Health advocates from the US, Kenya and SA have sounded the alarm over the impacts of America’s foreign aid suspension, urging a US court to reconsider a ruling on the constitutionality of the funding block, with a reminder that once a malnourished infant dies, no restoration of funds can undo the loss.
Each day of suspended support compounds the toll: vaccination gaps fuel outbreaks, and shuttered clinics sever lifelines for survivors of violence and displacement, according to the court documents filed by several groups in an ongoing legal challenge to the suspension of nearly all foreign support and the dismantling of the US Agency for International Development (USAID).
The Cape Times reports that a three-judge panel of the US Court of Appeals recently overturned a lower court’s temporary block on the aid freeze, ruling that the case lacked a valid legal basis as currently presented. However, one judge dissented, cautioning that Trump’s actions may have violated constitutional principles.
In response, the organisations have urged the full court to rehear the case, arguing that the injunction should be reinstated to prevent further irreparable harm while the court fully addresses the legal and constitutional questions.
Among those filing a new amicus curiae brief are Physicians for Human Rights (PHR), the Open Society Justice Initiative (OSJI), health professionals and affected individuals from Kenya and South Africa, including renowned South African physician Dr Salim Abdool Karim.
The amicus brief draws on research and documentation of the emerging harms of the US aid cuts, including PHR’s recent research in Ethiopia, the DRC, and Kenya, plus insights from global health experts (Abdool Karim, FRS, Dr Dvora Joseph Davey) and a Kenyan woman (Mary “Doe”) raising a child living with HIV.
“Maternal-health programmes reaching 93m women and children have been cut by 92%; water and sanitation initiatives slashed by 86%; and vaccine programmes halted threatening 500 000 preventable deaths annually. The freeze has derailed USAID-funded HIV prevention trials, abandoning participants mid-study and raising the risk of drug-resistant HIV, which experts warn will be ‘catastrophic’ for global health. For amici, these projections are daily reality,” the PHR brief read.
In an example close to home, court papers cite research by Dr Dvora Joseph Davey who has led a study since 2003 on rolling out PrEP in eight maternity clinics across Cape Town. In 2024, only three babies in the study were born with HIV; in the first five months of 2025, there were already three.
“In Tigray, Ethiopia, health workers reported to amicus PHR that in one camp alone, eight internally displaced people, including a pregnant woman, died when USAID-supported care was cut off. In the DRC, clinicians have reported severe maternal cases, including uterine ruptures and deaths from unattended home births after the loss of USAID-supported services.”
Karim, chair of the Africa CDC’s Emergency Consultative Group, said he had witnessed the mpox vaccination programme grind to a halt overnight when USAID staff managing vaccine storage in the DRC were barred from releasing supplies locked in USAID storerooms.
“Several hundred new mpox cases are now reported each week in the DRC, with a death rate at more than 1%.”
Doe, whose 15-year-old daughter is HIV-positive, said the sudden withholding of aid meant it has become increasingly difficult to obtain the ARVs needed to treat her daughter’s infection, and that in in one Ugandan clinic, five of 20 babies delivered between mid-January and mid-April were born HIV positive, a devastating reversal after years of near elimination of mother-to-child transmission.
The health advocates further contend that “prevention is cheaper than response”, urging the court to grant rehearing en banc (full Bench) and preserve the district court’s injunction.
Cape Times PressReader article – Legal battle over US foreign aid cuts (Open access)
See more from MedicalBrief archives:
USAID cuts force HIV/TB services into business rescue
US policy could impact funding of hundreds of HIV organisations
Another 150 000 HIV infections possible by 2028 from aid cuts
SA scientists reel as US freezes research aid to ‘country of concern’