The soil beneath Oumarou Compaoré’s boots is sandy and stony. It’s hardly the lush setting usually needed to support growing pineapples. But this farm in landlocked Burkina Faso is part of national efforts to reduce overall reliance on imports and adapt to an ever-harsher climate in the dry heat of Africa’s Sahel region.

Pineapples have long been seen as exotic fruit grown by richer coastal neighbors, and more expensive than the mangoes that grow outside many Burkinabe homes.

“People told us that here we could only grow cotton, maize or sorghum,” Compaoré said at the farm he founded in 2018 outside the western city of Bobo-Dioulasso, where he drives around in a van with an inscription that reads, “Pioneer in pineapple production in the Sahel.”

His pineapple initiative, inspired in part by border closures during the COVID-19 pandemic, is one of the more unusual projects challenging the idea that people in Burkina Faso must rely on neighbors for much of what they eat.

“Because the fruit was in short supply, we were able to sell it easily,” said Compaoré, who also had been growing papayas with little profit. Now his pineapple field has grown to about 50 hectares (124 acres).

The country’s military leaders have taken note. Their economic growth plan is tied heavily to agriculture. Pineapples are now part of the government’s formal development plan as it seeks to boost food self-sufficiency for the country of 24 million people.

While there are no available government data on pineapple production, farmers say more of them are venturing into it.

As of November, pineapple fields had expanded to around 100 hectares (248 acres) in the administrative region that includes Compaoré’s farm, the regional director of agriculture, Adanabou Eric Pascal, told local media at the time.

Kola Jean, the agricultural engineer at Compaoré’s farm who helps to train others on pineapple farming, estimated that over 100 farmers are now getting into production.

Food production is called a sovereignty issue

Under Capt. Ibrahim Traoré, who took power after a coup in 2022, Burkina Faso has presented food production as a sovereignty issue. It suspended rice imports in April this year with a stated goal of facilitating local production. It inaugurated two factories for tomato paste, a local staple, in 2024.

And at a major supermarket in the capital, Ouagadougou, there is a section dedicated to locally grown food — like shea butter, corn and cassava flour and drinks like mango juice — labeled, “Let’s consume what we produce.”

All are steps toward shaking off the dependence on imports that for decades has exposed millions of people to shifting transport costs and other price shocks.

Hunger remains widespread. A decadelong security crisis that has left jihadis in control of large swathes of territory has disrupted access to farmland and markets. Many people have been displaced. U.N. agencies have said some 2.7 million people face acute food insecurity during the annual lean season when stocks from the previous harvest run low and market prices peak.

Other farmers are being inspired

Mdme Kaba Séré, a pineapple farmer in Houet Province, said she used to work in the nonprofit sector but switched to farming in 2023 following international aid cuts.

She recalled being told at a young age that pineapples cannot grow in the Sahel, the dry strip of land south of the Sahara. Then she was trained on pineapple cultivation by Compaoré. “We saw what Oumarou was doing and thought: It is possible, why not?” said Séré, who has expanded her farm to about 60,000 seedlings.

“With pineapple, there is profit,” she said. “It has impacted my entire family because thanks to this I have been able to support them.” Because pineapples had long been seen as rare in Burkina Faso, farmers say the business is lucrative because it’s easy to find buyers even before the fruit hits the market.

But hurdles include investments in everything from fertilizer to irrigation and reliable transport. Pineapples require a lengthy growing period of up to two years, plus reliable access to water. Compaoré said he irrigates part of his land from a well, but digging wells is an investment many farmers cannot afford.

The climate can be problematic, too. Farmers are finding ways to adapt, including by irrigating with cool water in the evening during intense heat, said Pascal Bazongo, a professor of soil science and natural resource management at Burkina Faso’s University of Fada N’Gourma and an expert involved with Compaoré’s farm.

Compaoré is upbeat about future innovations and better yields. On recently acquired plots, about 30 workers moved through the field as music played from a loudspeaker. Their goal that day, he said, was to plant roughly 60,000 pineapple seedlings.

He expects the new fields to produce between 60 and 75 metric tons (66-83 tons) of pineapples, with a projected revenue of about 35 million CFA francs, or roughly $62,000. “We could even make the country self-sufficient in this fruit,” he said.

AP

BEL TREW

The muted beeps of the neonatal intensive care unit are drowned out by a sudden scramble of sound. A bundle is rushed into the corridor of this hospital in the Central African Republic (CAR) with a gaggle of people in its wake.

Under the swaddle of cloth is a newborn baby girl, eyes closed, her chest heaving with tortured, syncopated breaths.

Nurses quickly connect the baby up to a confusion of monitors, tubes and drips. A roar of a ventilator kicks in. The baby’s grandmother looks on anxiously.

Emmaus Johann, the doctor and seventh-year medical student, looks grimly at the statistics on the monitor. They have tried intubation, ventilation and now CPR. Blood is seeping onto the blanket. The newborn’s face goes grey. Her tiny body gives in.

“There was no ambulance. The only ambulance had taken a different child. There is nothing else out there,” the doctor says as the baby’s grandmother shatters into sobs in the background.

“They came just like that… by motorbike,” he continues, trailing off.

This is the only dedicated pediatric hospital in the whole of the CAR, a small landlocked country of five million people that suffers from some of the highest maternal and early infant mortality rates in the world.

This little girl has been brought in from a rural area 10km outside the capital. After a difficult labor, she was struggling with birth asphyxia. She had been on this Earth for about two hours and had spent almost all of it on the back of a speeding motorcycle in the desperate rush to get here.

“There’s a lack of equipment and care. There should be a neonatology service out there. But there isn’t one,” Dr Johann continues. “If the baby comes to us this late without oxygen, we cannot resuscitate her; it’s part of our daily routine,” he adds quietly.

And the fear is this horrific situation is only going to get worse. For centuries, giving birth was one of the most dangerous conditions a woman could go through: mothers and their babies died regularly in childbirth.

But over the last 25 years, that changed. Combined global efforts saw maternal mortality plunge by 40 per cent. Until now.

Now, the United Nations, aid agencies and humanitarian organizations are all sounding the alarm that progress is stalling, and in some cases reversing, across the world, including even in the UK.

The biggest factor is unprecedented aid cuts, first triggered by Donald Trump’s gutting of USAID in 2025, followed by European countries, including the UK, channeling foreign aid into defense. Compounding the crisis is an unprecedented level of conflict worldwide.

Researchers say that 2025 saw the highest number of conflicts between states since World War II, and the highest number of fatalities recorded since the Rwandan genocide. Although there is no aggregated global data since aid cuts were introduced last year, the signs are grim.

In the CAR, not only does it struggle with some of the highest maternal and infant mortality rates in the world and its own internal conflict, it is now dealing with an influx of refugees from neighboring war-ravaged Sudan.

Women in the CAR are 60 times more likely to die in pregnancy or childbirth than in the United Kingdom, according to the United Nations’ latest data. For every 100,000 births in the country, 829 women die.

At the only pediatric hospital in the country, Dr Kango Semplice, head of the emergency department, says this is translating into deaths. “The cuts were sudden. The country had just been getting back on its feet after conflict.

“We’ve had no funding since last year. With the little money that we have, we are targeting children that can be treated free of charge. I can assure you there will be deaths, both among babies and their mothers.”

Among the projects slashed were programs led by the United Nations Population Fund (UNFPA), which lost $3m in funding alone.

New data shows 11 million people have lost access to their essential sexual and reproductive health and protection services. Almost 1,100 health facilities and mobile clinics were forced to close, while an additional 727 facilities were disrupted, operating with reduced staff, limited hours or shortages of medicines and supplies.

Almost 6,000 health service providers lost their jobs, including frontline health workers and midwives. “When services get shut down, when maternity wards close, the mortality rate rises. It’s as simple as that,” explains Monica Ferro, head of UNFPA in London.

“That will mean that they will have no skilled birth attendants. They will have no access to medicines to treat the most preventable causes of maternal death. “This is completely unacceptable. No woman should die of childbirth, giving life.”

Conflict, climate change, and the weight of external debt are preventing countries like the CAR from becoming less dependent on external help, she continues.

“This is the perfect storm gathering. You have more people moving, more people in need and health systems that are stretched to the limit with less funding.”

In Birao, located just 60km from the Sudanese border, families are camping in the courtyard of the city’s hospital, which only has 60 beds, covering a local and refugee influx of more than 40,000 people. Many of them are pregnant mothers and their children, piling pressure on the already inadequate medical centers.

At the maternity ward, eight of the 12 medics lost their jobs following aid cuts over the last year, including all four midwives.

Delphine Zanaba, an assistant nurse, manages hundreds of consultations alone, at a time when the number of pregnant women coming every day has increased threefold.

She tries to comfort Amna, 37, a mother-of-six, who is screaming in agony just hours after losing her baby at nine months, and nearly bleeding to death herself.

Zanaba says she came in this morning with malaria, and her baby was breech and stillborn – both of which could have been prevented.

“The pregnancy hadn’t been monitored at all; this is a recurring problem. They don’t come for a single consultation for the entire pregnancy, not even one.”

Her niece, Radiya, 24, who fled slaughter at the hands of militants in Darfur with her on foot last year, says Amna would have had pre-natal consultations and been treated if the mobile clinics in the nearby refugee camp where they live had not closed.

“She keeps asking for her mother and saying she doesn’t want to live any more,” she adds in distress. “There used to be many more midwives… If this was available, the baby would have survived.”

Outside the ward, the hospital’s lead doctor, Ngonzo Lezin, explains they are the only hospital in a 20km radius. Since the massive reduction in aid, women have to pay for their care and so are not coming in anymore.

“Women are forced to give birth at home, in the camps. The numbers of deaths will increase, both mothers and children. It will be distressing not just for Birao but for the country.”

In the nearby refugee camp, a mobile clinic and safe space supported by UNFPA used to provide medical care, pre- and post-natal care and hospital transport for pregnant women. It was one of four such spaces in Birao serving thousands of women. Those have closed without US funding, along with two US-backed health facilities.

UNFPA’s program officer, Marie-Justine Mamba-Ibingui, shows off what are now just piles of rubble. “The women bitterly regretted the closure of the site here. And for me, too, it is bitter to see women taking risks when they want to give life. It’s heartbreaking,” she adds.

Mothers, who are waiting by what was the center, recount their horror stories. There, Busayna, 25, a mother-of-five who gave birth seven months ago, nearly died after she had to walk miles mid-labor to the hospital because there were no longer services in the camp.

Busayna’s husband was murdered by militants as they fled on a donkey from El Fasher, where human rights experts believe a genocide has taken place. En route, armed groups tried to rape the women, and when their husbands intervened, killed all the men.

“I’m just too exhausted, there are so many troubles. My husband is dead and we ended up on the street.” “When it was time for me to give birth, I had to walk to the hospital. They told me there was no transportation available at night, so I went on foot.

There was no aftercare. I gave birth that same night and left immediately.” This is playing out all over the world. In primary healthcare facilities in Nigeria’s restive northern states, mothers in the waiting rooms recount similar stories.

Nigeria has long been the worst place to give birth on earth. The country accounts for well over a quarter, or 29 per cent, of all estimated maternal deaths worldwide. In 2023, there were 75,000 maternal deaths, one death every seven minutes.

Part of the issue is the lack of doctors. In Nigeria, there is only one doctor to 9,000 patients; in the UK, that ratio is one to around 1,700. That means primary healthcare centers, staffed by nurses and midwives, are often the first and only port of call for pregnant women, despite having almost no supplies.

Blessing’s sister died, as did her baby, after three grueling days in labor, because the family didn’t have the money to take her to hospital. When Blessing was pregnant with twins and showing all the signs of deadly pre-eclampsia, she was terrified she might follow the same fate.

“It was not easy for me; I was very scared. I had a seizure, I even collapsed. They said they needed to operate on me, and I started crying because I know that my husband cannot afford the money,” she continues, explaining the hospital bills were the equivalent of two years’ salary.

Family and friends started frantically crowdsourcing the funds. “I thank God for my life and that my babies survived.”

The facility manager of this center in Adamawa state in northeast Nigeria, Simka Zamani, says the biggest issue is that they sometimes only get 30 minutes of power a day.

They also lack drugs and staff to help with the influx of women who only attend these centers because they can’t afford hospital bills. This center used to be supported by NGOs who helped purchase essential drugs and equipment for the most underprivileged women, but that has all gone in the last year.

Similar concerns are voiced at a second primary health center. There, the handful of women in the waiting room had lost 15 babies between them. Asina lost her baby just two days before.

Hawwa, 40, who is pregnant with her 13th child, said six of her babies have died in childbirth, and she has got to the point where she dreads being pregnant, but a lack of funding means she has no access to family planning.

“It is very traumatizing because where you give birth to a child and they survive, I fear the next one will die. I always fear the one I’m carrying will die,” she continues.

Nigerian health officials, like the doctors in CAR, fear that the situation will only get worse as funding cuts and conflict bite. Nigerian security forces have been battling a 12-year insurgency in the restive north of the country, as Boko Haram militants morph into multiple groups, including the so-called Islamic State.

The situation has got so bad that Donald Trump authorized multiple bombing raids on Nigeria at the end of 2025 and into this year.

“The cessation of the US funding was so abrupt, short notice, there was no adequate window for transition,” says Dr Sulaiman Saidu Bashir, executive chairman of Adamawa State Primary Healthcare Department. “And if we don’t address this problem here, it may spill over to other places, and it contributes to a global burden.”

Back in the CAR, nurse Zanaba is working her way through dozens of women in a makeshift waiting room. Most of them are refugees with terrifying stories of escaping drone strikes and slaughter.

“No woman should unnecessarily die in birth; we must stop this. I didn’t want to lose a mother. I don’t want to lose a mother. No more maternal deaths. It must stop now.”

The Independent

A new wave of African withdrawals has swept through the International Criminal Court. Chad turned its back on the court after three junta-led states in the Sahel exited. But most African countries still trust The Hague.

The establishment of the International Criminal Court (ICC) in 2002 was seen as a breakthrough in the global fight against war crimes, genocide, and crimes against humanity.

Yet criticism from parts of Africa is almost as old as the ICC itself: Time and again, the court has been accused of targeting Africa in a one-sided manner. Recently, this criticism has grown louder again — and culminated in a veritable wave of withdrawals.

At the end of July, Chad also announced its withdrawal from the court in The Hague: The government stated that the ICC’s effectiveness was “limited and unbalanced.”

In September 2025, Mali, Burkina Faso, and Niger initiated their withdrawal from the ICC, accusing it of being a neocolonialist tool of the West. The withdrawals officially take effect one year after they are announced.

At the same time, the ICC is at the center of a scandal: Its members have voted to remove Chief Prosecutor Karim Khan amid allegations of sexual misconduct. Khan has denied wrongdoing.

Justice: Withdrawal or accountability?

The wave of withdrawals from the ICC is cause for concern, says Attila Kisla, head of the International Justice Group at the Southern Africa Litigation Center in Johannesburg. Especially since some of these countries cited an alleged bias against Africa among the reasons.

“It is important to remember, however, that many of the proceedings — particularly in the early stages — were based on voluntary referrals by African countries seeking the court’s assistance,” Kisla told DW.

In 1998, Senegal became the first country to sign the Rome Statute, the international treaty that established the ICC in 2002. Today, 125 countries are parties to the statute. Of these, 33 are African states, representing about 60% of the continent.

The ICC aims to prosecute the most serious crimes under international law and operates according to the so-called principle of complementarity: It can only take action when states are unwilling or unable to prosecute certain crimes themselves.

However, according to Kisla, the fact that there have been no significant proceedings against individuals from powerful states or Western countries has not helped the court’s image.

The US itself is not a member of the court but its citizens could be prosecuted if they are accused of crimes committed on the territory of member states.

Furthermore, one must not ignore the current global political climate: “These withdrawals are taking place at a time when the US has openly declared its intention to dissolve the ICC and is exerting unprecedented pressure on the court and its supporters,” said Kisla.

The ICC has also issued arrest warrants for Vladimir Putin and Benjamin Netanyahu, even though neither Russia nor Israel is a state party.

In these politically charged times, the large number of African states that remain parties to the Rome Statute is of crucial importance: “Their continued membership reflects a conscious decision to defend international justice at a time when the ICC is under political attack,” said Kisla.

Conversely, however, according to Kisla, every decision to remain in the ICC also sends an important message: “Accountability for atrocities must not depend on politics or power,” he told DW. “It reflects a commitment to the rule of law and ensures that victims and survivors continue to have access to justice when domestic systems fail.”

War crimes victims lose protection

For the human rights organization Amnesty International (AI), the withdrawal of the four Sahel region states is a setback for the right to justice of the people in the affected countries.

“As victims of war crimes, genocide, and crimes against humanity, they are losing their last resort when they cannot find justice in their own countries,” said Alice Banens, a legal expert at AI’s regional office for West and Central Africa in Dakar.

She, too, describes these withdrawals as “attacks on the integrity of the international system and the International Criminal Court.” These fit into the broader context in which the ICC is facing attacks and sanctions from several states aimed at weakening the court’s ability to fulfill its mandate.

Amnesty has called on the states that have withdrawn so far — Burundi was the first African state to do so in 2016 — to voice any criticism within the system through discussions in the Assembly of State Parties to the Rome Statute.

Former member states can also reverse their decision: For example, South Africa formally initiated its withdrawal from the ICC in 2016 but halted the process in March 2017.

The occasion was the state visit of Sudan’s then President Omar al-Bashir, against whom the court had issued an arrest warrant for war crimes in Darfur. The South African government refused to arrest him.

More prosecutions outside Africa

According to Banens, there is still a widespread perception today that African issues dominate the ICC’s agenda. “That is simply not true,” she told DW. “While this was the case in the early years of the ICC’s work — when most, if not all, investigations concerned the situation in Africa.”

Today, however, more active investigations are taking place outside Africa than within the continent — for example, in Afghanistan, the Palestinian territories, Venezuela, the Philippines, and Ukraine, according to Banens.

Some states considering withdrawal argue that the ICC interferes with domestic legal processes and national reconciliation, according to Christopher Isike, a professor of international relations at the University of Pretoria.

“African countries, as well as major powers such as the US, Russia, and China — which are not members and do not recognize the ICC’s jurisdiction—have also cited this as a reason for their criticism,” Isike told DW.

Nevertheless, according to Isike, the ICC provides an external mechanism for accountability when countries recognize that their domestic judicial systems lack the independence or the political will to prosecute political or military officials.

According to Isike, countries such as Uganda, the Democratic Republic of the Congo, and even Mali have in the past themselves requested the ICC’s intervention because they lack the capacity to prosecute the perpetrators. This weakens the argument that any intervention by the court constitutes outside interference. “This perception of selective justice is the main reason for this way of thinking.”

There are also governments for which remaining a member of the ICC signals their commitment to human rights, democratic governance, and international law, according to Isike: “They believe that this gives them diplomatic credibility as a form of soft power,” he said.

For Isike, the debate over inequality in the justice system touches on something fundamental: the competition for the international order. African governments do not, in principle, reject international justice. “They want a system that is more universal and uniform and gives less cause for accusations of political selectivity.”

DW

It is barely noon, and a group of women sit near the beach on the outskirts of Djégbadji village, in West Africa’s Benin, sifting through mounds of salt harvested from the Gulf of Guinea’s ocean.

Large concrete vats covered with black tarpaulin show traces of white salt sediment as the seawater slowly evaporates under Benin’s midday sun – except that instead of using fire, the group uses solar energy.

The women have been working as part of a grassroots project called ProSEL Benin, a collaborative effort of the governments of Benin along with India, Brazil and South Africa (IBSA) and the United Nations Development Program (UNDP) that focuses on strengthening local salt-producing communities to access sustainable energy sources and create medium-sized enterprises for the production and marketing of local iodized salt.

Salt production is one of the main income-generating activities for the populations living in and around southern Benin.

Generations-Old Traditions

“In Benin’s coastal areas, women skim the salt from the coastal marshes… they put up their little huts and boil salt water in massive vats over an open fire inside the hut. They then sell the ‘cooked’ salt at the markets and on the roadsides.

It’s an unhealthy practice for various reasons,” says Robina Marks, who served as South Africa’s ambassador to Benin and Togo from 2021 to 2024 and was closely involved in the implementation of the IBSA-backed project.

The traditional method of collecting and cooking the salt has been practiced in Benin since at least the 15th century, primarily by women, and involves collecting saline soil, evaporating the water and filtering brine by burning chopped mangrove wood to produce salt.

The practice harms women’s health due to how they collect the salt and the conditions in which it is prepared. “It takes a very long time and is very labor-intensive,” Marks says.

The ProSEL Benin project attempts to change this traditional practice and make the process of collecting salt healthier and cleaner. Salt-making is an important source of income for communities here, relying heavily on the cutting down of mangroves.

ProSEL Benin’s research estimates that approximately 20,000 cubic metres of mangrove wood are cut down annually in coastal Benin for use as firewood in Indigenous salt-making. The UNDP and the Benin government discussed the new method about five years ago.

“But the idea came from the people on the ground, who had the needs. The Benin government came up with the project and wanted to work with UNDP,” says Aoualé Mohamed Abchir, who served as the UNDP Resident Representative in Benin from 2020 to 2024 and was instrumental in its development.

ProSEL Benin, Abchir says, is an attempt to advance three out of the 17 Sustainable Development Goals of the 2030 Agenda for Sustainable Development: gender equality; decent work and economic growth; and responsible consumption and production.

This project aims to help rural women in Benin make and sell clean salt and become self-reliant.

In 2021, the Board of Directors of the India, Brazil and South Africa Facility for Poverty and Hunger Alleviation Fund awarded USD 1 million to the UNDP to implement the salt project.

IBSA is an example of collaborative efforts between the three developing countries, as well as a South-South cooperation initiative within the United Nations that focuses on development cooperation among developing countries in the Global South.

When 60-year-old Cécile Koffi was first introduced to the salt project, it took some time to convince her to switch from the traditional method of making salt.

“There are a lot of things the salt does. Salt is intrinsic to the community’s women,” Koffi says, examining the day’s salt collection. Salt is culturally important to Benin, and its uses go beyond culinary applications.

“It is not only used as food, but it also has a cultural aspect to it. It is regarded as sacred and is used in many of the vodoun practices,” says Marks.

“When we go to the market to sell our produce, we sprinkle salt on the ground and sweep it up before setting up our spot. It is believed that every bad spirit will go away if we do that. Salt is very important. We use it in a lot of rituals,” says Koffi.

These deep-rooted cultural beliefs were one reason why it was difficult to get the women to change and adapt to the ProSEL Benin project, even though it was backed by the Benin government, explains Abchir.

Traditionally salt production is a cultural activity carried out by the Xwla populations of the coastal zone in Benin. The traditional production of salt by the salt farmers in the villages is subject to many prohibitions related to working days, village deities, and so on.

“The name Xwlajè is also intimately linked to the Xwla ethnic group,” says Luc Obale, national project director of ProSEL Benin. The Benin government has been working to certify the salt so that it can be sold with the label ‘Xwlajè’ to identify its cultural origin.

“The old method is their ancestral way of producing salt, so it has significance. Sometimes when you change the way you produce something, some people believe it may have negative implications.

The women could have got the salt directly from the sea, but there is a reason why they weren’t doing that before the project,” says Abchir.

The ProSEL Benin project targeted five areas in coastal Benin where people have traditionally harvested salt: Sèmè Kpodji, Grand Popo, Ouidah, Kpomasse, Comè and Lokossa.

“In those other areas, people have been more open to using sea water to make salt, but Ouidah is Ouidah. It is very special. They believe that the best salt can only be cooked, not dried. They believe that they have to cook it,” explains Abchir.

Ground-Level Interventions

The ProSEL Benin project is not the first intervention program that has attempted to make local salt cleaner and more environmentally sustainable, but it has been successful because caseworkers managed to get it off the ground, says Cessi Marlene Capo-Chichi, who works with UNDP as a project coordinator.

“Organizations have struggled to convince the local community to change their ways,” she says.

Some 500 meters from where the ProSEL project is ongoing by the beach, within the limits of Djégbadji village, is a coastal lagoon where women work inside a network of thatched huts, making salt in the traditional way.

“The traditional way of making salt is more laborious,” says 45-year-old Julienne Dekon, lifting a cane basket heavy with saline soil collected from the marshy land that surrounds her.

These days, the Benin government prevents the chopping down of mangroves for wood, and women are encouraged to use dried palm leaves and coconut shells for fuel instead.

Dekon says that she wants to continue working using the traditional method, although many of her friends have now switched to the modern method of salt making using seawater after joining the ProSEL project. As she begins boiling the saline water inside her hut, smoke fills the small space.

“When I have to work a lot, I do get tired. But I don’t know much about how this affects my health,” says Dekon. Dekon doesn’t remember when she started making salt, but it has been a very long time, and she is now accustomed to preparing using the traditional methods.

“The method on the beach (ProSEL project) is easy to do. But when it is raining, it is not possible to do it outside. But I can continue to make salt even in the rain, because I collect the soil and start cooking indoors.

The two systems are too different,” says Dekon, referring to the open-air concrete salt vats by the sea that are susceptible to the vagaries of the weather. However, the wet weather also affects the women using traditional methods.

From April to August, Benin experiences its rainy season, with short spells of rain between September and November, and the low-lying marshes near the lagoons are prone to flooding.

“We are pushing them to switch to the ProSEL system because during the rainy season the area where the salt is produced traditionally is inaccessible. It is completely flooded, and so for more than half the year, there is no production of salt. We needed to give them alternatives,” says Abchir.

While it is easier for the women to avoid the rains by tracking the weather, it is harder to bypass the persistent floods, he says.

Abchir says the project focused on giving the women access to seawater to make sure they could make salt and have steady income through the year.

“Using the seawater to make salt is less painful. You just get the water and let the sun evaporate it. You don’t have to cook it, and it is safer. You can also make more money,” says Abchir.

Just down the unpaved road from where Dekon works, a woman stands by the highway selling salt.

The difference between the salt produced by women like Dekon, who have been working using traditional methods and those engaged with ProSEL Benin is clear: the traditional salt is visibly yellow-brown with streaks of grey, colors that come due to the lack of a filtration process.

The ProSEL Benin salt is clean and white, fortified with iodine that the women mix into the salt just before filling it into bags.

A one-kilogram bag of salt produced by women using the traditional method, sold in local marketplaces and by the road, would cost approximately 800 West African CFA franc (approx. USD 2), while the same amount produced by ProSEL Benin would sell for 1,000 CFA.

For Public Consumption

ProSEL research indicates there are about 4,000 women harvesting salt in Benin. The country imports most of its salt from countries like Ghana, Senegal and India because its Indigenous salt farming covers only a small fraction of the country’s actual needs.

Stakeholders realized that it was not enough to teach the women how to make cleaner salt; they also had to be given access to markets to sell it.

One market that the project aims to tap into is the World Food Program (WFP) under the UN’s Benin office, which helps feed over 1 million children annually with daily school meals.

The WFP has been undertaking research to understand the feasibility of purchasing and using salt through these cooperatives led by women under ProSEL. The Benin government has ambitious plans for the harvested salt.

In December 2025, Benin’s food safety agency, ABSSA, the Agence Béninoise de Sécurité Sanitaire des Aliments, certified the salt for public consumption, after which the salt was prepared to be sold under the label Xwlajè.

Presently, the Xwlajè salt is sold in seven different supermarket chains across Cotonou, as well as in standalone shops located in the municipalities of Porto-Novo, Cotonou and Comè.

“In addition, steps are underway to market Xwlajè salt in the duty-free shops at Cotonou International Airport,” says Obale.

Abchir adds that a process that would take the women six hours now takes them two. Bringing about change has been difficult, he says, because it involved convincing people who were accustomed to working in a specific way for generations.

He admits that they wouldn’t have been able to do much without winning the trust of the women, their husbands who still oversee their lives, the mayor and the local community leaders.

“The local team went down to the women and understood their needs so that sensibilities could be understood, and it would be accepted. It is very difficult in Benin when outsiders come in and tell them what to do.”

Abchir says that there is a high risk of undoing all that work if there is mistrust in the community towards the project.

“They are accepting the changes. Now we are trying to build construction for storage, keeping machines, etc. It is a sensitive phase, but we are hopeful that it will work.”

Benin’s government has prioritized tourism over the last few years, and its Indigenous salt farming practices are a key part of its plans to introduce tourists to Beninese culture.

The ProSEL project does not aim to fully remove the traditional method of salt farming, says Obale.

“The modern salt production unit is located not far from the traditional production site to allow tourists to see the difference between the two production methods,” he says.

Mireille Adjovi, a new mother in her 20s, has come to work at the ProSEL site with her infant sleeping on her back.

“With the money I get, I am able to take care of my children. I will be able to send them to school. I think about myself last: my husband and children come first. Maybe the men give money for the household, but women still suffer a lot.

If women need something, husbands give the amount of money they want to give you, not what you need. The men don’t think about the women. So, the project helps me earn my own money,” says Adjovi.

For women like Adjovi, making salt is not just about following the jobs women before her have done for generations.

She doesn’t know what the UN’s SDGs are or even what IBSA means, but the work at ProSEL Benin allows her to prioritize her own health and well-being while working collectively in a women-led cooperative.

When she talks to other women working at the site, she also thinks about the hard-earned independence and self-reliance she now has.

IPS UN Bureau Report

Whenever it rains, Joseph, Gift and Alumbwe — ages 17, 15 and 12 — scramble to move their clothes to a dry corner of their home, deep in the Copperbelt Province of Zambia. That’s because rain streams through holes in the roof.

“The house is not okay. Even though we live here it’s only because we have nowhere else to go,” says Joseph, speaking in the local language Bemba. “When it starts raining, where we sleep becomes wet.”

They don’t have to move their mattresses, he explains, because they don’t have any — the boys sold them when they needed money. Instead, they sleep on a bamboo mat on the floor and share a blanket.

Their mother died in January, their father in February. Now these brothers are in the process of figuring out the basics of living alone. NPR is not using the brothers’ last name because they are minors.

Both parents were HIV positive but had been able to survive because of the daily medications they took to prevent the virus from progressing.

When the U.S. overhauled foreign aid at the start of President Trump’s second term, there were major cuts to global health — and disruptions to the U.S.’s flagship efforts to combat HIV/AIDS globally called PEPFAR or the U.S. President’s Emergency Plan for AIDS Relief.

The boys say that, in the overhaul, their parents could no longer get their HIV medications as the program that delivered medication to their remote area suddenly stopped. It took just about a year for both parents to succumb to the virus.

The phenomenon of child-headed households and orphans was a defining element of the early years of the AIDS epidemic in the 1980s and ’90s. But it diminished with major support efforts from the U.S. as well as the widespread availability of HIV medications that dramatically improved life expectancy.

It’s too early for official statistics to capture whether the shifting aid landscape has caused a spike in orphans and child-headed households. However, a reverend in Zambia — Billiance Chondwe — says he’s noticed a change.

NPR profiled Chondwe — affectionately known by his congregation as Pastor Billy — last year as his community dealt with the aid cuts and disruptions.

At the time, he told NPR many of his community members had suddenly lost access to their HIV medication as the nearby PEPFAR-funded clinics they depended on had shuttered. Now, he reports, children are paying the price.

In his community, he says, parents are dying of HIV. And that’s leading to the return of child-headed households.

He is trying to help 25 newly orphaned children, up from 11 a couple months ago. “There is a lot of stress and pressure,” Pastor Billy says, ticking off a long list of concerns. “They don’t have enough food. Where they are staying [is not suitable]. There’s no support.”

“God can take care of us”

As a teenager, Pastor Billy lost his twin sister to AIDS. “It brought me to my knees,” he remembers. In the decades since then it’s driven him to help others with the virus. Lately, that work has entailed tracking down people whose U.S. funded HIV-clinics closed overnight as a result of aid cuts last year.

Sometimes, he can help people connect with Zambian government clinics to get the medications they need — but not always. Increasingly, he says, he’s finding children scrambling to figure out what to do as their parents get sick without their HIV/AIDS medications.

That’s what happened in January when a community member asked him to check on a family living in a remote area. When he got there, he found Joseph and his brothers along with their ailing father.

“There was so much fear in the faces of the boys. There was so much worry and panicking in the face of the father,” Pastor Billy recalls.

Because Joseph’s family lived three, almost four, hours walking distance from the nearest hospital, community health workers — paid for by a U.S. government aid program — had brought HIV medications to their home. U.S. funding cuts changed that.

“In the rural remote areas, there used to be mobile clinics and nowadays it is not there,” says Pastor Billy. The boys watched as AIDS took hold and their parents grew weak and lost their appetite. Soon they were losing weight rapidly and struggling with diarrhea. They didn’t have the strength to walk to the hospital.

So the family came up with a plan of action. “We started selling things in the house,” Joseph says. “Whoever wanted to buy a mattress, we would sell. Whoever wanted pots, we would sell.” The money was to pay for a motorcycle taxi to get to the hospital.

Each night the boys would kneel in the dark and pray for help. The final months were fraught and painful as their parents argued about how the virus had been introduced into their household and worried about what would happen as their condition worsened.

Their mother ended up going back to her sisters’ place and dying there. Once their father died, Joseph says, he had no idea what to do. “We started going to church so that God can take care of us,” he says.

“Creating orphans at a remarkably rapid rate”

When the HIV/AIDS epidemic first hit Africa, the virus was infamous for killing people in their child-bearing years — and “creating orphans at a remarkably rapid rate,” says Dr. Eric Goosby, the second director of PEPFAR from 2009 to 2014 and now a professor of medicine at University of California, San Francisco.

That’s what he told NPR last year. “The community around [the kids] rejected them because the stigma for HIV was so severe.”

PEPFAR, which was created under President George W. Bush and grew to be a widely celebrated program, was committed to helping these children.

“We created a system of care that took care of almost 6 million kids every year,” Goosby explains. “It’s a largely unsung story for PEPFAR and it’s the only non-traditional medical intervention PEPFAR heavily funded.”

The system found local adults and provided stipends so they could care for the children and keep them in their home community. PEPFAR also paid for education, nutrition and medical care since about a quarter of the orphans and vulnerable children were HIV positive.

Pastor Billy says he saw how these efforts transformed children’s lives and futures. Now, much of that support network has disappeared. “Cutting [aid] this suddenly has taken us backwards to a place and a season of hopelessness. There is no clear direction, especially on how we can help child-headed homes,” he says.

Asked to comment on these assertions and the situation Joseph and his brothers find themselves in, the State Department sent NPR a statement saying that the U.S. is the most generous country with humanitarian assistance.

“If there are such tragic cases happening around the world, it’s not because we’re not spending enough money. It’s because the rest of the world is not spending enough money,” the statement said.

The statement also said: “The United States has not cut health funding, including PEPFAR, for Zambia.”

While appropriations from Congress for HIV have not changed, the money is often not being spent. The Trump Administration is in the process of revamping how the U.S. does global health work and it is trying to hammer out new agreements with individual countries, including Zambia.

The Foundation for AIDS Research or amfAR found an almost 20% drop in PEPFAR expenditures between 2024 and 2025 in Zambia and the loss of more than 5,000 PEPFAR staff in the country.

In the Copperbelt Province in particular, the amfAR country report shows that thousands of HIV-positive people lost access to their HIV medications between 2024 and 2025.

“The children they left behind”

As his family life turned upside down, Joseph says he had no choice but to drop out of school and give up on his dream of becoming a doctor. Unable to pay rent, the boys moved several hours away to the small, dilapidated house with the leaky roof where rent is minimal.

“Sometimes the roofing sheets will start coming off because of the wind,” Joseph says.

Joseph got a job as a part-time security guard so he could provide a home for himself and his brothers — and so they can continue their schooling.

As he puts on his uniform for work, his brothers head to school. Gift wants to be an engineer and Alumbwe a soldier. While school is free in Zambia, the boys struggle to pay for school books. But they still attend class.

When Joseph is not at work, he says, he’s either doing odd jobs to make additional money or trying to get medication for his two brothers, who are both HIV positive. Their clinic is still an hours-long walk away with a multi-hour wait once there.

Waiting in those lines, Joseph says, he’s realized how common his situation is. He says he sees many other children in similar circumstances. Sometimes Joseph doesn’t make it to the clinic before they run out of the drugs his brothers need, so they must go a day or so without their pills.

Pastor Billy tries to help with the medication pick-up but he too lives far away. About once a month their Uncle John travels from several hours away to check on the boys.

“It brings me sadness and heartache to see the children [my brother] left behind,” he says in Bemba. He says he feels guilty that he can’t house the boys but his household has not only his own five children but also his late sister’s six children.

Right now, he says, the best he can do is bring food when he visits. “I do some farming and when I harvest those crops I will then share with them,” he says.

“If my parents were still alive”

Joseph says playing soccer was the one reprieve he would get from the weight of his responsibilities. “I love soccer,” he says. But right now, he’s not playing.

His sneakers wore through. “If my parents were still alive, I would still be playing. They would have bought me shoes,” he says. The best he can do now is watch other kids play soccer. He says it makes him happy that at least some kids get to keep being kids.

NPR

ABDULWAHEED SOFIULLAHI

On a bustling day in northern Nigeria, Marian Shammah made her way to the Sabon Gari Market, one of the largest electronics hubs in Kano state.

The 34-year-old cleaner was in need of a refrigerator, but with rising costs and a meager income, she saw the second-hand appliances sold at the market as a lifeline. After locating the one she wanted, she paid the vendor 50,000 naira ($36) and took it home. But just a month later, the freezer collapsed.

“Only the top half of the refrigerator was working, and the freezer wasn’t working,” said Shammah. Her food spoiled, her savings disappeared, and she was soon back in the market searching for another appliance.

Although Shammah could have bought a new local appliance by adding about 50,000 naira more, she – like millions of Nigerians – believes second-hand products from America and Europe “last longer” than new products sold in Nigeria.

Observers say this trend is part of a larger crisis. Nigeria has become a major destination for the developed world’s discarded electronics – items often near the end of life, sometimes completely dead, and frequently toxic because they contain hazardous materials.

When they break down, they add to landfills, worsening an already dire e-waste crisis on the African continent.

Around 60,000 tons of used electronics enter Nigeria through key ports each year, with at least 15,700 tons already damaged upon arrival, according to the United Nations.

The trade in used electronic goods is powered largely by foreign exporters. A UN tracking study between 2015 and 2016 showed that more than 85 percent of used electronics imported into Nigeria originated from Germany, the United Kingdom, Belgium, the Netherlands, Spain, China, the United States, and the Republic of Ireland.

Many of these imports violate international restrictions, like the Basel Convention, an environmental treaty regulating the transboundary movement and disposal of hazardous electronic waste to developing countries with weaker environmental laws.

Across West Africa, the Basel Convention’s “E-Waste Africa Program”, a project focused on strengthening e-waste management systems across the continent, estimates that Benin, Ivory Coast, Ghana, Liberia, and Nigeria collectively generate between 650,000 and 1,000,000 tons of e-waste annually – much of it the result of short-lifespan second-hand imports.

Health risks

The United Nations describes e-waste as any discarded device that uses a battery or plug and contains hazardous substances – like mercury – that can endanger both human health and the environment. Several of the toxic components commonly found in e-waste are included on the list of 10 chemicals of major public health concern maintained by the World Health Organization (WHO).

According to the WHO, used electrical and electronic equipment (EEE) presents a growing public health and environmental threat across Africa, with Nigeria at the center of the trade.

“Much of the equipment shipped as used electronics is close to becoming waste,” said Rita Idehai, founder of Ecobarter, a Lagos-based environmental NGO, warning that devices imported and sold as affordable second-hand goods often fail shortly after arrival and quickly enter the waste stream.

The consequences are far-reaching. Many imported fridges and air conditioners, for instance, still contain CFC-based and HCFC-based refrigerants such as R-12 and R-22 – chemicals banned in Europe and the US for causing ozone depletion or being linked to cancer, miscarriages, neurological disorders, and long-term soil contamination.

These gases live for 12 to 100 years, meaning leaking equipment adds to a multi-generational environmental burden.

After these imported items stop working or fall apart, informal recyclers then dismantle the electronics with their bare hands, Al Jazeera observed. In Kano, the recyclers inhale poisonous fumes and manage the heavy metals without protection.

Their work earns them a meagre 3,500–14,000 naira ($2.50-$10) per week, they said, and the after-effects linger – including persistent coughing, chest pain, headaches, eye irritation, and breathing difficulties after long hours of burning cables and dismantling electronic devices. The health crisis extends into Kano’s communities.

Among casual recyclers and residents who live close to e-waste dumps, many report symptoms that range from chronic headaches and skin irritation to breathing issues, miscarriages and neurological concerns, according to health surveys done by the International Journal of Environmental Research and Public Health. These ailments are consistent with longtime toxic exposure, the researchers said.

Recent field assessments conducted by Nigeria’s Federal University Dutse also stressed that in and around Kano state, where the Sabon Gari Market is located, there are rising levels of heavy metals in soil and drainage channels.

Dr Ushakuma Michael Anenga, a gynecologist at the Benue State Teaching Hospital and second vice president of the Nigerian Medical Association, warned that toxic exposure from informal e-waste recycling poses grave health risks to communities in Kano.

“Exposure to heavy metals and refrigerant gases in e-waste causes extreme brief and long-term health issues, generally affecting the breathing and renal organs,” he told Al Jazeera.

“Common casual practices like exposed burning and dismantling result in direct, high-level exposure for workers and nearby residents. Children and pregnant girls are particularly inclined due to the fact that those toxicants can disrupt development or even skip from mother to unborn baby, [while] recyclers who work without defensive equipment face repeated, frequently irreversible damage.”

Profits over protection

In Sabon Gari Market, second-hand electronics are advertised as less costly lifelines for households and poor business owners burdened by inflation.

Many customers say foreign-used home equipment appears sturdier and seems like better value for money than new imports from the developing world. Meanwhile, others are just looking for cheap options in difficult economic times.

“I usually go for second-hand or foreign-used electronics because brand-new ones are too expensive for me,” Umar Hussaini, who sells used electronics at the market, told Al Jazeera.

“Sometimes you can get them for half the price of new ones, and they look almost the same, so it feels like a good deal at the time.” But the last refrigerator he bought stopped cooling after just three months. With no warranty or guarantee, the seller refused responsibility.

“For weeks, we couldn’t store food properly at home, and we ended up buying food daily, which was more expensive,” he said. “However, I have to buy another one again.”

For small business owners like Salisu Saidu, the losses can be even more devastating. He bought a used freezer for his shop, believing it had been serviced. Within weeks, it failed.

“I lost a lot of frozen food, which meant I lost money and customers,” he told Al Jazeera. Around his neighborhood, broken electronics are often dumped out in the street, sometimes emitting smoke or sparks.

“There’s also a lot of electronic waste piling up around,” he said, calling for tighter import controls, proper certification, and mandatory warranties to protect buyers from being sold what he described as “damaged goods disguised as fairly used”.

Bought as bargains, sold as burdens

At Sabon Gari Market, another vendor, Umar Abdullahi, is surrounded by imported refrigerators, air conditioners and washing machines stacked tightly together.

The products in his shop are advertised as “London use” or “Direct Belgium”, while he negotiates the sale of a double-door fridge for 120,000 naira ($87). Abdullahi’s store is where Shammah returned after the refrigerator she bought failed. But he admits that much of what he sells to customers arrives unchecked.

“We buy them untested from suppliers in Europe, and we also sell them untested so we can make our profit,” he told Al Jazeera.

This despite the fact that international rules under the Basel Convention, as well as Nigerian environmental regulations, prohibit the shipment of material considered e-waste – with penalties including fines and jail terms.

Nwamaka Ejiofor, a spokesperson for Nigeria’s National Environmental Standards and Regulations Enforcement Agency (NESREA), said the country does not permit the import of e-waste. However, the entry of used electronics is allowed under regulated conditions.

“The importation of used electrical and electronic equipment is regulated and may be allowed only where such equipment meets prescribed conditions, including functionality and compliance requirements,” she told Al Jazeera.

“Nigeria applies a combination of regulatory, administrative and enforcement measures to ensure that imported used electronics comply with national law and the country’s international obligations,” she added, listing out measures including environmental regulations, cargo inspection and verifying that imported equipment is “functional”.

However, despite this, some traders find loopholes in the system, including declaring cargo they plan to sell as personal belongings or second-hand household goods to avoid scrutiny.

Although NESREA says enforcement has improved, critics say the steady flow of mediocre goods continues largely unchecked. Even dealers at Sabon Gari Market acknowledge that most appliances are sold “as is”, without certification or guarantees.

‘Loopholes’

Behind the second-hand electronics trade is a network of collectors and exporters who source discarded appliances across Europe.

Baban Ladan Issa, who ships used electronics from Ireland to Nigeria, said items are gathered from weekend markets, private homes that are replacing old gadgets, and contractors clearing out equipment from offices, hotels and hospitals.

“Some suppliers mix working and damaged goods together,” he told Al Jazeera, noting that while he tries to avoid faulty items, not all buyers do the same.

Once assembled, shipments worth millions of naira are sent to Lagos through ships then down to sellers in the market in Kano state, sometimes packed in containers or hidden inside vehicles to reduce inspection risks.

Shipping records seen by Al Jazeera showed consignments labelled as “personal effects”, a classification that can limit detailed checks at ports.

Chinwe Okafor, an environmental policy analyst based in Abuja, said the problem is systemic. “Exporting nations regularly take advantage of loopholes by means of labelling nonfunctional e-waste as ‘second-hand goods’ or ‘for repair,’” she told Al Jazeera.

“In some instances, research estimates that over 75 percent of what arrives in developing countries is truly junk.”

“This permits wealthy countries to keep away from highly-priced recycling at home while pushing unsafe materials into nations with weaker safeguards.”

Ibrahim Adamu, a program officer with the NGO Ecobarter, added that mislabeling, poor inspection technology and corruption at ports make enforcement difficult.

“The highest profits are captured by exporters and brokers who arbitrage the gap between disposal costs in Europe or Asia and the strong demand for ‘tokunbo’ goods in Nigeria,” he said, using the local name for used imported electronics.

To forestall this, he said Nigeria “must reinforce border inspections” and implement a policy whereby producers and manufacturers bear financial responsibility. At the same time, “the international network has to adopt binding bans that [hold] manufacturers and exporters responsible”, Adamu said.

Little oversight, mounting risks

Although Nigeria has regulations governing the import of electrical and electronic equipment, enforcement gaps keep exposing markets like Kano’s Sabon Gari to ageing and near-end-of-life appliances, locals say.

Ibrahim Bello, a used electronics importer with a decade in the business, said many shipments that arrive from Europe are in less-than-ideal condition.

“Around 20 to 30 percent of the items we receive have issues when they arrive,” he told Al Jazeera. “Some are already damaged, while others stop working after a short time because they are old. “That’s just part of the business.”

Retailer Chinedu Peter gave similar estimates. “From what I’ve experienced, maybe 40 percent of the electronics have some fault as they come,” he said, adding that environmental and protection checks don’t happen as they are meant to. “Such a lot of items enter without special checks.”

Both men feel that clearer rules and certified testing systems will improve trust. But until then, thousands of ageing, unsuitable products will continue to flood Nigeria.

Shammah, back at Sabon Gari Market just weeks after her refrigerator broke, was once again searching through rows of stacked appliances, hoping her next purchase might last longer than the last.

“I don’t really trust these fairly used appliances again, but I still have to buy something because we need it at home,” she told Al Jazeera.

“This time I’m thinking … I can buy a new one from a proper shop, even if it takes longer, because I don’t want to lose my money again.”

Al Jazeera

Squinting against the dust kicked up by the helicopter’s rotor blades, dental therapist Senate Makhoali crouches low, loads up her equipment and jumps on board. Already this morning she’s endured a hair-raising, stormy flight in a tiny Cessna 206 airplane to land on a precarious mountain ridge.

Now, she steels herself for a bumpy chopper ride across a steep ravine to a village on the other side. As dentists’ commutes go, Makhoali’s is somewhat extreme.

“One minute it’s calm, the next you think you’re about to die,” she says of flying through the turbulent, ever-changing mountain weather in her home nation of Lesotho.

But the 27-year-old is getting used to it. For the past year and a half, she has served with the Lesotho Flying Doctor Service, an intrepid band of airborne health workers bringing essential medical care to isolated communities in this southern African nation.

Sometimes referred to as the Kingdom in the Sky, Lesotho is the world’s only nation lying entirely above 4,593 feet). Its rugged terrain, riven by jagged peaks and dramatic valleys, renders road transport nearly impossible in much of the country, leaving roughly 300,000 people scattered throughout the highlands without reliable access to health care.

For decades, the Flying Doctor Service was their lifeline, until the impact of President Donald Trump’s aid cuts in January 2025 all but severed it. Now, after a tumultuous year fighting for its very existence, the service is picking up the pieces and starting to rebuild.

And with the aid cuts serving as a wake-up call, the tenacious flying doctors of Lesotho are now looking to bounce back stronger, more efficient and less reliant than ever before — with or without U.S. support.

Coming in for a landing

In the mountains of Mohale’s Hoek district, the helicopter carrying Makhoali takes off in a whir of rotors that sends grazing goats and horses scurrying for cover. The chopper, which is operated by the South African humanitarian air service Mercy Air, scuds across the valley, buffeted by swirling winds, before landing beside a pair of bemused shepherds on a distant ridge.

A crowd quickly gathers, and volunteers help the medics carry their gear along a narrow path to the tiny village of Mphooko, where many haven’t seen a doctor in years.

“These communities are so far out in the mountains that they only go to a clinic when it’s life or death, or when the pain is more than they can stand,” says Makhoali, who had never flown before being assigned to the LFDS in May 2024. “For us to be able to come to them is such a big thing.”

Word of the team’s arrival has spread, and dozens of villagers have turned up to receive care. They come with the usual mix of coughs, colds, joint pain, eye problems and toothaches, as well as more serious issues.

Lesotho battles some of the world’s highest rates of HIV, TB and mental health issues, while injuries from horse-riding accidents are ubiquitous.

Makhoali lays out her equipment and sets up her dentist’s chair in a small stone cottage before calling in her first patient of the day. For the next six hours, she won’t stop.

Among her patients is Makhaphetsi Makhaba, a 25-year-old mother of two who’s lived her whole life in the village and has never before seen a dentist. By the time Makhoali has finished, Makhaba has lost a tooth and gained a filling.

“It’s a relief — my teeth have been hurting me for years,” says Makhaba, before heading next door to consult the LFDS nurses about her recurrent chest pains.

Makhoali and her colleagues finish treating the last of their patients in the late afternoon. Not long after, the helicopter returns to ferry them across the valley to the Flying Doctor clinic of Kuebunyane, where they will spend the night.

The clinic, which sits high on a mountain overlooking a breathtaking valley, was constructed in the 1980s and expanded in 2015 with funding from Irish Aid and the Clinton Health Access Initiative.

It was built with a parking lot and a driveway wide enough for an ambulance, yet none has ever been here — the nearest road of any kind is four hours away on horseback.

“They hoped cars would one day be able to come here,” sighs Makhoali. “We can dream.” For a few months of the year, Mercy Air’s helicopter flights boost the reach of the Flying Doctor Service by carrying providers directly into the most isolated villages in the country.

But the backbone of the service is a network of remote LFDS clinics, each with its own rudimentary airstrip. The clinics are run by LFDS nurses and are staffed and equipped via regular flights operated by the Mission Aviation Fellowship, a Christian U.S. nonprofit that has collaborated with the LFDS since the 1980s. Doctors are flown in once a month.

“Without these clinics and without the medical team visits, these communities simply wouldn’t be able to access basic health services,” says Makhoali.

Nearly grounded by U.S. aid cuts

For Makhoali and her colleagues, 2025 was a year like no other. The Flying Doctor Service is a branch of Lesotho’s national health service that was never directly funded by the U.S. Regardless, in January 2025, Trump’s aid cuts brought it to its knees.

At the time, Lesotho was among the world’s most aid-dependent nations, with the government funding just 12% of national health spending. The rest was funded by aid programs, with USAID alone accounting for over a third.

When that funding evaporated as part of the Trump administration’s dramatic cuts in foreign aid, the impact was felt throughout the health system. “The government’s priority was to save as much of its budget as possible for the purchase of drugs,” says Karabo Lelimo, head of the LFDS. “So, transport was affected, especially flights.”

Of the 12 clinics the LFDS operated at the beginning of the year, 10 were abruptly transferred to Lesotho’s District Health Management Teams, who were left to run them as best they could without air support.

Flight schedules were slashed and vital clinic staff lost their jobs. The organization’s chief doctor, Justin Cishiya, who had flown with the LFDS for 15 years, was transferred to help shore up an understaffed hospital in the capital, Maseru. By autumn of 2025, things were looking bleak. To Makhoali, it felt like she had “abandoned” her patients.

“The mood was so low,” says Lelimo. “To be here in the mountains trying to serve the nation but with no resources — it was something else.”

The clinic at Kuebunyane lost its support staff, including nurses, cleaners and the vital “trackers” responsible for following up on HIV patients who have stopped taking their antiretrovirals. The remaining nurses were severely overstretched.

Routine outreach missions to treat patients in remote villages were scrapped because the nurses couldn’t afford to rent horses for travel. A lightning strike knocked out the clinic’s solar power supply in March, leaving it unable to operate much of its medical equipment. Fuel, essential for heating, particularly in winter when the mountains lie under a deep carpet of snow, soon began to run dangerously low.

Facing an uncertain future

For a time, it looked uncertain whether The Flying Doctor Service would survive. Then, as the country approached the one-year anniversary of the cuts, the mood began to change, says Lelimo. The thinking in the LFDS and the health ministry began to switch from knee-jerk damage limitation, he says, to acceptance of the new reality and a critical assessment of how best to use existing resources.

“The USAID cuts were not the only problem,” says Lelimo, who spent seven years running one of the country’s most isolated LFDS clinics before he was appointed to take over management of the service in November 2025.

“There were a lot of defects that needed to be corrected. There were logistical issues, management issues which led to inefficiency in service delivery.” On taking over the reins, Lelimo found huge gaps in data collection, a chronic lack of oversight on spending, poor planning, little accountability, a lack of communication between the LFDS and its health ministry bosses and enormous waste.

Planes would routinely fly into the mountains half empty, sometimes returning without any cargo or passengers at all. “The cuts were a wake-up call,” says Lelimo. “As African countries, we need to do more self-introspection to see how much capacity we have without relying on foreign aid.”

Lelimo and his colleagues set about revitalizing the flying doctor service. A policy of mixed flights was introduced, whereby every flight, save emergency evacuations, would be carefully planned to combine patient transfers, nurse movements and cargo.

To address the shortage of antiretrovirals reaching mountain clinics, they introduced a new system of drug distribution. Those with easier access to clinics would receive just a month or two’s supply, while migrant workers and those living further afield would get up to a six-month supply.

To mitigate the loss of patient trackers, the flying doctors trained village health volunteers to take over. Budgets were reallocated and reporting improved, along with communication with the ministry.

Then, on December 19, the transfer of the 10 formerly LFDS clinics to the District Health Management Teams was rescinded and flights resumed. “We needed to revitalize the whole system,” says Lelimo. “I’m feeling so optimistic. The LFDS is still here, and stronger than before.”

Not only have the flying doctors managed to resume most of their former operations, they also have ambitious plans to resume building their network of remote health posts in the mountains. They plan to build two new airstrips in 2026.

At the same time, the emergency evacuation program, the only part of the service unaffected by the cuts, continues unabated.

A fall, a tooth extraction, a ray of hope

On a blustery Saturday in September, NPR joined one such flight after a man in a remote village sustained head injuries after falling from his horse. The local clinic lacked the means to treat his injuries, but driving him over winding mountain roads to the Maseru would take all day.

Within minutes of receiving the call, pilot Dave LePoidevin, a soft-spoken Minnesotan, was airborne and hurtling toward the distant province of Mokhotlong at 9,000 feet. After landing on a bumpy dirt airstrip, he taxied toward a waiting ambulance.

The patient, 24-year-old Tlotliso Lebeta, who had already endured a long and uncomfortable journey by horse and truck from his village, was loaded onboard. Less than an hour later, the plane touched down in the capital and Lebeta was whisked away to hospital.

“It’s a crucial part of the health system,” said pilot Jo Adams, a 44-year-old from Washington state who’s been based in Maseru since 2019. “An hour by air versus 10 hours on horseback and by road. Without the air service, people would die.”

At the time, Adams wasn’t sure whether the flying doctor service had a future. Today, he says he hasn’t “felt this optimistic in years.”

After her night at Kuebunyane clinic, Senate Makhoali and her colleagues are picked up by helicopter and flown to the even more remote village of Ha Mpheulane, which lies atop a steep escarpment with views over endless ranges of blue-tinged mountains.

A crowd is already waiting. While some of the health workers tend to patients, others run an awareness session for teenagers on a slope above the village, counseling them on sexual health and other topics. Makhoali extracts two dozen teeth.

“We’re excited to continue serving these communities,” says Makhoali. “And to do it even better than before.”

NPR

AYODELE S. OWOLABI

After launching what he called “a powerful and deadly strike against ISIS [ISIL] terrorist scum” in northwest Nigeria on December 25, United States President Donald Trump promised “many more”, reaffirming his stance that the US “will not allow radical Islamic terrorism to prosper”.

The strikes occurred less than a week after the newly formed Alliance of Sahel States (AES) commissioned a joint military force comprising a 5,000-strong contingent, presented as a symbol of collective self-reliance and security autonomy, in a concerted effort to combat terrorist groups in its member states.

They also followed moves by the Economic Community of West African States (ECOWAS) to establish an ambitious plan announced in August 2025 to activate a 260,000-strong joint counterterrorism force, backed by a proposed $2.5bn annual budget for logistics and front-line support.

While these developments may be presented by their proponents as decisive steps against terrorism, there is little evidence that militarized escalation alone can defeat armed groups in the Sahel. Instead, they signal an accelerating militarization of the region.

Not only does this fuel emerging geopolitical tensions in West Africa, but it also, more importantly, edges the Sahel towards interstate armed conflict, posing far graver risks to regional peace and stability.

A friendship turned sour

Until 2021, counterinsurgency and counterterrorism operations in the Sahel were governed by a loosely coordinated, non-hierarchical security architecture built around diplomatic and military collaboration among regional and extra-regional actors.

This architecture brought together ECOWAS, the European Union, the United Nations, the African Union, external powers such as the US and France, as well as regional powers such as Algeria and Nigeria, with ECOWAS playing a central coordinating role.

A typical example was the 2013 African-led International Support Mission to Mali, organised by ECOWAS in collaboration with the AU, UN and France to confront Tuareg rebels and allied armed groups in northern Mali.

More prominent was the EU-financed G5 Sahel counterterrorism force, which brought together African and European troops and operated between 2017 and 2023. While these arrangements were often marked by tension, competition and uneven outcomes, they functioned within a shared security framework that limited direct confrontation between states.

This balance was disrupted after the 2023 coup in Niger. By threatening the use of force to restore constitutional order, ECOWAS crossed a political threshold that transformed its role from intermediary to perceived adversary in the eyes of the Nigerien junta.

That threat was widely interpreted as an act of aggression, and it proved catalytic. In response, Niger’s military rulers, alongside their counterparts in Mali and Burkina Faso, moved to establish the Alliance of Sahel States as a deliberate effort to reclaim security autonomy, dismantle the existing multilateral security regime and sever ties with longstanding partners including ECOWAS, the EU, the US and France.

Notably, the AES institutionalizes a mutual defense pact that codifies this break with the previous multilateral security order by explicitly framing ECOWAS and its Western partners as threats to the sovereignty and national security of its member states.

Beyond deepening the rift between former allies, this posture signals a dangerous shift towards the securitization of neighboring states, raising the specter of interstate conflict in West Africa, a phenomenon largely absent since the 1990s.

Emerging geopolitical tensions

In severing security ties with the West, the AES have pivoted towards Russia as a principal security partner to counterbalance decades of US and European influence in West Africa, signaling a deepening but still evolving security partnership with Moscow.

While these strategic choices reflect an emerging self-help posture with new preferences for non-conventional allies, they are also intensifying geopolitical tensions across the region.

Nigeria’s military role in countering an attempted coup in neighboring Benin was praised as a major win for ECOWAS. But when a Nigerian Air Force C-130 aircraft made an emergency landing in Burkina Faso two days later, the AES interpreted this as a violation of its airspace and sovereignty, authorizing its air force to neutralize any aircraft involved in further violations.

Tensions were heightened by reports that France had provided Nigeria with surveillance and intelligence support during the Benin intervention, fueling apprehension about France’s potential re-entry into the AES security landscape.

With Nigeria now willing to extend security cooperation with the US following the Christmas Day strikes, the stakes have risen further for the AES.

Although aimed at militants operating in northwest Nigeria, the strikes appear calculated to bolster US strategic legitimacy as a counterterrorism actor in the region, potentially opening the door to further operations in Nigeria’s northeast, where ISWAP and Boko Haram remain active.

Given Nigeria’s influence within ECOWAS, this emerging security partnership with the US is likely to shape the operational capacity of the proposed 260,000-strong ECOWAS force.

This does not bode well for the AES, which is intent on insulating its member states from Western security influence in the name of sovereignty.

Because ECOWAS forces would be deployed in member states at the epicenter of terrorist violence, many combat engagements would take place in locations adjacent to AES territories.

With AES troops also operating in these areas, military clashes between the two sides become increasingly likely, particularly given the region’s porous borders and fluid combat environments.

Given that the Christmas Day strikes reportedly hit unintended targets, the risk that future air strikes by a US-backed ECOWAS could spill into AES territory cannot be dismissed. For deterrence, the AES may seek to leverage Russia’s military backing, evoking echoes of Cold War-era security brinkmanship.

Implications for regional stability

Without reconciliation between the AES and ECOWAS, two major risks loom for regional peace and stability. First, rising geopolitical tensions could draw AES and ECOWAS member states into direct interstate military confrontations, potentially plunging West Africa into a regional war.

Such a conflict would serve neither side’s counterterrorism objectives. Beyond devastating the region, it would create space for armed groups to expand their operations amid fractured and distracted security responses.

Second, the standoff risks turning West Africa into a new theatre for global power rivalry, with a Russia-backed AES on one side and a US and France-backed ECOWAS on the other.

In the context of an emerging New Cold War, the use of veto power by these global actors at the UN Security Council could further complicate conflict resolution, with profoundly destabilizing consequences for the region.

The AES and ECOWAS now face a stark choice: to revive Cold War-style bloc politics in West Africa while the region slides towards chaos, or to negotiate a security sub-coalition that prioritizes human security alongside national sovereignty.

Regardless of how the AES views ECOWAS, the burden lies with the latter to manage the unintended consequences of escalating tensions.

While there are few indications that the AES is willing to cooperate directly with a West-backed ECOWAS on counterterrorism, ECOWAS could pursue diplomatic engagement to negotiate a concept of operations that guarantees respect for AES sovereignty.

As Africa’s most experienced regional security organization, ECOWAS possesses the diplomatic capacity to do so. For progress to be made, Francophone ECOWAS member states should take the lead in these efforts, while Nigeria exercises its influence more discreetly.

Whether ECOWAS can reclaim ownership of its security agenda and define the terms of external engagement will shape not only West Africa’s future, but that of the continent as a whole.

Al Jazeera

Gunfire echoed through — and then abruptly, the country went silent.

Rumors of mass killings by security forces in Tanzania spread fast, but as the internet went dark and bodies disappeared from the streets, the true scale of the violence slipped out of reach. Months later, there is still no official death toll.

President Samia Suluhu Hassan has meanwhile firmly rejected allegations of state-led violence and insists that security forces were responding to looting and an attempted coup.

“When we are accused of using excessive force to quell the post-election violence, the question is: what level of force would have been considered minimal?” Suluhu Hassan said.

A DW investigation into two major incidents in Mwanza region found evidence of atrocities. Eyewitness and survivor accounts, leaked police files, ballistics reports and geolocation data indicate the use of lethal force.

Survivors and eyewitnesses told DW that unarmed civilians were gunned down and soldiers later removed the bodies.

Protests, curfews and an internet blackout

On October 29, eight protests took place in Dar es Salaam and quickly spread to Arusha, Dodoma and Mwanza, fueled by anger over alleged electoral fraud, opposition suppression and heavy‑handed policing.

As violence erupted and unrest spread — buses and gas stations were torched and factories looted — the government imposed a 6 p.m. curfew and shut down the internet.

A DW investigation found that during that blackout in Mwanza, security forces gunned down people in residential areas. A government investigation is underway.

UN experts estimate at least 700 individuals were killed and the opposition puts the number at up to 2,000 countrywide. DW cannot confirm those figures, but we found evidence to suggest that many of the victims in Mwanza were not protesters.

‘They told them to lie down — then they shot them’

The first incident occurred in Kisesa, a town along the road between Mwanza and the suburb of Mji Mwema. The road became a death artery on the night of October 29 into October 30. According to multiple eyewitnesses, police killed four men in Kisesa at around 7 p.m., after a day of protests.

All survivors and eyewitnesses spoke to DW on condition of anonymity. They say police are trying to silence them and destroy evidence. DW has changed their names. Nuru, who witnessed the shooting, described how the men were executed.

“Akida had been sitting behind his house with two other young men. They were eating chips,” Nuru said. “Then the police arrived and told them to line up. There is a salon nearby, and there was a man ending his shift there. Police told him to join the others who were already lined up.”

What happened next, Nuru said, was swift and brutal: “Then the police ordered them to lie down. The man from the salon tried to run away, and they shot him in the back, in the chest and then in the head.

The ones who had been ordered to lie down were all shot dead.” The victims were Akida, 31; Chacha, 40, the man from the salon; Hamu, 31; and Zuberi, 24.

Sporadic gunfire continued throughout the night, said Tanga, another witness, making it impossible for families to retrieve the bodies.

“Even if he was your friend, after he had been shot, you could only run away — you wouldn’t dare come back to collect his body.”

According to Tanga, it was soldiers who removed the dead. “They had special lorries for carrying the bodies.”

Shot while watching the news

The second incident took place the following evening, October 30, in Mji Mwema. This time, the victims were inside a video hall, watching the news.

Imani, one of the survivors, was inside with about 14 other people when shooting began outside. “We were inside watching the news,” he said. “Suddenly, we heard bullets firing outside. Some of us were hiding under the benches.” Then the gunfire moved inside.

“When we lay down, I heard bullets being fired again. I felt like they were firing into the air, but they were actually shooting at us,” Imani said. “The whole incident took less than a minute, and then they left.”

Imani realized he had been shot only after the attackers were gone. “I felt something warm on my cheek,” he said. “The flesh of my cheek had been ripped off. I had been shot.”

Eyewitnesses told DW that several bodies lay in and around the video hall after the shooting. Neema lost two relatives that night — her son, Simba, and her brother, Khamisi.

“I went out to assist a man who had been shot in the back and thigh; he had managed to crawl to our door. He survived,” she said. “While we were helping him, a young man came crying, ‘Mama Simba, come see — Uncle Khamisi and Jabali have been killed!'”

Neema tried to reach the scene. “I tried to cross the road, but the shooting continued. We had to turn back,” she said.

Usi, another survivor, was with Simba moments before he died. “I told Simba, we need to run but he refused,” Usi recalled. “He said, ‘we haven’t done anything wrong; we should just stay quiet.'”

Usi hesitated — and then made a split-second decision. “I realized the only way out was to run right through the line of officers. I just bolted.”

Ballistics and removal of bodies

Using geolocation data and eyewitness accounts, DW traced the attackers’ movements: The shooters approached the video hall from the south, first attacking people near the TAG Church Nyasaka Center before driving about one minute up the road to the video hall.

DW obtained several bullets from both the Kisesa and Mji Mwema incidents. Ballistics expert Byron Adera examined the images.

“You can almost certainly say 7.62 by 39 millimeters,” Adera said. “They are ammunition widely used by small arms and light weapons of the nature of AK-47 variants.”

Those weapons, he said, are standard issue. “In Tanzania, the small arms and light weapons of the type of AK-47 happen to be the majority of the first-line weapon systems in the hands of the Tanzanian police,” Adera said.

“And, of course, the defense forces also use AK-47 variants.” Eyewitnesses in Kisesa say police in uniform carried out the shootings. In Mji Mwema, eyewitnesses say the shooters wore black combat gear. Soldiers collected the bodies in both places, according to the eyewitnesses.

Akida’s mother went to Bugando the day after her son was killed. “There were a lot of bodies piled on each other all over,” she said. “They managed to set him aside and told us to pay 300,000 shillings [$120, €102].” She said the family was forced to wait days before being allowed to bury him.

A leaked police report — and no official answers

An internal Mwanza police report leaked to DW lists 68 “deceased civilians.” The report identifies 58 of them by name, including several who were killed in the incidents DW investigated.

The DW investigation found that excessive force was used against innocent citizens and that the government may have more questions to answer.

DW repeatedly contacted the Mwanza police and requested comment from the Tanzanian government on the two incidents. DW also wrote to the government spokesperson. There was no response.

Months after election crackdown, hundreds of people remain unaccounted for.

DW

FERGUS KELL

Ugandans will go to the polls on 15 January. Two weeks after election day will mark the 40th anniversary since incumbent president Yoweri Museveni first took power in 1986. The 81-year-old Museveni is widely expected to celebrate this milestone from inside State House as president again.

Bidding for a seventh consecutive term in office, his ruling National Resistance Movement (NRM) is campaigning under the slogan ‘protecting the gains’.

This defensive posturing captures not only the NRM’s familiar appeals to stability and legacy, which have helped to consolidate its primary support base in rural areas, but also its ability to use state machinery to protect its own authority by suppressing alternative centres of power.

As with the 2021 elections, supporters of Museveni’s leading challenger Robert Kyagulanyi (a musician-turned-politician widely known as Bobi Wine) have reported abductions, arbitrary detention and violence at the hands of security forces.

Another opposition figurehead, Kizza Besigye, remains detained in a Ugandan prison on treason charges after his abduction in Nairobi in 2024.

Ahead of an expected new term for Museveni that could include major economic milestones, this election campaign has so far generated little fresh clarity on how the NRM will manage his succession, amid longstanding speculation over the positioning of his eldest son.

Neither has it offered much for Uganda’s discontented young urban population, who have seen seismic demonstrations elsewhere in East Africa in recent years.

Opposition and the Gen-Z factor

Ugandans watched significant protest movements erupt in Kenya in 2024 and around Tanzania’s election in 2025. The protests were led by the ‘Gen-Z’ demographic that makes up around a third of the population in these countries.

Uganda does share some important conditions with these neighbors: a rapidly growing young urban population more instep with online influencers than narratives of liberation; a political climate in which opposition political leaders and activists face abduction and detention; and a sense of opportunity among young people borne out of solidarity with Gen-Z protesters elsewhere.

Yet other factors are different. Kenya’s protests were leaderless, renouncing the influence of the late Raila Odinga; and Tanzania’s erupted while polling stations were still open and the main opposition leader Tundu Lissu was in prison.

In contrast, in Bobi Wine, young Ugandans have a genuine opposition figurehead present on the ballot. Unlike in Tanzania, where legal challenges to the election results were forbidden, the possibility of a court petition to challenge the results may act to dilute potential flashpoints in Uganda, even if it is highly unlikely to succeed.

Ugandan politics also remains heavily militarized. Protests in November 2020 saw 54 demonstrators killed by security services. Speaking last month about possible election demonstrations, President Museveni reminded citizens that ‘one soldier carries 120 bullets’.

Even if military intervention and illusory electoral institutions again combine to restrain widespread disorder in these elections, the conditions for potential unrest will remain. Many young urban Ugandans remain critical of the perceived lethargy of the NRM and repeated corruption scandals that sparked protests in 2024.

Unless these issues are addressed over the next presidential term, there is the risk that they could manifest in unrest during a potentially difficult political succession.

NRM renewal and succession

The longstanding question of Museveni’s succession remains dominated by his son, the chief of Uganda’s defence forces, General Muhoozi Kainerugaba.

Muhoozi leads a civic movement, the Patriotic League of Uganda (PLU), which has been influential in the wider repositioning of ruling elites in the NRM and military.

The PLU claims to hold an allied majority within the NRM’s central executive committee following internal party elections in 2025, which included high-profile upsets of established party figures at the hands of PLU-affiliated candidates.

Muhoozi has also partly tempered his famously provocative public outbursts in recent months, intensifying speculation over his next political move.

The national election itself is a sideshow to succession issues and wider competition among Uganda’s elite. As President Museveni’s capacity for unilateral decision-making reportedly declines, he has drawn his family closer to the centre of power.

Simultaneously, the wider NRM is facing increasing polarization, reflected by the reported disquiet among the losers in party primaries.

This context also helps explain why recent years have seen renewed efforts by the ruling party to co-opt and divide elements of Uganda’s political opposition – forestalling the emergence of any real alternative power centre for more moderate NRM elements, who question the logic of a dynastic succession.

New government appointments that emerge from the election will be seen in relation to the succession, reflecting a political system under strain more than one empowered by stability.

High stakes for Uganda’s future

These political dynamics may have greater consequences for Uganda’s long-term trajectory than in most previous presidential terms.

Speaking at Chatham House back in 2012, President Museveni said ‘Uganda is at a take-off stage’ – highlighting the country’s oil discoveries and planned infrastructure investment.

In the 14 years since, Uganda has shown steady economic growth and resilience to significant external shocks, but many citizens feel they are still waiting for that promised boom to materialize.

Uganda is now preparing for its first oil production and revenues in 2026-27, with the East African Crude Oil Pipeline (EACOP) progressing despite financing difficulties and environmental concerns.

Other strategic infrastructure projects are moving forward, including a $4 billion oil refinery and a long-awaited new railway to Kenya.

When Museveni pictured these projects might ‘take-off’ over a decade ago, Uganda was poised to benefit from the peak of Chinese infrastructure lending, and from deepening Western security and development cooperation.

The picture now is far more diversified, with Gulf state partners playing an increasingly significant role. The refinery, seen as a cornerstone for Museveni’s personal legacy and narratives of self-reliance, is being pursued with a UAE investment firm and a loan from a Bahrain-based private financier.

The influence of Western governments has also wavered. Uganda had already clashed with the US and other development partners well before the Trump administration’s major cuts to USAID. Ahead of the elections, reduced engagement is evident in the closure of governance programmes and lack of large-scale election observation.

However, last month the US agreed $1.7 billion in healthcare funding to Uganda under its new strategy – adding to an agreement in mid-2025 for Uganda to admit third-country US asylum claimants. World Bank lending to Uganda has also now resumed after a two-year freeze in 2023.

President Museveni has deftly managed the competing strategic interests of external partners. But this is an increasingly complex balancing act to sustain in a fragmented global context – and one that will intensify the demands on his eventual successor.

Though these elections may not be a tipping point, they also will not remove the converging pressures of an uncertain political succession and the need to deliver economic results for Uganda’s vocal youth. On these issues at least, the stakes remain high.

Chatham House