标签： Africa

NAIROBI, Kenya — Tensions have escalated in East Africa after Kenyan civil society groups accused national authorities of deliberately flouting a court order to activate an American-supported Ebola quarantine facility, following confirmed reports that U.S. personnel evacuated from the Democratic Republic of the Congo are already isolated in the country. The controversy comes amid an ongoing deadly Ebola outbreak in eastern DRC that has already claimed more than 900 lives, reigniting fierce debate over public health risk and rule of law in Kenya. The two-month-old outbreak in DRC has recorded 2,344 confirmed infections to date, with a death toll climbing to at least 930, according to official data. To manage risk for U.S. citizens responding to the crisis, Washington backed a plan to quarantine evacuated American workers in Kenya, a stable U.S. ally hundreds of miles east of DRC with no confirmed Ebola cases of its own to date. U.S. humanitarian organization Samaritan’s Purse, which runs two Ebola treatment centers in the DRC towns of Bunia and Nyankunde, confirmed over the weekend that seven of its American staff, deployed to the outbreak front lines, are currently serving a 21-day quarantine period in large military tents in Kenya. The group emphasized none of the personnel have developed any Ebola symptoms so far. While the organization declined to disclose the exact location of the quarantine site, local Kenyan media has identified Laikipia Air Base, a military installation located roughly 115 miles north of the capital Nairobi, near the town of Nanyuki, as the intended site for the U.S.-backed facility. Local residents in Nanyuki have already held multiple demonstrations against the planned quarantine center, and two civilians have lost their lives in clashes that broke out when protests turned violent. As of Monday, neither Kenya’s Ministry of Health nor the U.S. State Department had responded to repeated requests for comment on the reports of quarantined Americans. Officials at Laikipia Air Base also could not be reached for a statement. The U.S. government has committed $13.5 million to support Kenya’s national Ebola preparedness programming, and Kenyan President William Ruto has publicly defended the planned quarantine facility as a core component of the bilateral public health partnership between the two nations. Ruto added that U.S. funding will also support the construction of 24 additional regional Ebola preparedness centers across Kenya. But the project hit a legal block last month, when Kenya’s high court issued a formal order barring the facility from being opened or operationalized. Kenyan Health Minister Aden Duale subsequently issued a formal order suspending all construction work on the site. The court order stemmed from a legal petition filed by two Kenyan civic groups — the Law Society of Kenya and constitutional advocacy organization Katiba Institute. The petitioners argued that hosting a quarantine for at-risk Americans evacuated from the DRC outbreak posed an unacceptable threat to Kenya, noting that the country’s already overstretched public health system could be completely overwhelmed if a local outbreak were to occur. Following the emergence of reports that Americans are already being quarantined in violation of the court order, leaders of the civic groups are demanding accountability. Nora Mbagathi, chief executive of the Katiba Institute, told the Associated Press that the activist community is deeply alarmed by the new reports. “Should any Kenyan government official be involved in this ongoing operation, they have completely betrayed the public trust and must be held personally accountable,” Mbagathi said. In its own official statement to the AP on Monday, the Law Society of Kenya called any deliberate violation of the court order a clear act of “impunity and lawlessness.” In his statement on the quarantine, Samaritan’s Purse President and CEO Franklin Graham confirmed additional details of the operation: the quarantined staff are housed in large military tents within a secured fenced gravel compound, sleep on military cots, and receive all meals from the U.S. military. Graham has not responded to repeated questions asking why the quarantine is active in Kenya despite the formal court order halting the project.

In the quiet agrarian community of Oriire, southwestern Nigeria’s Oyo state, a day of joyous feasting and interfaith prayer unfolded Friday as dozens of schoolchildren snatched from their classrooms by al-Qaida-linked militants returned to the embrace of their families. For Aliyu Saheed, a local farmer whose three young sons – the youngest just 5 years old – were among the captives, the news of their July 10 rescue marked the most euphoric moment of his life, ending two months of sleepless nights haunted by fear he would never see his boys again.

The mass abduction carried out on May 15 marked a worrying new chapter for Nigeria, Africa’s most populous nation. For years, large-scale school kidnappings by armed jihadist groups were concentrated in the conflict-battered northeast and northwest. But this attack, which targeted children as young as 3 in a region previously untouched by such violence, confirms what security analysts have warned about for months: armed factions are expanding southward, pushing beyond their traditional strongholds to seize new territory and control key natural resources.

When the gunmen stormed three local schools, they abducted 39 children and three teachers, marching their captives into a sprawling nearby forest reserve that connects northward to Kwara State, a region already grappling with persistent militant abduction activity that often targets students for large ransom payments. The attack left one teacher dead during the abduction, with two more losing their lives while in captivity, local media reports confirm. Nigerian President Bola Tinubu has identified the perpetrators as Ansaru militants, a breakaway faction of the notorious Boko Haram group that has reemerged and grown more active across the country in recent years.

Survivors of the two-month captivity have shared harrowing accounts of abuse and deprivation at the hands of their captors. Nine-year-old Shuaib, Saheed’s eldest son, recalled that the group was held in open ground without any shelter, left exposed to sweltering sun and heavy rain, fed only a meager diet of boiled rice and palm oil. “I could not say anything for fear of getting beaten,” Shuaib told the Associated Press. “They flogged us with a cane all over the body, and they hit me in the back with the butt of their gun.” Alamu Folawe, head of one of the targeted schools, added that the youngest children suffered the worst violence, with their mouths stuffed with cloth to muffle their cries and avoid drawing attention to the militants’ hideout.

While the rescue operation – a joint effort by Nigeria’s military, intelligence services and police forces – resulted in eight kidnappers arrested and multiple other militants killed, many of the freed children carry lasting physical scars and deep psychological trauma. Eight-year-old Kehinde Kaosarat, one of the last children released from hospital, has not left her mother’s side since returning home, and multiple families report that their children now refuse to consider going back to school. For Saheed, this fear is shared: “Sending them back to the school does not sound meaningful to me right now,” he said. The trauma comes at a time when Nigeria already has one of the highest out-of-school child populations in the world, a crisis that deepens with every attack on educational institutions.

The abduction has drawn urgent new attention to Nigeria’s under-patrolled forest reserves, which have increasingly become strategic corridors and hiding spots for expanding armed groups. “The thing to learn is that the forested areas of the country must be much better surveilled because that is where those armed groups operate and keep their victims,” explained Joachim MacEbong, senior analyst at global risk consultancy Control Risks.

The militant expansion into the southwest has piled mounting pressure on President Tinubu, who was elected in 2023 on a campaign promise to end Nigeria’s persistent security crisis. While the U.S. military provides limited logistical and intelligence support to Nigerian forces focused on the northern insurgency, the country’s overstretched security apparatus remains largely absent from remote southern communities bordering forest zones. Though Tinubu announced that the Ansaru informant network was dismantled during the rescue, analysts note that the root drivers of insecurity – including systemic corruption and weak governance – remain unaddressed.

James Barnett, an Africa security research fellow at the U.S.-based Hudson Institute, pointed out that Ansaru has spent years quietly building networks in southwestern Nigeria, and a high-profile attack like this could encourage further militant activity in the region. Even as the community came together Friday to celebrate the children’s safe return – with Christian and Muslim leaders joining in prayers of gratitude – many residents remain on edge. Hundreds fled the area after the abduction, and while some have begun to trickle back, farmers whose lands sit close to the forest reserve still hesitate to resume their daily work.

“The rescue of the Oriire abductees is wonderful news and should inspire some confidence in Nigeria’s ability to better manage these threats,” Barnett said. “But it is not the end of insecurity in the southwest or Nigeria as a whole.”

In the quiet Sokoto State town of Kware, northwestern Nigeria, Maryam Aminu felt a familiar mix of grief and frustration when her 18-month-old toddler became the second of her six children to relapse into acute malnutrition this April. For months, the family has struggled to put consistent, nutrient-dense meals on the table, a hardship that intensified sharply in February after her husband Shehu lost his job as a taxi driver, a casualty of skyrocketing petrol prices triggered by the ongoing war in Iran.

“Even though I suspected what the diagnosis would be, I was heartbroken and angry because I knew exactly why this happened,” Aminu explained from the plain living area of her family’s two-bedroom home, where coal stove ash drifted through the small space. “Meals are irregular, and we can barely afford enough to eat, let alone food that keeps children healthy.”

Child malnutrition relapse is no longer an isolated case in Sokoto or across northern Nigeria, local health workers and international aid officials confirm. The ripple effects of the Middle East conflict have piled a new crisis onto a region already reeling from extreme poverty and a years-long insurgency that has displaced thousands and cut off many farming communities from their land. Now, the global fuel shock sparked by the war has pushed food insecurity to catastrophic levels for millions of impoverished people, with children bearing the brunt of the harm.

This growing crisis comes as Nigeria is already grappling with sustained economic volatility sparked by President Bola Tinubu’s sweeping economic reforms, which included the elimination of national fuel subsidies and currency devaluation three years ago. New data from the World Bank released this week underscores the scale of deprivation: more than 139 million Nigerians now live below the poverty line or are classified as vulnerable to falling into poverty.

The global spillover of the conflict reaches far beyond the Middle East, the United Nations Children’s Fund (UNICEF) warned in a new report published this week. If hostilities continue through the end of 2024, an additional 23.4 million children worldwide will fall into monetary poverty, defined as lacking sufficient income to cover basic needs. Eighty percent of these newly vulnerable children will live across Africa and Asia, the agency estimates.

“Children are paying the heaviest price for the escalating conflict in the Middle East, even children thousands of miles from the fighting,” UNICEF Executive Director Catherine Russell said during a visit to Sokoto this week. “The longer hostilities continue, the more devastating the long-term consequences will be for a generation of children.”

The disruption to global energy supplies stems from the closure of the Strait of Hormuz, the critical chokepoint that carried one-fifth of the world’s total oil and gas trade before the outbreak of war. The shutdown triggered a cascading global fuel crisis that drove up prices for nearly every essential good, from household groceries and gasoline to agricultural fertilizer and commercial travel. In Nigeria, retail petrol prices jumped nearly 75% between February and April, surging from 800 naira ($0.58) per liter to 1,400 naira ($1.02) per liter, passing higher costs directly to low-income households that already spend most of their income on food.

For months, U.S. President Donald Trump has pursued a range of strategies to force Iran to reopen the strait, including targeted airstrikes, naval blockades, negotiations, and public threats, but the waterway remains closed to commercial traffic.

At public health facilities across Sokoto, frontline workers say they have seen a sharp and steady rise in the number of children returning for repeat malnutrition treatment this year. Unofficial hospital records shared with the Associated Press show nearly 40 children who had previously recovered from malnutrition after February are now back in care for a second diagnosis — a figure that does not include the many families who cannot afford to travel to facilities for treatment.

“I’m worried, and often angry, about how quickly these numbers are growing,” said Halimah Muhammad, a community health worker based in Sokoto.

Beyond the immediate threat to child health, soaring prices and persistent economic hardship are setting the stage for long-term developmental harm, Russell warned. Children growing up in chronically food-insecure households face far higher rates of stunting, which irreversibly impacts physical and cognitive growth. Financial stress also pushes more children to drop out of school to support their families, locking intergenerational poverty in place for decades.

“Their long-term development will be compromised, and many will not be able to stay in school because their parents face such extreme financial pressure,” Russell said. “The long-term implications for these children are absolutely terrible.”

The conflict has also disrupted global fertilizer supplies and sent prices soaring, compounding risks for northern Nigeria’s majority farming communities. Many of these communities are already unable to access their farmlands regularly due to ongoing violence by armed insurgent and bandit groups, and higher input costs have made this year’s planting season far more precarious, threatening future harvests and deepening the food crisis.

Shehu Aminu, Maryam’s husband, says the erosion of purchasing power has been overwhelming. “Two years ago, 2,000 naira could buy a nutritious meal for my whole family. Now that same basket of food costs 5,000 naira,” he said. Most days, the family only eats pap, a cheap corn pudding, and plain rice. “There is simply no way to give our children the food they need to grow. I wake up every morning unhappy, because I can no longer provide for the people I love.”

Communities across northwestern Nigeria are already caught between overlapping security crises: routine attacks by bandit groups that specialize in kidnapping for ransom, and expanding territorial control by Islamist insurgent groups. The distant war in Iran has only multiplied existing vulnerabilities, analysts say.

“This distant conflict offers no reprieve for the north’s most vulnerable populations, it only makes every existing crisis worse,” said Ikemesit Effiong, a partner at SBM Intelligence, a Lagos-based geopolitical risk advisory firm.

The pattern of repeated child malnutrition seen in Maryam Aminu’s family plays out across hundreds of households in the region. Larai Malami, a 35-year-old mother of 10, gave birth to her youngest child last December, and the infant has already been diagnosed with malnutrition twice. Her husband lost his job as a motorcycle taxi rider last year, and crossed the border into neighboring Niger to search for work, leaving Malami to care for their children alone.

Skyrocketing fuel prices keep food costs unaffordable and keep her husband from being able to afford to return home, Malami says. “I worry that my child will never get fully healthy,” she said.

It is a fear Maryam Aminu shares. For her 18-month-old daughter, she says, “I just wish she were excited and full of life, like a toddler should be.”

In a coordinated pre-planned assault that underscores the growing security crisis in the Sahel, an alliance of jihadi militants and Tuareg separatist fighters ambushed a Malian military convoy in Mali’s violence-plagued northern region on Saturday, with rebel spokespeople confirming dozens of government troops were either killed or taken prisoner. The attack, which took place in a remote stretch of the Gao region, has been officially confirmed by Mali’s national military, which issued a brief statement confirming the assault on the convoy carrying Malian soldiers and their foreign allies. The military declined to release further details on casualties or damage, noting only that a counteroffensive against the armed groups is currently ongoing.

Two separate groups have independently claimed joint responsibility for the operation: Jama’at Nusrat al-Islam wal-Muslimin (JNIM), the regional al-Qaeda affiliate active across the Sahel, and the Azawad Liberation Front (FLA), a unified Tuareg separatist movement formed in 2024 to push for an independent Azawad state in northern Mali. In their public statements, both groups confirmed that the targeted convoy included members of Mali’s regular military alongside personnel from Russia’s Africa Corps, the paramilitary force that has propped up Mali’s ruling junta since the country cut ties with United Nations peacekeeping forces in 2020.

FLA spokesperson Mohamed Elmaouloud Ramadane outlined the details of the assault in a press statement, noting that the convoy was traveling from the northern outpost of Anefis toward the regional capital of Gao when the attack unfolded in the open Sahara Desert. Observers have identified the convoy as a likely logistics support unit, as visible fuel tankers accompanying the column indicate it was moving supplies to forward government positions. Ramadane added that multiple army vehicles, including armored vehicles, were destroyed in the ambush, while other working vehicles were seized by the alliance.

The rebel alliance has released multiple videos purportedly documenting the aftermath of the attack. The footage, which has not been independently verified by The Associated Press, shows captured Malian soldiers surrendering while surrounded by rebel fighters, as well as armed rebels transporting detainees in their own vehicles. One clip shows rebels opening fire on a group of soldiers lying on the ground, confirming the heavy violence of the assault.

This attack marks the latest in a growing pattern of coordinated operations between the once ideologically opposed JNIM and FLA, a partnership that regional security analysts warn poses a severe threat to Mali’s fragile stability and the authority of its military junta, which has ruled the country since a 2020 coup. Mali, a landlocked nation at the heart of the Sahel, a vast semi-arid belt stretching across Africa south of the Sahara, has become the global epicenter of Islamist extremist violence over the past decade. Tuareg separatist groups have waged an on-again off-again insurgency for independence since 2012, and the FLA unified multiple separate separatist factions into a single movement earlier this year.

The April 2024 coordinated assault on Malian forces, the largest such attack in the country in more than 10 years, first signaled the depth of the growing collaboration between JNIM and the FLA. The new ambush adds to a sharp upward trend in militant attacks against government forces across the Sahel, where armed groups are increasingly pushing to expand their territorial control and influence amid a fragmented security landscape.

Half a world away from the polarized abortion debate playing out across the United States, thousands of African women face heightened danger to their lives and health as American anti-abortion groups expand their influence and funding on the continent. This growing international push gained new momentum from the Trump administration, which implemented sweeping cuts to U.S. foreign aid for any global organization that provides or advocates for abortion-related services — changes that threaten to cut off access to reproductive health support tied to as much as $30 billion in global assistance.

For decades, conservative American anti-abortion organizations have pushed for restrictions both domestically and internationally, and Africa has become a key front for their efforts, given that many African national health systems rely heavily on foreign donor funding to operate. New analysis from the Institute for Journalism and Social Change has pulled back the curtain on the scale of this funding: 17 major U.S. anti-abortion nonprofits poured more than $16 million into African operations between 2019 and 2022, followed by an additional $9.3 million in spending across 2023 and 2024. Researchers warn that even these figures are an underestimate, as U.S. churches and many religious anti-abortion groups are exempt from mandatory public financial disclosure requirements, leaving millions more in unreported spending off the books. Institute researcher Claire Provost describes the documented spending as “just the tip of the iceberg” of the full scope of U.S. anti-abortion investment in the continent.

This influx of American funding and support has emboldened a widespread campaign of harassment against local reproductive health workers and rights advocates across multiple African nations. A 2024 report from Marie Stopes International, a leading global reproductive health provider, documented a surge in online harassment, legal threats, and even criminal detention of staff delivering legal abortion and reproductive care. In the Democratic Republic of Congo, health workers have been detained for days for providing services that are fully legal under local law, before being released without any formal charges. In Ethiopia, the local head of U.S.-based anti-abortion group Family Watch International has targeted senior reproductive health leaders with social media trolling and published YouTube videos spreading harmful misinformation about abortion. In Kenya, personal contact information for staff at reproductive rights organizations has been published online, with workers falsely accused of murder. One anonymous Nairobi-based private abortion clinic owner told the Associated Press that staff have been repeatedly detained by police, who demand bribes in exchange for dropping fabricated criminal charges. Kenyan government officials declined repeated requests for comment on these reports.

Health and rights advocates warn that this growing anti-abortion push is rolling back decades of incremental progress toward expanding safe reproductive care across Africa. The Maputo Protocol, adopted by the African Union 20 years ago, enshrines safe abortion as a human right and requires signatory nations to legalize the procedure in cases of rape, incest, risk to the pregnant person’s health, and fatal fetal abnormality. But implementation of the protocol has been inconsistent at best, leaving millions of women with no access to legal care. The African Institute for Development Policy estimates that sub-Saharan Africa records more than 6 million unsafe abortions every year, and the region already has the world’s highest rate of maternal mortality, making it the deadliest place globally for women of reproductive age.

In recent months, the anti-abortion movement has notched high-profile policy wins across the continent, powered by U.S. funding and organizing. Last year, U.S., European, and African anti-abortion groups joined with senior Kenyan government officials for a Nairobi conference focused on advancing a conservative “family values” agenda. Charles Kanjama, vice chairman of the conference organizing body the African Christian Professionals Forum, framed the fight over abortion access as an international “culture war.” In May 2024, that work paid off when a Kenyan appeals court overturned a lower court ruling that had affirmed abortion access as a fundamental constitutional right; Kanjama led the legal challenge, and called the ruling a victory that “restored constitutional balance.” Just one month later, delegates from 20 African nations finalized a draft regional charter in Ghana that calls for rejecting established sexual and reproductive health rights, which will go to a vote before the African Union in 2025. Sharon Slater, co-founder of U.S.-based anti-abortion group Family Watch International, was among the organizers fundraising for the charter’s adoption at a European Parliament event in Brussels earlier this year.

In response to questions about the new aid restrictions, the U.S. State Department defended the policy in a statement, saying “the American people expect their tax dollars to support programs that save lives … and reflect American values, not fund abortion-related activities, left-wing social agendas, or wasteful overseas bureaucracies.” The department added that U.S. assistance continues to support broad maternal and child health programming under the administration’s America First Global Health Strategy. But healthcare providers and reproductive rights advocates say the reality on the ground tells a different story: while the Trump administration and anti-abortion groups frame their work as protecting life, the end result is a growing number of preventable deaths among African women.

Decades of advocacy by U.S.-based anti-abortion groups have reshaped reproductive health policy both at home and abroad, with the reversal of Roe v. Wade marking their biggest domestic victory. Now, the second Trump administration is injecting dramatic new momentum into their cross-border campaign to export conservative “family values” to nations across the globe.

Speaking at the annual March for Life anti-abortion demonstration in Washington D.C. in January, Vice President JD Vance unveiled sweeping new restrictions on U.S. funding for international nongovernmental organizations, foreign governments, and United Nations agencies that work to expand access to abortion, gender-affirming care, and diversity programming overseas. “We’re going to start blocking every international NGO that performs or promotes abortion abroad from receiving a dollar of U.S. money,” Vance told the gathered crowd.

These expanded restrictions build on decades of on-the-ground anti-abortion advocacy led by U.S. conservative nonprofits, particularly in sub-Saharan Africa, a region where local health systems rely heavily on foreign assistance. Already home to the world’s highest rate of unsafe abortions and the highest maternal mortality linked to pregnancy termination, sub-Saharan Africa bears 70% of the world’s global maternal deaths, recording roughly 180,000 preventable pregnancy-related fatalities each year.

Analysts estimate the new policy could impact at least $30 billion in U.S. foreign aid, upending global reproductive health frameworks that have been in place for decades. For conservative advocates, the shift represents a long-sought alignment of U.S. foreign aid with their ideological goals. “We’re seeing opportunity here to have a consistently pro-life ethic,” explained Nicole Hunt, a representative of Colorado-based conservative evangelical group Focus on the Family. “We’ve been influencing health policies for a long time with our foreign aid. This is just a new direction.”

A key target of the movement is the Maputo Protocol, a 20-year-old international agreement signed by most African nations that enshrines safe abortion as a human right. The protocol requires signatory countries to legalize abortion in cases of rape, incest, fatal fetal abnormality, and when a pregnancy threatens a woman’s life or health, but implementation across the continent has been uneven, forcing millions of women to seek unregulated, unsafe procedures each year. The African Institute for Development Policy records more than 6 million unsafe abortions annually across sub-Saharan Africa, and emboldened by the new U.S. policy, anti-abortion activists are now working to roll back even the limited access guaranteed by the protocol.

Reproductive health advocates say the policy shift has already created a new, hostile landscape for reproductive rights work across the continent. “We’ve now moved into a new era where we are the ones who are in opposition because the most powerful and influential supporters of reproductive health — the U.S. and a lot of Europe — are now more aligned with anti-rights groups,” said Nardos Hagos, regional representative for the International Planned Parenthood Federation in Nairobi. “We’re gonna see more women dying from unsafe abortions.”

Tracking the full scope of U.S. anti-abortion funding flowing into Africa is complicated by loose disclosure rules for religious and charitable groups. An analysis by the Institute for Journalism and Social Change, a research organization, of public tax filings from 17 major U.S. anti-abortion groups found funding to Africa jumped 50% between 2019 and 2022, reaching more than $16 million. Previously unreported data from the institute shows the same groups spent nearly $9.4 million across the continent in 2023 and 2024 alone.

Claire Provost, a researcher with the institute, notes that these numbers are just “the tip of the iceberg,” because U.S.-based churches and many religious organizations are exempt from mandatory annual financial disclosure requirements that would reveal how much funding they direct to anti-abortion work in Africa. One major group increasingly active on the continent is The Church of Jesus Christ of Latter-day Saints, commonly known as the Mormon church, which has more than 1 million followers across Africa and has hosted “Strengthening Families” conferences across the continent over the past eight years.

Sean E.R. Donnelly, the church’s Africa communications manager, told the AP roughly a quarter of the $1.5 billion the church spent on international programs last year went to African development projects focused on healthcare, education, and emergency relief “with the goal of helping people, especially families.” When asked about reproductive rights, Donnelly said the church is “not really active” on abortion issues, though it does invite government officials to its conferences to help craft “policy and strategy to make sure that we protect the family.” The church’s official position opposes elective abortion in most cases, but allows exceptions for rape, incest, and threats to a pregnant woman’s life or health.

Local rights groups have noted that the church held a major conference in Sierra Leone last year, just as the country was moving forward with plans to decriminalize abortion. Pressure from local religious lobbies ultimately stalled the reform, a change that advocates link to the ideological and financial support from U.S. conservative groups. Donnelly denies the church interfered in the process, saying “This is not how the church operates in Africa or globally.”

Beyond shifting funding, the growing influence of U.S. anti-abortion groups has emboldened a wave of harassment and intimidation targeting reproductive health workers and providers across Africa. Hannah Ruguru, who works at a reproductive health clinic in Kisumu, western Kenya, entered the field after her own sister died from an unsafe backstreet abortion. Today, her work has become increasingly dangerous: she has been screamed at by anti-abortion protesters, and deleted her Facebook account after years of relentless online abuse. “Sometimes you can get scared,” she said. “But at the end of the day, I’m helping women.”

A 2024 report from Marie Stopes International, which operates the clinic Ruguru works at, documents widespread coordinated attacks across multiple African countries led by U.S.-based groups and U.S.-funded local organizations. In the Democratic Republic of Congo, health workers have been detained for days for providing legally allowed abortion services before being released without charge. In Ethiopia, the head of the local office of U.S.-based anti-abortion group Family Watch International has targeted senior reproductive health leaders with online harassment and spread anti-abortion misinformation via YouTube. In Kenya, staff contact information has been published online with false accusations of murder, and private clinic owners report repeated police harassment, detention, and extortion.

Musoba Kitui, regional director of the Ipas Africa Alliance, which advocates for safe abortion access, called the combination of new U.S. aid restrictions and growing ideological incursion deeply concerning. “The changes in U.S. foreign aid policy combined with this advancing American interest in ideology in Africa is really concerning,” Kitui said. “We think the consequences are going to be dire,” especially for women and marginalized LGBTQ+ communities who already face barriers to care.

Anti-abortion leaders frame the campaign as a necessary defense of traditional cultural values against what they describe as an imposed global progressive agenda. At a 2023 conference in Nairobi bringing together U.S., European, and African anti-abortion Christian leaders alongside senior Kenyan government officials, attendees framed the fight over reproductive rights as an global cultural conflict. “It’s a culture war, really,” said Charles Kanjama, vice chairman of the African Christian Professionals Forum, the conference organizer. He noted that international aid previously flowed overwhelmingly to reproductive rights groups, but “we are hoping that … we can start attracting money from people who think like us.”

That momentum is already translating to institutional change across the continent. In June 2024, representatives from 20 African nations finalized a draft charter in Ghana that calls for rejecting international sexual and reproductive health rights frameworks; the charter will go to a vote before the African Union in 2025. Anti-abortion activists from the U.S. have already begun international fundraising to support the charter’s passage.

In Kenya, one of Africa’s largest economies, the impact of shifting policy is already visible on the ground. The African Population and Health Research Center records an average of seven preventable deaths from unsafe abortion complications every single day. While the 2010 Kenyan constitution allows abortion when a woman’s life or health is at risk, and courts have expanded access to cases of rape, incest, and threats to mental health, a colonial-era penal code still criminalizes abortion providers and patients, who face up to 14 years in prison. Most public hospitals refuse to perform even legal abortions, leaving women to choose between costly private care or unregulated dangerous procedures. In May 2023, a Kenyan appeals court overturned a lower court ruling that affirmed abortion access as a fundamental right — a case led by Kanjama, who called the ruling a restoration of “constitutional balance.”

The Kenyan government did not respond to repeated requests for comment on the issue. In a statement responding to questions about the new U.S. aid rules, the U.S. State Department defended the policy: “The American people expect their tax dollars to support programs that save lives … and reflect American values, not fund abortion-related activities, left-wing social agendas, or wasteful overseas bureaucracies. U.S. assistance continues to support a wide range of maternal and child health services as part of the America First Global Health Strategy.”

On the ground in Kenyan public hospitals, doctors and public health workers say the reality of the policy is a growing tide of preventable death. “By the time the women come, we are often dealing with a life-threatening situation,” said Dominic Omollo, reproductive health coordinator in Bondo, western Kenya, where public hospitals only treat life-threatening complications from unsafe abortions, not the procedures themselves.

For 25-year-old Mary Olouch, that reality proved fatal. A fish seller in rural Karabok village, Olouch discovered she was pregnant while already raising a young child, and hid her pregnancy from her husband. She did not qualify for a legal abortion at a public hospital, and could not afford the cost of private care. She bled to death after an illicit abortion, leaving her young child motherless. Today, two trees mark her grave just meters from her home.

After Olouch’s death, Loice Ochieng, a local community health volunteer, said women in the village began speaking openly about abortion for the first time — a topic that had long been taboo. “Because they have seen that this thing can cause death,” Ochieng said.