United States government assistance intended to grow democracy in the region has dropped in favour of health projects, resulting in a drop in its spending in the region by half -- from $2.97 billion in 2015 to $1.55 billion last year.
This comes as the US is proposing a 30.8 per cent cut to its overall foreign aid budget, according to a State Department budget document seen by The EastAfrican.
The budget proposal eliminates all funding through the development assistance account in all the countries in the region, a vote that has benefited education and water projects.
According to data from Foreign Assistance, a US government agency that tracks its development aid, US aid to the region has dropped over the past three years despite its planned spending remaining high. This year, Washington plans to spend $3.06 billion in the region, a drop from $3.75 billion two years ago, even though what it actually spent was lower.
Kenya's health sector was set to be the biggest beneficiary in the aid spending, with a planned spending of more than $1.68 billion in the past three years, but in the end it only received $530 million.
In 2015, the American administration expressed displeasure with the handling of its health funds under the Centres for Disease Control (CDC) programmes jointly run with the Kenya Medical Research Institute (Kemri), after it emerged that more than $7 million in funding had been spent in half the budget period.
In an earlier interview with The EastAfrican, CDC Kenya country director Dr Kevin De Cock said the improprieties were a cause of concern, especially around the signing of new agreements.
"Once the current discussion that we have, which is about financial management, and the report, is out, I believe we can have the discussion on collaborations. We are coming to a conclusion on how to move forward with technical co-operation and support. We are also consulting on how to ensure financial management is done properly. We cannot have a repeat of this experience; so things may change," Dr De Cock said.
In 2015, when the loss of funds was revealed, the US scaled back its health sector aid to the country to $94.6 million from $435.6 million the previous year, showing the significance of the governance concerns raised.
South Sudan, which has been embroiled in civil war since late 2013, also bore the brunt of the Trump administration cutbacks this year, recording the largest budget aid cuts, from a high of $610.4 million in 2015 to $225.2 million this year.
Most of Washington's spending in Juba will go to humanitarian assistance and peace and security efforts. In the past two years, the country has received more than $635 million from the US towards its worsening humanitarian situation, as its citizens face starvation and war.
Last year, the US threatened to cut its aid to Juba if the political impasse between President Salva Kiir and his exiled rival Riek Machar were not solved and sanity restored.
"We're not going to provide help incessantly if they're not willing to accept responsibility and do the things necessary to deliver to their people. These leaders have to stop these atrocities against their people," former secretary of state John Kerry then said.
Somalia has also seen its aid reduced by the Trump administration even as it redirects its energies towards a military effort to defeat Al Shabaab militants. This year, the country will receive $196.3 million, down from $300 million in 2015, with a majority of it expected to go into humanitarian assistance. The country is currently in dire need of aid, with more than three million of its displaced population in need of food.
"We are facing the largest humanitarian crisis since the creation of the United Nations. We need more than $4.4 billion to avert this crisis," Stephen O'Brien, the UN humanitarian chief, told the Security Council after a visit this month to Somalia and South Sudan.
Somali Finance Minister Abdirahman Dualle Beileh said that the current drought was getting worse and pleaded against any cuts in funding to the country.
"I pray that we don't get to the famine level. As it is, the drought is much more serious than the one we had in 2011. So we hope the donor community, including the US, will not cut back on the aid but instead assist us with more to avert the humanitarian crisis we are headed into," Mr Beileh said.
According to the Organisation for Economic Co-operation and Development, the US is Africa's official bilateral aid partner with over $9 billion. The UK follows with $4 billion, then France $2 billion. In terms of official development aid receipts to East Africa, Ethiopia received the largest sum of over $3.5 billion in aid last year, followed by Kenya and Tanzania with over $2.5 billion and Uganda with $1.5 billion.
Globally, US spending to foster democracy, human rights and accountable governance has risen for the first time in five years, from a low of $1.12 billion last year to $2.7 billion this year. During Barack Obama's presidency, democracy aid across the globe fell by 28 per cent.
Most of the funding to non-governmental organisations under the civil and democracy sectors has been on the decline in the past seven years. Kenya recorded the biggest allocation fall, receiving $7.1 million last year, down from $14.1 million in 2010, during its constitutional referendum period.
Interestingly, Tanzania, which has been engaged in a constitutional referendum debate in the past two years, has seen its democracy and civil society funding rise from $0.2 million seven years ago to $4.8 million last year.
In its fourth quarter economic insight for Africa, the accountancy and finance body (ICAEW) says that spending cuts to accommodate increased infrastructure expenditure are likely to lead to further decrease in aid.
"Aid is one of the main channels through which a change in US policy under the Trump administration could impact Africa," said ICAEW Middle East, Africa and South Asia regional director Michael Armstrong.