The U.S. supplied the majority of Tanzania's birth control until it was abruptly cut off in 2025. It's unclear how the country will fill the gaps.

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Family planning clinics in multiple African countries are reporting shortages of contraception. This is after the Trump administration dismantled USAID back in 2025. It was the largest donor for family planning services in Africa. NPR's Durrie Bouscaren reports.

DURRIE BOUSCAREN, BYLINE: When Patrick Kinemo heard that the U.S. had ordered the destruction of almost $10 million worth of contraceptives at a warehouse in Belgium last year, his heart sank. Many of the supplies were intended for his home country of Tanzania.

PATRICK KINEMO: The fact that these had already been paid for and they were scheduled to come to us, but we couldn't convince the U.S. government to actually allow those to come to us.

BOUSCAREN: Kinemo is a country director for MSI Reproductive Choices, a sexual health provider based in the United Kingdom.

KINEMO: We are living on a month by month, quarter by quarter, looking at the resources we have.

BOUSCAREN: The collapse was so sudden and so complete that MSI and other nonprofits have struggled to keep up. Especially in rural areas, Kinemo says, clinics often run out of more popular forms of contraception.

KINEMO: So that then exposes them to the risks of unwanted pregnancies, and certainly, then unsafe abortions and so on and so forth.

BOUSCAREN: Abortion is illegal in Tanzania, except to protect the life of the mother. But 1 in 5 maternal deaths in Tanzania are linked to unsafe abortions, when women find their own ways to terminate a pregnancy.

KINEMO: Family planning is a life-saving intervention. Each year, we know almost 8,000 girls discontinue school because they're falling pregnant.

BOUSCAREN: Instead of directing aid through USAID, the Trump administration has made deals directly with countries for health assistance, but Kinemo doubts that family planning will be part of it.

KINEMO: It's mainly focusing on HIV, general maternal health, infectious diseases like TB, but family planning is not included. And so there's a huge risk.

BOUSCAREN: In a statement to NPR, the State Department said the agreement will help Tanzania finance, manage and sustain its health system over the long run.

Durrie Bouscaren, NPR News.

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