Cuts to US foreign aid are having a devastating impact on family planning programs in countries like Uganda, leaving health workers jobless and communities without access to vital reproductive health services. The decision, made despite congressional funding, is described as the largest disruption to international family planning efforts ever.

The Impact on Frontline Workers

Prossy Muyingo, a dedicated health worker in central Uganda, spent twelve years providing vital reproductive, maternal, and child health information and services to her community. She often provided discreet access to birth control pills for women fearing domestic violence, offering a safe haven for those seeking control over their reproductive health.

A Personal Story of Disruption

For years, a young woman would secretly visit Muyingo’s home each night to obtain and discreetly take birth control pills. Muyingo, as a community health worker in Mityana District, kept a supply of pills and HIV medication readily available. However, in September 2025, Muyingo’s position was eliminated due to the U.S. aid cuts, leaving her unable to directly provide contraception and relegated to informally counseling neighbors facing unintended pregnancies.

A Deliberate Policy Shift

This situation is indicative of a larger crisis unfolding in international family planning efforts. The current administration has actively sought to dismantle programs supporting contraception and related reproductive health services abroad, despite Congress having allocated funds for these initiatives.

State Department Stance

Secretary of State Marco Rubio explicitly stated there were no plans to spend the appropriated money, signaling a deliberate policy shift away from supporting global family planning. This change has been implemented with minimal public announcement, but is clearly reflected in budget documents and internal memos.

Decades of US Leadership at Risk

For decades, the United States has been the leading global contributor to international family planning, providing over 40% of all donor funding and impacting millions of lives. USAID prioritized family planning since its inception in 1961, and U.S. support has been instrumental in preventing unintended pregnancies and reducing maternal mortality rates.

Widespread Consequences

Estimates from the Reproductive Health Supplies Coalition indicate a massive funding shortfall in 2026, leading to the closure of rural clinics, the termination of community health workers and nurse midwives, and the withdrawal of technical expertise from health ministries. Shortages of essential contraceptives, including implants and pills, are becoming widespread.

Key Countries Affected

The impact is particularly severe in five key countries – Nigeria, Ethiopia, Uganda, Tanzania, and the Democratic Republic of Congo – where U.S. support was crucial. Muyingo and other former community health workers are now facing immense pressure from community members who are no longer able to access essential services.

The irony lies in the fact that the necessary funds have already been allocated by Congress, yet remain unspent. The State Department claims to be ‘evaluating’ family planning programs, but the administration’s long-standing opposition to international family planning is evident, dating back to shortly after inauguration. This policy shift threatens to reverse decades of progress in reproductive health and empower women globally.