By Felix Oketcho
The United States Agency for International Development (USAID) has formally notified the Government of Uganda of the termination of a major health grant that has been supporting seven regional referral hospitals across the country.
In a letter dated April 28, 2025, addressed to the Ministers of Finance and Health, USAID announced it would end funding under the Regional Referral Hospital Strengthening Activities, citing directives from the U.S. Secretary of State following President Donald Trump’s recent Executive Order to realign U.S. foreign aid.
The termination, which takes effect on May 28, 2025, applies specifically to what is known as the G2G-IL 30 agreement and not the broader Development Objective Agreement (DOAG) signed in 2018. USAID clarified that the move is administrative and linked to a broader foreign policy shift rather than any breach by the Ugandan government.
According to the letter signed by USAID/Uganda Mission Director Daniele Nyirandutiye, the affected hospitals Mbarara, Jinja, Moroto, Mbale, Gulu, Lira, and Kabale must submit close-out plans and budgets by May 5, 2025, and final expenditure reports by June 15, 2025. The government will also be required to refund any unused USAID funds not allocated for valid pending expenses.
“USAID/Uganda wishes to emphasize that this termination only applies to G2G-IL 30 and not the DOAG,” the letter states, urging responsible ministries to avoid incurring new costs beyond what is necessary for the administrative closeout.
The U.S. agency also reminded Uganda that all property acquired through the grant except excess property would remain with the Government of Uganda and would not require a separate disposition plan.
While USAID acknowledged the strong partnership with Uganda’s health sector, it noted that the termination was necessary to comply with new U.S. policy directions. The letter leaves open the possibility that a Termination Agreement Officer may be appointed to oversee the closeout process.
The decision comes just three months after President Trump signed an Executive Order directing a review and realignment of all U.S. foreign aid programs. USAID cited clauses in both the 2018 DOAG and the 2022 Consolidated Implementation Letter that allow for such termination with a 30-day notice.
The Ministries of Finance and Health have until May 2, 2025, to acknowledge receipt and acceptance of the notice
