Gregory Rockson’s view
US President Donald Trump’s abrupt halt of foreign aid is a policy misstep with dire consequences for vulnerable populations: In many low-income countries, where up to 60% of health budgets rely on this aid, pulling the plug without warning risks the lives of millions.
However, while the humanitarian imperative to protect these communities is clear, we must also address the practical shortcomings of a model that has long fostered dependency.
The current framework of perpetual aid — without clearly defined sunset clauses — has inadvertently undermined the drive toward self-sufficiency in recipient nations. The Trump administration’s call for a wide-ranging review of foreign aid practices, and an eventual shift to local ownership of development is not without merit. Indefinite aid can stifle the incentive to invest in and build sustainable systems.
Consider Uganda as a case in point: In 2022, USAID announced a five-year, $38 million malaria control program with Kampala. Meanwhile, Uganda ramped up its annual military spending to $1 billion. With proper prioritization, the government could feasibly reallocate the approximately $8 million annual budget it has recently lost to maintain the anti-malaria program. This example illustrates that the challenge lies less in the scarcity of resources and more in the strategic allocation and long-term planning required for genuine self-reliance.
Given this context, recipient countries and aid-implementing partners must use the current review period wisely. It is time to craft detailed sustainability plans that not only safeguard current achievements but also lay the groundwork for a future where local communities drive their own development. Rather than lobbying for an indefinite continuation of aid, these plans should articulate a clear transition strategy. A two-to-three year extension period would allow governments and organizations to implement measurable, well-defined steps toward full local ownership, thereby avoiding the chaos of an immediate funding gap.
In my experience raising capital for mPharma, a pharmacy operator in 10 African countries, I have seen firsthand the value of linking investments to sustainability goals. Initiatives like mPharma’s QualityRx program have revitalized hundreds of pharmacies across Africa, created thousands of jobs, and significantly improved access to affordable primary care. This model proves that the benefits are substantial and far-reaching when commercial capital is channeled into social impact projects. If even a modest portion of the US aid budget were converted into equity investments or concessionary loans for innovative health care businesses, we could forge a far more resilient system that is less vulnerable to abrupt policy reversals.
The current stop-work order is a short-sighted decision that jeopardizes immediate welfare. We must balance the moral imperative to save lives with the need to foster genuine, long-term development. Transitioning from an unsustainable model of endless aid to a system that champions local enterprise and self-determination is not only desirable — it is essential.
In this moment of crisis, let us seize the opportunity to reform US foreign aid. By instituting a carefully managed transition period and integrating sustainable practices with strategic private investments, we can protect vulnerable populations today while setting the stage for a future of true, self-reliant development. This approach is both compassionate and pragmatic, ensuring that our global community moves toward a more equitable and sustainable future.
Gregory Rockson is the co-founder and CEO of mPharma, a primary care operator serving 1.4 million patients annually across 10 African countries.