Inlay

Sweden will phase out development aid to five countries - Zimbabwe, Tanzania, Mozambique, Liberia and Bolivia - in the coming years as Stockholm redirects resources toward Ukraine, the Swedish government announced on Friday. Minister for International Development Cooperation and Foreign Trade Benjamin Dousa said the shift was necessary to meet Sweden’s growing foreign-policy commitments. “Ukraine is Sweden’s most important foreign policy and aid policy priority and therefore the government is going to increase aid to Ukraine to at least $1.06 billion in 2026,” he said, adding pointedly: “There isn’t a secret printing press for banknotes for aid purposes and the money has to come from somewhere.” ADVERTISEMENT According to the government, the redirection of funding will free up more than 2 billion Swedish crowns over the next two years, resources that will be channelled into projects such as rebuilding Ukraine’s energy infrastructure. Sweden has already slashed aid to more than ten countries since the right-leaning coalition came to power in 2022 including reductions affecting Burkina Faso and Mali. Although Sweden remains a significant global donor, contributing roughly 56 billion crowns annually over the past three years, it plans to reduce that figure to 53 billion crowns per year for 2026–2028 while also shifting part of the aid budget toward immigration-related costs. A broader reckoning for African aid-dependent economies The announcement adds to mounting anxiety across African nations that rely heavily on foreign development support. ADVERTISEMENT For countries such as Zimbabwe, Tanzania and Mozambique - states grappling with weak fiscal buffers, high unemployment, and post-pandemic slowdowns, Sweden’s withdrawal comes at a time when global aid flows are already under strain. Many African governments now face a deepening funding gap as traditional donors rethink their priorities amid global conflicts, climate pressures and domestic political shifts. This trend mirrors broader realignments in donor countries, including the United States. Under President Donald Trump’s assertive “America First” development posture, Washington has increasingly pushed for aid programs that emphasise “self-reliance,” scaled-back funding envelopes, and tighter conditionalities. ADVERTISEMENT The recent restructuring of U.S. global health and development initiatives, including reduced engagement in several African states following the dismantling of USAID structures reflects the same pattern of shrinking external support for traditional beneficiaries.

Watch “Rovina’s Choice.” It was January, my final week in the outgoing Administration. In a few days, Donald Trump would be inaugurated as President. I had come to the United States Agency for International Development in early 2022, leaving my surgery practice and public-health research in Boston to lead the agency’s global-health efforts. Now I’d be returning to my previous life. I spent my last days at U.S.A.I.D. in meetings with our civil- and foreign-service leaders, thanking them. Their work with partner countries had helped to contain twenty-one outbreaks of deadly disease, sustain Ukraine’s health system after Russia’s invasion, combat H.I.V., tuberculosis, and polio, and reduce maternal and child deaths worldwide. On a budget of just twenty-four dollars per American—out of the fifteen thousand dollars in taxes paid per person last year—they had saved lives at an almost unimaginable scale. An independent, peer-reviewed analysis in The Lancet estimated that U.S.A.I.D. assistance had saved ninety-two million lives over two decades. Many of the leaders voiced trepidation about what the incoming Administration might bring, but I struck a sanguine note. U.S.A.I.D., I pointed out, had more than sixty years of solid bipartisan backing. Trump had advanced significant parts of the agency’s work in his first term. He had personally pledged to end H.I.V. as a public-health threat by 2030. The incoming Secretary of State, Marco Rubio, had been a vocal supporter of the bureau. There would be isolated partisan skirmishes—over diversity initiatives, abortion-related policies, and the like—but more than ninety-five per cent of our bureau’s work had never been under contention. Clearly, I lacked imagination. Within hours of being sworn in, President Trump signed an executive order for a “pause” to all foreign assistance. Secretary Rubio sent a cable suspending every program outright. No program staff could be paid. No services could be delivered. Medicines and food already on the shelves could not be used. No warning had been given to the governments that relied on them. It was immediately obvious that hundreds of thousands of people would die in the first year alone. But the Administration did not reconsider; it escalated. Elon Musk exulted in swinging his chainsaw. Within weeks and in defiance of legal mandates, he and Rubio purged U.S.A.I.D.’s staff, terminated more than four-fifths of its contracts, impounded its funds, and dismantled the agency. Neither Congress nor the Supreme Court did anything to stop it. We are now witnessing what the historian Richard Rhodes termed “public man-made death,” which, he observed, has been perhaps the most overlooked cause of mortality in the last century. Brooke Nichols, the Boston University epidemiologist and mathematical modeller, has maintained a respected tracker of current impact. The model is conservative, assuming, for example, that the State Department will fully sustain the programs that remain. As of November 5th, it estimated that U.S.A.I.D.’s dismantling has already caused the deaths of six hundred thousand people, two-thirds of them children. The toll is appalling and will continue to grow. But these losses will be harder to see than those of war. For one, they unfold slowly. When H.I.V. or tuberculosis goes untested, unprevented, or inadequately treated, months or years can pass before a person dies. The same is true for deaths from vaccine-preventable illnesses. Another difficulty is that the deaths are scattered. Suppose the sudden withdrawal of aid raises a country’s under-five death rate from three per cent to four per cent. That would be a one-third increase in deaths, but hard to appreciate simply by looking around. The Administration, for its part, has denied causing widespread harm, even as it has made the scale of the damage harder to measure—halting data monitoring and dismissing the inspectors general who might have documented it. This is common in cases of public man-made death. During Mao Zedong’s disastrous Great Leap Forward, from 1958 to 1961, the Chinese government released no accurate mortality data. Observers abroad understood that a hunger crisis was under way when China began importing grain, but the scale of the catastrophe was not known until the mid-nineteen-eighties, when the first reliable census allowed historians to calculate that between twenty-three and thirty million people had died. A fuller accounting of the fallout from U.S.A.I.D.’s shutdown will probably have to await analysis of the United Nations’ 2025 mortality statistics, which likely won’t appear until 2027. But there are other ways to glimpse the scale of the harm. With a documentary team that includes both American and local journalists, I have been following what has happened in Kenyan communities where U.S.A.I.D. had been active—in an advanced-H.I.V. ward in Nairobi, in primary health-care centers that had sharply reduced malaria, in a refugee camp, and elsewhere. We chose Kenya because I’d done a lot of work there during my tenure, and because it’s on a familiar path of development. Like India, South Korea, and many Latin American countries that the U.S. assisted to advance from low-income recipients of aid to higher-income trade partners, Kenya had reached the lower rung of middle-income status. The country had made dramatic leaps in health-system capacity and life expectancy with the help of a mixture of projects. U.S.A.I.D. supplied medicine, food, and staffing for some of the most desperate and vulnerable, while providing technical assistance and investment to accelerate the country’s expertise in needs ranging from H.I.V. control to primary care. I was especially worried about what would happen to the programs for childhood malnutrition, which, during the past two decades, had made extraordinary progress around the world. In place of a system that waited for emaciated children to reach distant hospital wards, often hours away, we had helped countries bring the front line to where they lived. A community health worker, carrying a tape measure and a scale, could detect danger early at home. A packet of peanut-paste therapeutic food could reverse starvation for the vast majority of severely malnourished children. Hospitals became a backstop for complications and for the frailest cases, while communities worked to strengthen local food sources. The method was simple, frequent, and close at hand: measure the upper arm, check for swelling, provide supplemental nutrition, watch for infection or decline, return the next week. The results were dramatic. Mortality rates for severe malnutrition, once twenty per cent or higher, fell below five per cent. In Kenya, communities we worked with, including refugee camps, saw death rates drop to under one per cent. The United States had played a central role in developing and manufacturing the formula for therapeutic supplements. U.S.A.I.D. then had helped UNICEF, the World Food Programme, local health systems, and other actors scale up the approach worldwide. Globally, under-five child mortality fell by more than half since 2000, in major part owing to the advances in malnutrition treatment, which saved more than a million lives in 2023 alone. Still, most of the world’s malnourished children lack access to these programs. But, instead of trying to close that gap, we are washing our hands of it and reversing the gains. In Kakuma, a vast refugee camp near the South Sudan border, starting in spring, our documentary team followed clinicians and families inside the stabilization unit at Clinic 7, where the sickest children come. Because of the termination of U.S. support, the World Food Programme’s supplies had been reduced to forty per cent of minimum needs, and cases of acute malnutrition had surged. Two-thirds of the clinic’s community health workers were laid off, hobbling the early-detection system that once saved most children before they needed acute care. Clinic 7 is where we met Rovina Naboi, who had fled South Sudan with her family. In our short film, she reveals what it was like trying to keep her desperately ill daughter, Jane Sunday, alive in a system that has broken down. There are valid criticisms of U.S.A.I.D. It sometimes fostered dependency. It could be inefficient. Too much of its funding went to international institutions, rather than to local ones. And its history includes episodes in which aid was bent to American military and political aims—in Vietnam, Iraq, Afghanistan, and elsewhere. Yet no other agency of the U.S. government has saved more lives per dollar. It helped move billions of people out of poverty. And it showed how to deliver results for all of humanity, including Americans, through coöperation, rather than coercion. The destruction of U.S.A.I.D. does nothing to improve this work. Instead, we have public man-made death. And the cruelty and lethality will only grow as the Administration expands its rollback of public-health advances to the homeland. We cannot let the people affected—health workers like those of Clinic 7, families like Rovina Naboi’s—go unseen. And we cannot let the consequences go unaccounted for.

Secretary Rubio, I have read your Substack post from 3 December 2025. From the outset, let me extend congratulations to the United States on assuming the G20 Presidency. We offer our sincere wishes for a successful term, one that we hope will serve the cause of global unity and inclusive progress. Substack Post by Secretary Rubio: America Welcomes a New G20 Follow us on WhatsApp | LinkedIn for the latest headlines Your words, however, compel me to speak, not merely as a representative of a government, but as a voice from a nation whose very existence is a testament to a profound truth: that the deepest divides can be bridged. Not through dictation, but through dialogue, not through power alone, but through unwavering principle, not through unilateral action but global solidarity. On the Nature of True Leadership South Africa is a founding member of the G20, no single member of the G20 has a unilateral right to exclude South Africa from the G20. You draw a contrast in our approaches to G20 leadership. Let us discuss that contrast honestly, guided by the wisdom that today’s adversary can indeed be tomorrow’s partner in peace. South Africa’s Presidency was built on a simple, powerful belief: that treating Africa and the Global South as equal partners and honestly addressing the systemic macroeconomic issues that impede their growth, is not an act of charity, but a strategic imperative for a stable, prosperous world. We reaffirmed multilateralism and the United Nations because our own liberation was won not in isolation, but through the solidarity of a global community that recognised a shared stake in justice. We understand, in our bones, that the world is an interconnected whole. The poverty, instability, or environmental distress in one corner of it does not remain there; it becomes a burden, or a crisis, for all. The success of our G20 Presidency was a result of the conducive environment for the free flow of ideas that South Africa has created. The people of South Africa created a hospitable environment in the true spirit of Ubuntu, which led to the South African G20 being a people’s G20, and many delegations attested to this in their public comments. For example, as our President Cyril Ramaphosa noted recently in a speech: • A German delegate is said to have commented: “I’ve attended summits on six continents. I’ve never experienced warmth like this.” • A Japanese delegate had this to say: “Your security guards smile while being vigilant. Your drivers share stories while navigating. Everyone, from the protocol officers to the coffee vendors, treats us like welcomed family, not foreign dignitaries.” • A French delegate shared something profound: “We came to discuss economic frameworks. But what we’ll remember is how your people made us feel. That’s not soft power, that’s real power.” World leaders, diplomats, delegates and observers have been sharing their impressions online as well. For example, the Prime Minister of India, Narendra Modi, said: “Thanks to the wonderful people of South Africa and the government of South Africa for organising the summit.” The Managing Director of the International Monetary Fund, Kristalina Georgieva, praised South Africa’s “incredible hospitality”. Germany’s Chancellor Friedrich Merz posted: “In a difficult international environment, it is important to preserve the G20 as a forum for global coordination – and to integrate Africa firmly. Thank you for your hospitality and ambitious presidency in these turbulent times.” The UN Development Programme’s South Africa Representative wrote: “South Africa delivered a G20 that showed the world what African leadership looks like – dignified, strategic and people centred.” It is a matter of public record that the United States chose not to attend our G20 meetings. Given that absence, the notion of our “sabotaging” consensus is not just incorrect, it misunderstands the very purpose of a forum like the G20. Our role as host was not to force agreement, but to create the conditions for it: a table of equals, governed by the spirit of Ubuntu. That spirit, “I am because we are”, is not a slogan. It is the philosophy that steered our nation away from the precipice of bloodshed and towards reconciliation. It is what led delegates from across the world to describe our gathering as a “people’s G20.” True leadership doesn’t mean everyone leaves getting everything they want; it means everyone leaves feeling they have been truly heard. On Our Sovereign Path of Healing You then turn to critique our domestic policies and by extension our national interest. Here, I must speak with clarity, for to misunderstand our journey is to misunderstand the enduring scars of inequality and the long road to healing. South Africa today is governed by a ten-party Government of National Unity not the ANC alone. Ours is a vibrant, contested, and living democracy a definitive repudiation of the tyranny of a single race that once ruled us. Our policies of redress are not a political invention. They are the fulfilment of a promise made to all South Africans as we emerged from the darkness of apartheid. That promise is enshrined in our Constitution, a document born from what many called a miracle of negotiation or to borrow from your Supreme Court Justice, the late Ruth Bader Ginsberg, the best Constitution in the world. Its Preamble is a vow to “heal the divisions of the past and establish a society based on democratic values, social justice and fundamental human rights.” The Constitution of South Africa enjoins us to transform our society for the better through the rule of law. Thirty years into our democracy, we are not a perfect society, and it is still not uncommon to meet a beneficiary of our transformative policies who is the first of their family, or even their community, to enter a particular profession. That is the living legacy of apartheid a systemic racial inequality that once permeated every walk of life and whose shadows we are still dispelling. Do not take my word for it. Listen to the words of our founding President, Nelson Mandela. In 1997, he stated: “If we are genuinely interested in ending the old social order and bringing in a new one, characterised by justice and equity… the economic power relations represented by the reality of the excessive concentration of power in a few white hands have to change. We make this demand… because we cannot see how it would be possible to pull our country out of an economic crisis… while we perpetuate this power structure.” And in 1995, he reminded us: “With freedom and democracy, came restoration of the right to land. And with it the opportunity to address the effects of centuries of dispossession and denial.” As you can see, in Madiba’s political imagination, reconciliation and redistribution, were two side of the same coin, not opposites nor mutual exclusive. This is the same Nelson Mandela who spent 27 years in prison for fighting that system of racial tyranny, and for much of that time, until the year 2008, his name remained on a United States official list as a “terrorist.” History, we have learned, often renders a different judgment. It reminds us that one nation’s “terrorist” can be another’s, and ultimately, the world’s, moral beacon. It teaches us profound humility in judging the complex, painful journeys of other nations toward justice. Our democratic journey is but 30 years young. It asks an immense task: to dismantle the entrenched architecture of over 300 years of colonialism and apartheid. No nation on earth has performed such radical surgery on itself overnight. We are building, brick by brick, the foundation of a new society. Yes, our economy has faced profound challenges. But new green shoots are emerging historic investments in a just green energy transition, a renewed and systemic fight against corruption, and the resilient determination of a people finally claiming their rightful place in their own land. Emerging from a challenging past, South Africa builds on this to ensure that living standards improve for all. South Africa’s growth performance has strengthened substantially since the end of Apartheid in 1994. For example, in 1994, South Africa’s GDP was R3.6 trillion (in constant 2023 prices), and by 2024, the size of our economy was R7.3 trillion. Indeed, like many countries, we had our domestic challenges, including State Capture, and we are rebuilding from that, but to suggest that our economy is a failure is an exaggeration. I must also state that, because of the democratic government, South Africans, as individuals, are, on average, 1.5 times better off, by monetary measure, than in 1994, the dawn of democracy. More importantly, when we measure using the Human Development Index, which combines health and education indicators, we have advanced from a Medium to a High HDI profile. Today, more than 95 per cent of households have access to electricity, and piped water now reaches close to 90 per cent of households. This was not the case in 1994, when access to basic services was structured along racial lines, with white South Africans given preference over all other groups. Consider this for a moment: in 1994, only 40 per cent of black South Africans had access to electricity, compared with virtually universal access for white households. This skewed picture has only changed because successive democratic administrations did not waver on redistribution. You also state that ” President Trump has rightly highlighted, the South African government’s appetite for racism and tolerance for violence against its Afrikaner citizens have become embedded as core domestic policies. It seems intent on enriching itself while the country’s economy limps along, all while South Africans are subject to violence, discrimination, and land confiscation without compensation.” This could not be further from the truth. In the farming sector you highlight, where Afrikaner farmers continue to dominate and power the country’s food security, along with other farmers, we have made progress. South Africa’s farming sector has more than doubled in value terms since 1994. It saw significant growth from 2000 onward under the democratic government. South Africa is now the only African country in the top 40 global agricultural exporters, and exports are reaching record levels, just under US$14 billion in 2024, and set to surpass this figure in 2025. No country with land grabs and invasion would reap such success. Indeed, we continue land reform through a just and equitable approach to ensure the farming sector is inclusive. We cannot have a farming sector where the majority of African farmers produce only 10% of the commercial output. But to build a shared prosperity environment, the South African government is utilising a market-based principle of land reform and securing property rights. To show that farmers are not threatened, the farming sentiment in the country remains robust, and commercial banks continue to invest in the agricultural sector. This is a show of confidence in our system. We must all appreciate that, given the history of racial discrimination in South Africa, which excluded black people from the mainstream economy and also excluded black people from critical economic areas, the inclusion programmes and prioritisation of Black people’s inclusion remain fundamental, transformation is a Constitutional imperative that the late Former President Mandela stood for. A Final Word of Shared Hope Secretary Rubio, the world is watching. It is growing weary of double standards. It is tired of lectures on democracy from those who seem to have forgotten that democracy, at its best, must listen as much as it speaks. We do not seek your approval for our path. Our path is our own, chosen by our people and guided by our sovereign laws. But we do seek, and we will always extend, a hand of respectful partnership. We believe in a world where nations can disagree yet still find common ground for the sake of a child’s health, a community’s stability, and our planet’s future. That is the world Madiba fought for. That is the world we, in South Africa, are still building every single day. In that spirit of shared humanity and clear-eyed hope, we remain open to dialogue, committed to maintaining our overall relations. Yours in mutual respect, Minister Ronald Lamola Minister of International Relations and Cooperation