Despair as USAID Ends Funding for Uganda's Referral Hospitals Project

Uganda’s Minister of Finance, Matia Kasaija, and Minister of Health, Jane Ruth Aceng, have been officially asked to oversee the closing steps of a U.S.-funded project that supported seven regional referral hospitals in Uganda.

The United States Agency for International Development (USAID) announced in a letter dated April 28, 2025, that it will end its direct government-to-government (G2G) funding under the Regional Referral Hospitals project. The funding termination takes effect on May 28, 2025.

This decision comes after an Executive Order by President Donald Trump on January 20, 2025, which called for a full review and realignment of U.S. foreign aid. Following this directive, the U.S. Secretary of State provided new guidance leading USAID to end the hospital funding in line with shifting U.S. interests and priorities.

The terminated support refers to a specific agreement (G2G-IL 30) that was signed on August 30, 2022. USAID clarified that while this part is ending, the broader 2018 Development Objective Agreement (DOAG) with Uganda remains in place.

Hospitals in Mbarara, Jinja, Moroto, Mbale, Gulu, Lira, and Kabale were part of this project. They are now required to stop spending any new money under the agreement and submit a closeout plan with a budget to USAID by May 5, 2025. By June 15, 2025, all hospitals must also submit a report showing how they spent the funds.

If there is any unused money left, the Ugandan government will have to return it to USAID, unless it is set aside for pending bills. In case the funds are not enough to cover obligations made before the termination notice, hospitals are allowed to file a claim for the difference.

Ownership of items such as medical equipment, supplies, and other assets bought through the program will remain with the Ugandan government. A separate disposal plan is not needed, except for surplus property.

USAID reminded all hospitals involved that they must keep records related to the project for three years after the program ends. The U.S. government also reserves rights over any intellectual property developed under the agreement and may assign a Termination Agreement Officer to supervise the closeout.

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USAID/Uganda expressed its appreciation for the work done together with Uganda’s ministries and hoped that the partnership helped in strengthening the national health system.

The Ugandan government was asked to confirm that it received and agreed to the termination letter by May 2, 2025. USAID provided an official contact email for any follow-up questions.

Several key officials—including permanent secretaries, the accountant general, and referral hospital directors—were copied in the letter. Attachments included parts of the original agreement and clauses explaining the termination and suspension process.