Judith Murungi
PhD Student, University of Ottawa, Faculty of Law, Common Law Section.
ABSTRACT
The United States Agency for International Development (USAID) had been a leading contributor to Uganda’s health care and disease prevention and treatment responses. In this paper I analyze how dismantling USAID has had negative impacts on Uganda’s health financing and consequently, on global health security. However, it this crisis opens up an opportunity for Uganda to work towards more health resilient systems that do not need to rely heavily on foreign assistance. Uganda is still below the required 12% domestic resource allocation to health in its national budget as stipulated under the Abuja Declaration. I argue that although foreign assistance is good to the extent it helps build national capacity, it may also contribute to weakening individual country health systems structures if not used prudently.
Past a certain threshold, foreign assistance makes countries vulnerable to donor shifts as a result of over- dependence on donor funds. As a result, countries like Uganda are then more vulnerable to epidemics and disease outbreaks at a time when little or no financial aid is available to them by donors. The existing weak health structures make the situation even worse. Global health security is then jeopardized because there are greater risks of diseases being spread beyond the country’s borders and a looming possibility of eroding past gains. I argue that global health security heavily depends on how resilient a country’s health system is in the wake of an abrupt and substantial loss of funding, and Uganda’s priority should be strengthening its health systems in order to promote global health security.
The first section of this paper demonstrates the role played by the U.S. in Uganda’s Health Security. The second section discusses the impact of dismantling USAID on Uganda’s health security. Section three explores strengthening Uganda’s health security under the America First Global Health Strategy, and section four addresses leveraging remittances.
KEYWORDS
Health Financing, Global Health Security, Resilience, USAID, Remittances, Abuja Declaration.
REFERENCES
1)Addressing-Health-Financing-Challenges-in-Africa-Through-Domestic-Resource-Mobilization-and-Innovative-Financing-Mechanisms_7-April-2025.
2) African Union, Abuja Declaration on HIV and AIDS, Tuberculosis and Other Related Infectious Diseases, 2001., https://au.int/sites/default/files/pages/32894-file-2001-abuja-declaration.pdf.
3) Alaa Dafallah, Sophie Witter, & ReBUILD for Resilience Consortium, Diaspora as Partners: Strengthening Resilience of Health Systems and Communities amidst Aid Volatility, 10 BMJ GLOB. HEALTH e019622 (2025).
4) America First Global Health Strategy, https://www.state.gov/america-first-global-health-strategy
5) Angel N. Desai et al., The Global Public Health Imperative—Where Do We Go From Here? 8 JAMA NETW. OPEN e2517283 (2025)
6) Carolinah Nakibuule, East Africa: Uganda Advances Preparations for Innovative Diaspora-Backed Health Financing Pilot, https://allafrica.com/stories/202512030410.html.
7) Cheikh M Faye, Rethinking Global Health Resilience amid Donor Funding Cuts, 13 LANCET GLOB. HEALTH e1655 (2025).
8) C. M. Zikusooka et al., Is Health Care Financing in Uganda Equitable? 9 Suppl 2 AFR. HEALTH SCI. S52 (2009).
9) Damali Mukhaye & Busein Samilu, Makerere Halts Key Projects after Trump Orders, (Feb. 4, 2025), https://www.monitor.co.ug/uganda/news/national/makerere-halts-key-projects-after-trump-orders-4912396#google_vignette
10) Dave Burrows et al., Transitions from Donor Funding to Domestic Reliance for HIV Responses.
11) IDI’s Global Health Security Programme at a Glance, https://idi.mak.ac.ug/idis-global-health-security-programme-at-a-glance/#
12) Gloria Nambassa & Zuly Qodir, Addressing Corruption and Government Challenges: The Case of Uganda’s Strategic Developments Policies, 11 TRANSFORM. GLOB. 147 (2024).
13) John Musenze, US Aid Freeze Deals Blow to Uganda’s Health, Research, (Oct. 2, 2025), https://www.scidev.net/global/news/us-aid-freeze-deals-blow-to-ugandas-health-research .
14) K. Afsal & Rs. Reshmi, Diaspora Philanthropy: A Study of Diaspora-Funded Philanthropic Organizations’ Activities in the Health Sector of Kerala, India, GLOB. SOC. WELF. (2023), https://link.springer.com/10.1007/s40609-023-00288-5 .
15) Lisa Eckenwiler et al., Thinking through Abrupt Closure in Humanitarian Assistance: Key Ethical Considerations in Seemingly Impossible Conditions, 5 PLOS GLOB. PUBLIC HEALTH e0004656 (2025).
16) Ministry of Finance, Planning and Economic Development, Budget Speech Delivered at the 2nd Sitting of The 1st Meeting of The 5th Session of The 11th Parliament of Uganda : Thursday 12th June 2025, at Kololo Independence Grounds by Matia Kasaija (MP) Minister of Finance, Planning and Economic Development (2025) < https://ugbusiness.com/2025/06/economy/2025-2026-budget-matia-kasaijas-speech-in-full>
17) Mohammed Lamorde et al., Support for the Response to COVID-19 in Uganda: Contribution of the Global Health Security Program at Makerere University’s Infectious Diseases Institute, 22 AFR. HEALTH SCI. (2022), https://www.ajol.info/index.php/ahs/article/view/230598.
18) Reevaluating And Realigning United States Foreign Aid, https://www.whitehouse.gov/presidential-actions/2025/01/reevaluating-and-realigning-united-states-foreign-aid/.
19) Regional Workshop Brings Together African Countries to Advance Remittances and Diaspora Contributions to National Development, (Nov. 18, 2025), https://www.uneca.org/stories/regional-workshop-brings-together-african-countries-to-advance-remittances-and-diaspora.
20) Responding to the Health Financing Emergency Immediate Measures and Longer-Term Shifts – Conference Copy, https://cdn.who.int/media/docs/default-source/health-financing/responding-to-the-health-financing-emergency-conference-copy.pdf?sfvrsn=ff8988cb_3
21) The Turning Point, (Aug. 11, 2025),
22) U.S DEPARTMENT of STATE, Strengthening Health Ties with Uganda and Lesotho under the America First Global Health Strategy, (2025), https://www.state.gov/releases/office-of-the-spokesperson/2025/12/strengthening-health-ties-with-uganda-and-lesotho-under-the-america-first-global-health-strategy.
23) U.S. Department of State, Uganda,
24) U.S. Embassy in Uganda, U.S. Health Programs in Uganda: A Partnership That Saves Lives, https://ug.usembassy.gov/global-health/#:~:text=U.S.%20Health%20Programs%20in%20Uganda,and%20advancing%20health%20information%20systems.
25) Uganda National Health Compact (2025-2030)
26) U.S DEPARTMENT of STATE, Strengthening Health Ties with Uganda and Lesotho under the America First Global Health Strategy, (2025), https://www.state.gov/releases/office-of-the-spokesperson/2025/12/strengthening-health-ties-with-uganda-and-lesotho-under-the-america-first-global-health-strategy.
27) Olivier Uwishema et al., A Wake-Up Call: Can Africa Sustain HIV/AIDS Programs Without Foreign Aid? 8 HEALTH SCI. REP. e71248 (2025).
28) Uganda Vows Self-Reliance As U.S. Halts Aid Support, (Jan. 28, 2025), https://allafrica.com/stories/202501290053.html.
29) Regional Workshop Brings Together African Countries to Advance Remittances and Diaspora Contributions to National Development, (Nov. 18, 2025), https://www.uneca.org/stories/regional-workshop-brings-together-african-countries-to-advance-remittances-and-diaspora.
Cite this article
Murungi, J. (2026). Global Health Security in Jeopardy: How Dismantling USAID Weakens Uganda’s Global Health Security Architecture and How Remittances Might Be a Game Changer. INTERNATIONAL JOURNAL OF HEALTH & MEDICAL RESEARCH, 5(10), 1126-1133. https://doi.org/10.58806/ijhmr.2026.v5i10n16
