The decision of the US Presidential Administration to suspend funding for the US Agency for International Development (USAID) for 90 days has become a serious challenge for many partner countries, including Ukraine. This decision was the result of a dispute in Congress, where serious disagreements between Republicans and Democrats over budgetary spending have emerged. The United States is a major international donor, and its assistance has a significant impact on the economies and social sectors of many countries.
After a six-week review, the United States officially cancelled 83% of USAID programmes. This decision has not only affected ongoing projects, but also called into question the future of a number of important US-supported initiatives.
It also has a direct impact on healthcare initiatives in Ukraine, which have been supported for years through international technical assistance. In particular, through USAID programmes aimed at improving the healthcare system. In recent years, this support has been key in providing diagnostics, prevention, treatment and social assistance to thousands of patients.
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Critical challenges in the fight against infectious diseases in Ukraine
Much of the diagnostics, treatment and prevention has been funded by international donors, including USAID and the Global Fund. Without stable funding, many programmes could be terminated or significantly reduced, putting the health and lives of thousands of people at risk.
According to the Centre for Public Health, in February 2025 alone, 646 new cases of HIV infection were officially registered in Ukraine, as well as 1009 people with tuberculosis. At the same time, 62 people died of AIDS-related diseases in the same month. These figures underscore the scale of the challenges facing Ukraine and demonstrate the critical need for funding to combat these diseases.
In total, as of October 2024, 147,599 people living with HIV were under medical supervision in healthcare facilities. According to official registration data, the highest HIV prevalence per 100,000 people was registered in Odesa (971.8), Dnipro (938.8), Mykolaiv (747.4) regions and in the city of Kyiv (631.0).
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Impact on Ukrainian healthcare programmes
Historically, Ukraine has relied heavily on international public health assistance. In particular, much of the funding for the fight against HIV/AIDS, tuberculosis and viral hepatitis was provided by the Global Fund and USAID.
The Ministry of Health of Ukraine, in response to a request from the Humanitarian Media Hub, confirmed that as of the beginning of 2025, USAID had funded a number of international technical assistance projects, including “Support to the Tuberculosis Response in Ukraine”, “Innovations to End the HIV Epidemic”, “REACH 95: Accessibility of Quality HIV Services in Healthcare Facilities in Ukraine”, as well as a number of programmes aimed at developing rehabilitation services, improving access to quality medicines, providing assistance to people affected by war, implementing healthcare reform and strengthening the public health system in general.
At the same time, the Ministry of Health noted that USAID does not fund viral hepatitis diagnosis and treatment services in Ukraine. However, consumables for confirmatory diagnostics are not procured by the state, which may pose risks to access to quality diagnostics.
“The procurement of medical devices, exclusively test kits for detecting markers of viral hepatitis B and C and medicines for the treatment of patients with HBV and HCV, is carried out at the expense of the state budget,” said Deputy Minister of Health Edem Adamanov.
For HIV, USAID covered the procurement of antiretroviral (ARV) drugs in 2025, drugs for pre-exposure prophylaxis, and rapid tests.
“HIV prevention services, care, and support services and medical products for prevention programmes in 2025 are procured at the expense of the Global Fund. In 2026, the procurement of ARVs, HIV prevention services, care, and support services is planned at the expense of the state budget, and drugs for pre-exposure prophylaxis — at the expense of the Global Fund,” the Ministry of Health said. The Ministry also confirms that in 2025 and 2026, tuberculosis treatment will be funded by the state budget and the Global Fund.
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The importance of funding
State healthcare programmes are funded mainly from the state budget of Ukraine, with the Medical Guarantee Programme remaining the main mechanism. However, the Ministry emphasises that it is actively negotiating with other international donors and organisations to attract additional resources:
“Efforts are aimed at developing cooperation with European partners, including the European Commission, EU member states, as well as relevant agencies and institutions,” they say. They also actively cooperate with the Global Fund, the World Bank, the WHO and other international organisations.
Despite the MoH’s efforts, the lack of a detailed plan to cover the funding gap remains a critical challenge. This is especially true for support for HIV/AIDS, tuberculosis and public health programmes.
“Currently, the Ministry of Health, together with the Public Health Centre of the Ministry of Health of Ukraine, is taking all necessary measures to ensure the continuity of HIV treatment despite the termination of USAID funding,” they said.
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What to do
The termination of USAID funding could have long-term consequences for Ukraine’s healthcare system. Patients who have been receiving life-saving treatment through international programmes will be most affected. The Ukrainian government needs to urgently develop a comprehensive plan to replace resources, as without a systematic approach, this situation could lead to a significant deterioration in public health and an increase in mortality from infectious diseases.
The Ministry of Health acknowledges the problem and assures that it is making efforts to address it, but the lack of a concrete action plan remains a critical challenge. At the same time, the question arises: will there be enough domestic resources and international support to avoid a healthcare crisis?
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