everything is gone," said Dr. Jean Kaseya, Africa Centre for Disease Control (CDC) Director General, stating that two to four million additional Africans are likely to die annually as a result of shock aid cuts by the United States and other key donors. He described the situation as a "disaster," revealing that some African countries rely on "external assistance" for 80% of their HIV and malaria responses.
According to Kaseya, 30% of Africa's health expenditure originates from official development assistance (ODA), which has seen a 70% cut this year, falling from $81 billion to $25 billion. USAID's withdrawal is particularly damaging in sub-Saharan Africa, where it has been instrumental in strengthening health care, education, and economic development. The cuts threaten to "reverse two decades of health achievements in maternal, child health and infectious diseases," with Kaseya warning that entire health systems "could collapse".
Specific devastating impacts are already being reported. The World Health Organization (WHO) reported that Kenya, Lesotho, South Sudan, Burkina Faso, and Nigeria would run out of antiretroviral medicine (ARV) for HIV within months due to USAID cuts.
In South Africa, the cutting of PEPFAR's $400 million a year for HIV programs risks patients defaulting on treatment, increased infection rates, and a rise in deaths. PEPFAR is a program credited with saving approximately 26 million lives globally. Some 15 million people in sub-Saharan Africa depended on PEPFAR-funded ARVs. UNAIDS estimates suggest that within months, at least 1 million people could face treatment disruptions, leading to tens of thousands of preventable deaths.
Beyond HIV, the impact on malaria is also significant. The US was the largest donor to the Global Fund to Fight AIDS, Tuberculosis, and Malaria, contributing over $1.5 billion annually, and its withdrawal jeopardizes efforts that have prevented 44 million malaria deaths since 2000. Africa bears approximately 95% of the global burden of malaria, and US funding provided essential tools like free mosquito nets, diagnostic tests, and treatments. There are concerns that programs could backslide, potentially leading to a 20% increase in malaria burden in some countries.
The abrupt aid cut has also disrupted infectious disease surveillance and response efforts. For instance, mpox testing dropped by 16% in the Democratic Republic of Congo (DRC) recently due to the loss of USAID funding for transporting samples to laboratories, exacerbated by conflict in the eastern DRC.
It is this challenging context that The Beginnings Fund steps in with the support of anchor donors such as The ELMA Foundation, Gates Foundation, Mohamed bin Zayed Foundation for Humanity, the Children’s Investment Fund Foundation, Delta Foundation and others.
Among the attendees at the launch ceremony of the fund was Ethiopia's Minister of Health, Dr. Mekdes Daba, who emphasized that mothers and newborns should not be dying from preventable causes and that building resilient, “well-resourced health systems is a shared responsibility,” Daba said.
WHO Director-General Dr. Tedros Adhanom Gebreyesus welcomed the fund's launch, noting that every seven seconds a mother or baby still dies a preventable death.
While philanthropy like the Beginnings Fund is crucial, experts also stress the need for African nations to prioritize regional collaboration, invest in local institutions, and explore diversified, sustainable financing options, including increased domestic funding and leveraging development finance institutions, to reduce heavy reliance on foreign aid.
The Africa CDC is already pursuing avenues like increased domestic funding, innovative financing, blended financing, and contributions from the diaspora.
