The U.S. government has reached an agreement to continue providing some of the world’s poorest countries with free, lifesaving medicines and medical equipment for mothers, infants and young children, following months of uncertainty and supply disruptions.
The U.N. Children’s Fund, or UNICEF, will procure the supplies, a State Department spokesperson told Reuters by email, without disclosing further details. UNICEF said the one-year agreement is worth $25 million.
The funding represents only a fraction of the assistance affected by the Trump administration’s aid cuts and dismantling of the U.S. Agency for International Development (USAID).
However, the deal should prevent another sudden interruption in supplies that some of the world’s most vulnerable countries depend on as they negotiate new health assistance agreements with Washington.
Nine former U.S. aid officials, nongovernmental organization representatives and government officials told Reuters that an interruption had been a significant concern because the existing contract between the now-defunct USAID and its supplier was due to expire last month.
Shortages
The agreement covers the procurement and delivery of maternal and child health supplies, as well as some nutrition supplies, to at least 15 countries previously covered by the program, including the Democratic Republic of the Congo, Haiti and Mali, UNICEF said.
It follows nearly 18 months of disruption after Washington moved to freeze and then scale back many U.S. aid programs as part of its “America First Global Health Strategy.”
In countries such as Congo, shortages resulting from the disruption have already emerged.
At Nyangezi General Hospital in eastern Congo, health workers said they had run out of lifesaving medications, including oxytocin, used to prevent and treat postpartum hemorrhage, and amoxicillin, an antibiotic used in pediatric care and during childbirth.
“It was a donation we received (previously) from USAID, and at the moment, there is none,” midwife Alice Bulambo told Reuters.
The main government-run warehouse in the area has experienced stockouts for more than a year, said Olivier Kabarati Amani, chief medical officer for the Nyangezi health zone.
As a result, health facilities have been forced to buy medicines at market prices. Over the past six months, “the cost of care has doubled, if not tripled,” Amani said, as the health care system in eastern Congo continues to struggle with Ebola.
The State Department said it “has prioritized ensuring all lifesaving commodities have continued to be made reliably available.”
Transition
Maternal and newborn health supplies accounted for less than 1% of the more than $5 billion spent by the USAID Global Health Supply Chain Program between 2016 and 2023, according to the most recently available annual report. The spending was channeled through private contractor Chemonics.
Reuters first reported plans to close the program, which also managed the donation and delivery of supplies to combat malaria and HIV, in April, with aid officials warning that the Sept. 30 shutdown could cause shortages.
The planned closure of the Chemonics supply chain program is part of the broader U.S. global health strategy, which aims to move countries toward self-reliance while scaling back U.S. support and reducing reliance on contractors.
The U.S. has instead signed more than 30 bilateral health aid agreements with recipient countries, including Congo. The agreements require countries to contribute funding and are worth billions of dollars combined.
However, the details of the agreements are still being worked out, and it had been unclear what would fill the gap in the ordering process in the meantime.
Although many countries were already moving toward taking responsibility for their maternal and child health needs, order lead times can reach a year or more, five former USAID officials said.
The Congolese government aims to take over by next year but has struggled with the recent uncertainty, said Polydor Kabila, coordinator of the universal health care program in the president’s office.
Alongside the UNICEF agreement, U.S. authorities have extended the deadline for Chemonics to deliver some key malaria and HIV supplies, the State Department spokesperson told Reuters. The U.S. has also signed an agreement with the Global Fund to Fight AIDS, Tuberculosis and Malaria that allows countries to order new U.S.-funded HIV and malaria supplies through the fund’s ordering platform.
In a statement, UNICEF said it would work with the U.S. to “keep health and nutrition supplies moving so more children receive lifesaving care.” The agency added that no orders had yet been placed but were expected shortly.