Last week, the Chinese government pledged a Ksh1.8 billion ($14 million) grant to Kenya, one of the biggest development assistance packages from Beijing in the recent years.

The deal signed by Treasury Cabinet Secretary John Mbadi and Chinese ambassador to Kenya Guo Haiyan is meant to upgrade five key hospitals across the country.

But the announcement was pivotal, coming at a time the US, Kenya’s main foreign aid donor, is cutting back on most of the money it used to give.

The Donald Trump administration has indicated it is truncating 5,341 contracts, initially provided mostly through USAid, worth some $75 billion. It greenlighted another 898 programmes worth $78 billion, although most of them will end within the next 11 months.

The decision which all but ends the existence of USAid, has policy experts warning of a bleak future. USAid spent $32.5 billion in Africa in the 2024 fiscal year, although, overall, the US sent some $41 billion to sub-Saharan Africa to fund humanitarian responses and programmes, such as health and climate initiatives.

Ethiopia was the top African recipient of USAid funding in 2023, with $1.37 billion, Somalia ($973 million) and DR Congo (943 million). Kenya received $436 million, with some of it going into refugee camps serving people from South Sudan and Somalia.

In Kenya, USAid had been the backbone of health services such as research and treatment of malaria, tuberculosis and HIV/Aids, and even bankrolled some nutritional programmes.

Now some of the programmes, such as HIV drugs, may be cut.

Some US politicians concede that a Chinese influence in future foreign aid will be inevitable.

Democrat Senators Jeanne Shaheen (New Hampshire), Ranking Member of the Senate Foreign Relations Committee, Chris Coons (Delaware), Cory Booker (New Jersey), Brian Schatz (Hawaii), Tammy Duckworth (Illinois) and Jacky Rosen (Nevada) argue that cutting down USAid would make it difficult for the US to counter China.

On March 14, 2025, the Democrats wrote to US Secretary of State Marco Rubio to provide answers to how the USAid cut will impact America’s interests.“For less than 1 percent of our annual budget, the US builds partnerships around the globe that diminish the threat of terrorism, the spread of disease and build peace,” Senator Shaheen said.“I am still waiting to hear why this administration does not consider programmes that have eradicated polio, cut malaria deaths in half and saved 25 million lives through HIV treatment to be ‘lifesaving.’ China alone will benefit from this decline in American global leadership.”Their worry was that trump had terminated vital US foreign assistance projects, including in countries where the Washington maintains military bases, and cut critical vaccine and global health projects around the world.

The State Department ignored them.

But US funding cuts don’t necessarily mean Beijing is jumping in. Some experts say China had already identified its niche.

Dr Adhere Cavince, a China-Africa scholar told The EastAfrican that US withdrawal obviously leaves a gap that is both inviting by also challenging.“Inviting because China can use the opportunity to strengthen its partnership with global South countries that heavily relied on US aid; challenging because China may not be keen to support the kind of programmes that the US did. They would instead double down on their competitive areas: Infrastructure development, trade, digital inclusion and capital development. They could also come in on the health front- supplies of medicines,” he said.

In Africa, China has constructed “friendship” offices for the African Union, the Economic Community of West Africa, Intergovernmental Authority on Development and parliament buildings for Zimbabwe and Cameroon.

The US funding cuts may mean China will pump more money in social programmes, but only where their influence is strong, the scholar argues.

Read: US vs China: Who’s fooling Africa?When Trump first suspended USAid, Kenya’s Prime Cabinet Secretary Musalia Mudavadi said that African countries will have to wean themselves of aid, fast.“The geopolitics and shifting global dynamics being witnessed is a clear indicator that we should be looking at ways of being self-reliant moving into the future. We cannot afford to prevaricate. Other countries are making moves. We must make ours now,” Mr Mudavadi said on the side-lines of a UN Human Rights Council meeting in Geneva on February 28.

He said Africans must learn quick decision-making, and build stronger partnerships with private sector.

Some observers, however, say African countries will first face the shock, and may even be stuck in it for lack of capacity.

Dr Angela Muvumba Sellström, senior researcher at the Nordic Africa Institute in Uppsala, Sweden, says the abrupt termination of US support for HIV/Aids management and mitigation, for example, will pose a wide range of problems to individuals, communities and countries.“Here are the consequences: Individuals off antiretroviral medications will see their viral loads increase, and, depending on how long they’ve been living with HIV (and on treatment), will become vulnerable to opportunistic infections. They will then have to rely on the public sector for health care, increasing the disease burden on the system. They will be out of work and unable to support their families,” she told The EastAfrican“This has a ripple effect on livelihoods and the functioning of society.”It means productive parts of the population, who have been kept healthy through subsidised medication, will be felled by sickness and public health systems will struggle to cope with new infections, she warned. Given the way Africa struggled to manage pandemics, in the past, the continent will face a burden that will drug more people into poverty.

According to her, it is not that African governments should not take responsibility for their populations. The current geopolitical and socio-economic conditions, however, are not built for them to do so because they have no money.“And even when the Chinese step in, the basic need in African health systems, she argued, is a sustainable supply of medical services. African states should find ways to build their own drug production capacity – and that takes time. And while hospitals built by the Chinese would be a help, what about the medicines to treat people in these hospitals?”One solution, she said, is for African countries may still need multilateral lenders that have leverage with private sector and deal with the growing debt in Africa through an emergency plan to forgive some of the debt so these countries can reroute their resources to health crises caused by funding cuts.

Abdisaid M. Ali, chair of the Lome Security Forum, said Africa’s next aid system should focus on strengthening government structures.“Foreign aid in Africa has been at an international bridge for the last six decades built on well-established western international aid structures and guarded by UN, international NGOs, and military institutions that have never ceded primacy to the host African governments. But the donors implemented their projects through parallel structures with the existing authorities which weakened most of these host governments,” he told The EastAfrican.“So, any non-traditional donors who could implement projects through the government entities would be considered as the most viable and effective partners.”

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