Liberia’s Health Crisis: The Cost of USAID Withdrawal

By Darius Spearman (africanelements)

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A Deep Connection Severed: Liberia and U.S. Aid

The bond between Liberia and the United States runs deep, a connection forged in the early 1800s when freed slaves and free-born Black people from America established the West African nation. In fact, the capital city, Monrovia, bears the name of former U.S. President James Monroe, and the Liberian flag strikingly resembles the Star-Spangled Banner. This historical link has long been reinforced by substantial U.S. support, particularly through the United States Agency for International Development (USAID). However, this vital lifeline is now being abruptly cut, leaving Liberia and other African nations grappling with an uncertain future (Africanews).

The withdrawal of USAID funding presents a significant threat to Liberia’s health sector and its overall development. For instance, USAID funding accounted for an astonishing 2.6 percent of Liberia’s gross national income, marking the highest percentage among all countries globally (Africanews). This substantial contribution highlights Liberia’s profound reliance on external assistance. The deputy finance minister of Liberia, Dehpue Y. Zuo, responsible for drafting the development budget, acknowledged the U.S.’s right to make its own decisions. Nevertheless, he expressed a strong belief that there “should have been a transition” period for the aid withdrawal, emphasizing the sudden and disruptive nature of the cuts (Africanews).

Health Sector in Peril: A Looming Crisis

The abrupt withdrawal of USAID funding poses an immediate and severe threat to Liberia’s health sector. USAID funding alone constituted 48 percent of Liberia’s health budget, underpinning critical programs that served countless lives (Africanews). These programs included essential initiatives such as malaria control, maternal health services, HIV/AIDS treatment, and various community health programs. The funding also supported hundreds of health projects operated by numerous aid groups across the nation (Africanews).

The human cost of these cuts is already becoming painfully clear. Consider the story of Roseline Phay, a 32-year-old farmer from Sarworlor, a village accessible only by motorbike. Phay, who already had two daughters, sought contraceptives at the closest clinic in Palala because she was not ready for another child. Her younger daughter, Pauline, was only 18 months old and still breastfeeding. Now, Phay is approximately five months pregnant, unable to access prenatal care or scans (Africanews). Furthermore, when Pauline stopped breastfeeding, she became malnourished, a condition that could have been easily prevented with nutritional supplements previously provided by USAID (Africanews). Her plea for medicine echoes the desperation of many: “We are begging for medicine. If they bring it to Palala or Fhokoleh, even if it can’t come to the community, I will walk to Palala or Fhokoleh. But there’s no medicine” (Africanews).

USAID’s Contribution to Liberia’s Health Budget

The cessation of U.S. aid carries broader implications for women and girls across Africa, especially concerning access to essential health services. The end of U.S. aid is considered a “death threat” to women and girls in Africa, as many depend on free contraceptives and other health services provided by aid programs (context.news). Countries like South Sudan, the Democratic Republic of Congo, and Madagascar, which already face high maternal mortality rates, will likely experience catastrophic consequences from the withdrawal of funding (context.news). The fallout from aid cuts is already evident in Zimbabwe, where thousands of health workers were informed via WhatsApp to vacate work premises after President Trump’s executive orders took effect (context.news). A 29-year-old single mother in Zimbabwe, who worked for a USAID-funded organization providing sexual health services, was told not to report for work after the cuts (context.news).

The impact extends far beyond individual stories. Models predict that continued USAID funding cuts could lead to more than 14.1 million excess all-age deaths by 2030 (cidrap.umn.edu). This includes a staggering 4.5 million deaths in children younger than age 5 (cidrap.umn.edu). USAID funding has historically played a crucial role in reducing adult and child mortality across low-income and middle-income countries over the past two decades (hifa.org). The United States has been the backbone of health aid for decades, contributing nearly a third of all global health aid (healthpolicy-watch.news). Unless these abrupt funding cuts, announced and implemented in the first half of 2025, are reversed, a devastating number of avoidable deaths could occur by 2030 (cidrap.umn.edu).

Projected Global Deaths Due to USAID Funding Cuts by 2030

A Vulnerable Nation: Liberia’s Historical Context

Liberia’s history of conflict and existing challenges significantly exacerbate the impact of aid withdrawal. The nation endured a devastating 14-year civil war, which left the country in a profoundly vulnerable state (borgenproject.org). This prolonged period of instability crippled infrastructure, displaced populations, and eroded social structures, making recovery a long and arduous process. The scars of war are still visible, impacting every aspect of Liberian society.

Furthermore, corruption and government conflict are identified as major causes of poverty in Liberia, infiltrating many sectors of society (borgenproject.org). These systemic issues hinder effective governance and resource allocation, making it even more challenging for the country to absorb the shock of sudden aid cuts. Despite these challenges, Liberia has made progress in certain areas. For instance, the Liberia National Policy on Condoms was created in 2017 to prevent HIV/AIDS spread and increase safe sex awareness (borgenproject.org). Two-thirds of Liberians now have access to clean water sources, thanks to efforts by nonprofits like Water Aid and Waves for Water after the Ebola outbreak (borgenproject.org). The World Food Program USA provides monthly food support to approximately 30,000 refugees in Liberia’s three official refugee camps (wfpusa.org). Action Against Hunger (AAH) reached over 300,000 people in Liberia in 2019 through malnutrition screenings and treatment, and advocates for improved nutrition nationwide (borgenproject.org). The withdrawal of aid threatens to undo these hard-won gains, pushing the nation back into deeper crisis.

The Weight of Dependency: Liberia’s Aid Reliance

Liberia has historically relied heavily on international aid, and the sudden cessation of USAID funding starkly highlights this dependency. Between 2014 and 2023, Liberia received an average of $527.6 million in aid annually (Africanews). This year, Liberia was slated to receive $443 million, but the total estimated impact of the current cuts amounts to $290 million, representing funds that had not yet been disbursed (Africanews). This substantial reduction underscores the immediate financial void that Liberia must now contend with.

International aid organizations, including various UN agencies and major charities, are struggling to cope with the loss of more than $60 billion in U.S. funding (healthpolicy-watch.news). Crucially, none of these organizations are positioned to quickly replace USAID’s extensive operations or maintain the same reach to vulnerable populations (healthpolicy-watch.news). This reality makes the Liberian deputy finance minister’s call for a transition period even more poignant, as the existing global aid infrastructure is simply not equipped to absorb such a massive and sudden withdrawal of support. The absence of a planned transition leaves Liberia and other aid-dependent nations in a precarious position, scrambling to find solutions where none are readily available.

Liberia’s High Dependency on USAID Funding

Beyond Health: Broader Societal Impacts

While the health sector faces the most immediate and devastating consequences, USAID funding impacted nearly every facet of Liberian society. For example, USAID funding was instrumental in building schools and health clinics, providing training for teachers and doctors, and offering scholarships for study in the U.S. (Africanews). It also supported small-scale farmers and covered the cost of school meals, demonstrating its pervasive influence on daily life and long-term development (Africanews).

Morris Wamah, the director of the Liberian Initiative for Developmental Services, previously worked on implementing USAID programs focused on land ownership. He emphasized that his work was seen as a vital peacekeeping effort, especially since conflicts over land have erupted following Liberia’s civil war (Africanews). Wamah echoed the deputy finance minister’s contention that the funding cut should have been implemented gradually, allowing Liberia to build its own capacities. His stark warning encapsulates the widespread fear: “I can just imagine, if the way USAID pulled out, if WHO pulls out and maybe the World Bank too pulls out, Liberia is going to collapse” (Africanews). This sentiment highlights the profound vulnerability of a nation that has relied so heavily on external support for its foundational services and stability.

Charting a New Path: Towards Self-Reliance

The current crisis forces Liberia to confront its deep dependency on foreign aid and consider alternative paths toward sustainable development. While the immediate void left by USAID is immense, the situation underscores the urgent need for Liberia to strengthen its internal capacities and explore diverse funding mechanisms. One critical area for consideration involves addressing systemic issues that divert potential domestic resources.

The problem extends beyond mere aid cuts; corporations and the ultra-wealthy continue to dodge taxes that could otherwise fund essential public services (publicservices.international). Therefore, fighting for tax justice and advocating for debt forgiveness are essential steps toward achieving sustainable development worldwide (publicservices.international). For Liberia, this means not only seeking new international partners but also rigorously pursuing domestic revenue generation and ensuring that existing resources are managed transparently and effectively. The path to true self-reliance will be challenging, but it is a necessary journey for Liberia to secure a stable and prosperous future for its people.

ABOUT THE AUTHOR

Darius Spearman has been a professor of Black Studies at San Diego City College since 2007. He is the author of several books, including Between The Color Lines: A History of African Americans on the California Frontier Through 1890. You can visit Darius online at africanelements.org.