By Ammu Kannampilly, Jennifer Rigby and Victoire Mukenge
NAIROBI/LONDON/NYANGEZI, Democratic Republic of Congo, Oct 16 (Reuters) - The US government has struck a deal to continue supplying some of the world's poorest nations with free life-saving medication and equipment for mothers, infants and young children, after months of uncertainty and challenges with supply.
The UN children's agency UNICEF will now procure these items, a State department spokesperson told Reuters by email, without giving details
of the arrangement. UNICEF said the agreement is worth $25 million and will last for one year.
That sum represents only a small part of the aid affected by the Trump administration's cuts and dismantling of the US Agency for International Development (USAID).
But it means that some of the world's most vulnerable nations will not face another abrupt disruption to supplies they relied on while they work on new health aid deals with the US. Nine former US aid officials, NGOs and government officials told Reuters that this had been a real concern because the deal the now-defunct USAID had with its contractor was due to run out last month.
SHORTAGES
The agreement covers the procurement and delivery of maternal and child health supplies, as well as some nutrition supplies, to at least 15 countries previously covered, including Democratic Republic of Congo, Haiti and Mali, UNICEF said.
It follows almost 18 months of disruption after Washington's move to freeze and then scale back many US aid programmes as part of its "America First Global Health Strategy".
In countries such as Congo, shortages due to the disruption have already been showing up on the ground.
At the Nyangezi General Hospital in eastern Congo, health workers said they had run out of supplies of life-saving medications including oxytocin to prevent and treat post-partum haemorrhage and amoxicillin, an antibiotic for paediatric use and during childbirth.
"It was a donation we received (previously) from USAID, and at the moment, there is none," midwife Alice Bulambo told Reuters.
The main government-run warehouse in the area has faced stockouts for over a year, said Olivier Kabarati Amani, chief medical officer for Nyangezi health zone.
As a result, facilities are forced to buy medicines at market prices. Over the last six months, "the cost of care has doubled, if not tripled," Amani said, at a time when the healthcare system in eastern Congo is already struggling with Ebola.
The US State Department said it "has prioritized ensuring all life-saving commodities have continued to be made reliably available."
TRANSITION
Maternal and newborn health items amounted to less than 1% of the more than $5 billion spent by the USAID Global Health Supply Chain program between 2016 and 2023, according to the most recently available annual report. The spending was channelled through private contractor Chemonics.
Reuters first reported on plans to close this programme, which also managed the donation and delivery of supplies to tackle malaria and HIV, in April, with aid officials warning that the September 30 shutdown could cause shortages.
The plans to close the Chemonics supply chain are part of the broader US global health strategy, which aims to move countries towards self-reliance alongside scaled-back US support and reduced reliance on contractors.
The US has instead signed more than 30 bilateral deals on health aid with recipient countries, including Congo, which require co-financing from the countries and are worth billions of dollars in total.
But the details of the deals are still being worked out and it had been unclear what would fill the gap in the ordering procedure in the meantime.
While many nations were already moving towards taking over their maternal and child health needs, lead times for orders can be a year or more, five former USAID officials said.
The Congolese government aims to take over by next year, but has struggled with the recent uncertainty, said Polydor Kabila, coordinator of the universal healthcare programme in the president’s office.
Alongside the UNICEF deal, the US authorities have extended the deadline for Chemonics deliveries of some key malaria and HIV items, the State Department spokesperson told Reuters. The US has also signed a deal with the Global Fund to Fight AIDS, Tuberculosis and Malaria to allow countries to order new US-funded HIV and malaria supplies through the Fund's order platform.
In a statement, UNICEF said it would work with the US to "keep health and nutrition supplies moving so more children receive life-saving care," adding that no orders have yet been placed but are expected shortly.
(Reporting by Ammu Kannampilly in Nairobi, Jennifer Rigby in London and Victoire Mukenge in Nyangezi; editing by Philippa Fletcher)
