As health crises multiply by the day in Africa, the U.S. — the world’s biggest global health donor — has frozen foreign aid for 90 days. In the meantime, Uganda declared an Ebola outbreak in its capital, Kampala, on Thursday, which has killed one nurse. In Tanzania, the Marburg virus — similar to Ebola, but typically much deadlier — killed all the 10 people confirmed positive in an ongoing outbreak. In the Eastern part of the Democratic Republic of the Congo, an armed conflict could lead to the further spread of mpox, a rash-causing virus, which has already killed more than a thousand people, many of them children. And in Somalia, 10 clinics providing health services to women and children are on the brink of collapse, while more than 2,000 health workers face unemployment, Dr. Deqo Mohamed, an obstetrician in Somalia, told POLITICO’s Rory O’Neill. No news is bad news: A waiver for lifesaving humanitarian assistance, which Secretary of State Marco Rubio announced Tuesday, hasn’t provided on-the-ground guidance for organizations that stopped work due to the freeze. The State Department did not respond to a request for information about the guidance. Rubio told talk show host Megyn Kelly in an interview published Thursday that the waiver clarifies what the freeze applies to and that if U.S. foreign aid has paid for medicine sitting on shelves somewhere, it must be distributed. "We don’t want to see people die and the like,” he said. Fearing reprisal, aid organization leaders are afraid to publicly criticize the freeze or sue the Trump administration for stopping their grants or contracts, even as some stare down the potential closure of their organizations. Meanwhile, the U.S. Agency for International Development fired nearly 400 contractors in its global health bureau as a result of the funding freeze. Nearly 60 senior government officials at USAID have been put on paid administrative leave, leaving some wondering whether they’re next to be fired. Why it matters: The blanket stop-work orders put millions of lives at risk and create a vacuum that other countries — or even terrorist groups — could fill, an aid group senior executive, speaking anonymously for fear of reprisal from the Trump administration, told reporters Thursday. “I was shaking, to be honest with you, when there was this U.S. pause regarding the response in Tanzania,” said Dr. Jean Kaseya, director-general of the Africa Centres for Disease Control and Prevention. Without U.S. funding, the Africa CDC didn’t know how to respond to the outbreak, Kaseya told reporters Thursday, welcoming Rubio’s decision to exempt lifesaving aid from the freeze. What’s next: African leaders plan to meet in Ethiopia in mid-February to discuss sustainable financing for health in their countries, which could include looking at more domestic funding sources, Kaseya said. “As someone taught me, in one of the Western countries, we’re entering a new era where we’ll definitely see the decrease of foreign assistance to Africa,” Kaseya said. “It means ourselves as Africans, we need to take care and to take the ownership,” he added.
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