Health is an essential foundation for long-term development of economies and societies. With a rapidly growing population of 460 million, a healthy, productive workforce requires sound investments in human capital. The USAID/West Africa Regional Mission has identified health as one of its top priorities, and through its Regional Health Office (RHO), the Mission is focused on partnering with West Africans in strengthening health services and systems throughout West Africa. Presently, RHO implements family planning and reproductive health service delivery programs in four focus countries: Cameroon, Côte d’Ivoire, Mauritania and Togo. Additionally, RHO supports the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) programming in Benin, Burkina Faso and Togo. In 2024, RHO began supporting the President’s Malaria Initiative (PMI) program in Togo. Through programming and collaboration with the West Africa Health Organization (WAHO), the institution entrusted by the Heads of State and Government to ensure the coordination of regional health interventions within the ECOWAS region, and with other donors and partners, the RHO reaches other West African countries through an advocacy and policy role. USAID’s support to WAHO benefits all 15 ECOWAS member states.

By working with key institutions in the region, RHO is ensuring timely access to quality essential health products and services, improving in-country and regional collaboration and coordination, and supporting the global health security agenda (GHSA). Funded activities support the scale up of best practices for distribution, warehousing, logistics, data visibility, and contraceptive stock monitoring. This support enables the four focus countries the ability to manage their health commodities more effectively. RHO is also working toward achieving common, shared goals in family planning and reproductive health, including maternal and child health, HIV/AIDS prevention, care and treatment, nutrition, and malaria. USAID’s engagement with regional organizations helps to operationalize family planning commodity security initiatives and build the knowledge repository for public health professionals to learn from one another. 

Together with WAHO, RHO is strengthening national health systems by using relatively small, catalytic investments. An intensive focus on systems and institutional capacity-building, along with the continued prioritization of High Impact Practices (HIPs) and related policies, better equip countries to reduce morbidity and mortality, combat infectious diseases, and advance equity in healthcare.). In ECOWAS member states, WAHO is also promoting public-private partnerships with health care providers and institutions to create platforms for strategic dialogue. By engaging the private sector in health care provisions, investments in health care are increasing, as well as the availability and quality of health services. 

RHO also builds the capacity of host country governments and National Statistics Offices to collect, monitor and evaluate data on their family planning, fertility, maternal and child health, nutrition, HIV/AIDS, and malaria for policy and decision making through the Demographic and Health Survey (DHS) activity. Cameroon, The Gambia, Mauritania and Togo are some of the recent beneficiaries. 

Family Planning and Reproductive Health, and Maternal and Child Health 

The Regional Health Office in the USAID/West Africa Regional Mission promotes expanded access to, and utilization of quality family planning (FP) services in Cameroon, Côte d’Ivoire, Mauritania, and Togo. USAID's program, Expand Family Planning and Sexual and Reproductive Health (Expand PF) aims to improve unmet need, preferred method use, and access to full contraceptives method mix by scaling up the usage of High Impact Practices at the subnational, national, and regional levels. ExpandPF collaborates with other USAID programs such as Propel Health, Propel Adapt, Global Health Supply Chain Technical Assistance (GHSC-TA Francophone TO), and West Africa Breakthrough Action (WABA) to achieve its wide reaching goals. Other health services that are supported include: antenatal, labor and delivery, postpartum care and FP; well child visits; nutrition and HIV/AIDS prevention; treatment and care that is tailored to meet the needs of and facilitate access for youth. 

RHO also supports commodity security through a regional contraceptive early warning system managed by WAHO for the ECOWAS member countries to: coordinate contraceptive stock data and address stock imbalances; improve data visibility; and inform robust reproductive health commodity supply chain management and decision-making. 

With the Ouagadougou Partnership RHO is mobilizing domestic resources and supports implementation plans for FP aimed at doubling the number of modern contraceptive users from 6.5 million to 13 million by 2030 in line with FP 2030 goals. The Partnership includes the governments of nine francophone West African countries supported by USAID, the French Ministry of Foreign Affairs, the Agence Française de Développement, the Gates and Hewlett Foundations, the United Nations Fund for Population Assistance (UNFPA), WAHO and others. Due to the successful collaboration with the Ouagadougou Partnership and the commitment to increase utilization of quality health services, member states have exceeded the target for 2.2 million new contraceptive users by about 263,000 users.

HIV/AIDS Prevention, Care and Treatment

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) is the largest commitment by any nation to address a single disease in history. As part of PEPFAR’s West Africa regional platforms, which includes Benin, Burkina Faso, Ghana, Liberia, Mali, Senegal, Sierra Leone, and Togo, the Regional Health Office in the USAID/West Africa Regional Mission supports HIV programming mainly with governments and civil society organizations in Burkina Faso, Togo, and Benin. RHO's goal with PEPFAR funding is to accelerate progress in these three countries toward achieving the UNAIDS 95-95-95 goals by 2025 (95% of people living with HIV know their HIV status, 95% of those who know their status are on lifesaving antiretroviral therapy and 95% of those who are on antiretroviral therapy are virally suppressed) and eliminate HIV/AIDS by 2030. 

USAID’s program, #Ending AIDS in West Africa supports health workers at facilities and at the community level to provide comprehensive and effective HIV prevention, care and treatment services to key and general populations in high burden HIV areas, including interventions against gender-based violence, stigma, and discrimination. 

In collaboration with government Health Ministries, civil society organizations and the Global Fund to fight AIDS, Tuberculosis, and Malaria, RHO is helping to reduce service inequalities among female sex workers, men who have sex with men, children, adolescents, youth, adult women, and adult men. #EAWA relies on the rapid scale-up of effective and innovative practices, and supports index testing, enhanced peer outreach, self-testing, pre-exposure prophylaxis, electronic patients record (etracker), transition to the fixed-dose combination tenofovir/lamivudine/dolutegravir (TLD), and differentiated service delivery with multi-month antiretroviral dispensing.

In FY24, with support from RHO, PEPFAR-supported health facilities in Benin, Burkina Faso, and Togo ensured the continuity of lifesaving antiretroviral therapy for 119,167 people living with HIV, 95% of whom achieved viral suppression.

Capacity Strengthening of Community-based Organizations in West Africa (CBO Cap)

On January 16, 2024, the USAID West Africa Regional Health Office awarded a four-year cooperative agreement “Capacity Strengthening of Community-based Organizations in West Africa (CBO Cap)” to Enda Sante. The goal of the four-year regional program is to strengthen sustainability and accelerate the transition to local partners in the West African region for direct funding from USAID and other donors in four initial target countries namely Benin, Burkina Faso, Senegal, and Togo. The program will reinforce the model for South-South training, support and experience-sharing, aimed at developing local expertise in the West African region. The program will target both health and non-health non-governmental local partners. It will be implemented in a participatory and inclusive manner to ensure greater ownership, alignment with national policies and sustainability of best practices. This work will be done through an open collaboration with local partners, government authorities, national Programs and USAID Missions.

President's Malaria Initiative (PMI)

The U.S. President’s Malaria Initiative (PMI) delivers cost-effective, lifesaving malaria interventions and catalytic technical and operational assistance to support Togo toward ending malaria. PMI is led by USAID and the U.S. Centers for Disease Control and Prevention (CDC). As a new PMI partner country, activities are focus on identifying partners and programmatic activities in support of Togo's National Malaria Strategic Plan 2023-2026. Malaria remains a major public health issue in Togo, despite a 48% decline in incidence and 60% drop in mortality from 2000 to 2022 (2023 Global Malaria Report). In 2023, Togo reported nearly 2.4 million confirmed malaria cases, a 6% increase compared to 2022 and the highest number of reported cases since 2019. Malaria-related deaths saw a significant rise, with 1,281 reported deaths, a 42% increase from 2022. 

The USAID PMI Evolve program in Togo is designed to strengthen entomological surveillance and enhance the national strategy for insecticide resistance monitoring and management. Key activities include conducting vector bionomics studies at three sites and monitoring insecticide resistance across six sites, which will also serve as surveillance locations for the invasive malaria vector Anopheles stephensi. In addition, the program will support the enhancement of laboratory research capacity and assist with the renovation of an entomology lab. 

USAID’s REACH Malaria program supports Togo’s efforts in malaria case management at both health facility and community levels. The program assists with implementing the national malaria in pregnancy (MIP) strategy, which includes distributing ITNs at the first antenatal care visit, ensuring pregnant women receive at least three doses of intermittent preventive treatment (IPTp), and promoting timely, quality case management in line with WHO guidelines. REACH also supports Seasonal Malaria Chemoprevention (SMC) in four additional districts in Togo’s Plateaux region. Given rising concerns over antimalarial resistance in the horn of Africa, REACH is building the NMCP’s capacity to generate standardized data on drug efficacy and parasite resistance by conducting surveys at six rotational sites.

USAID enhances the National Malaria Control Program’s (NMCP) capacity to strategically plan, implement, monitor, and evaluate social and behavior change (SBC) interventions aligned with the 2023–2026 National Strategic Plan (NSP) goals. Activities include assessing the current communication plan, developing and conducting a malaria knowledge, attitudes, and practices (KAP) survey, and using the survey findings to refine the new SBC plan. Based on this updated plan, PMI will support creating and distributing SBC materials at all levels, including schools and communities. Recognizing the importance of community involvement in malaria control and elimination, RHO will collaborate with the Peace Corps to implement SBC activities that engage targeted communities actively in malaria prevention efforts.

USAID’s Country Health Information Systems and Data Use (CHISU) program supports the NMCP with surveillance, monitoring, and evaluation efforts. This support will enhance data collection and improve data quality, while building staff capacity at both central and decentralized levels to enable evidence-based decision-making.

USAID’s GHSC-FTO activity supports the NMCP in strengthening its supply chain system by providing technical assistance in procurement and supply management best practices. Additionally, the Global Health Supply Chain - Procurement and Supply Management (GHSC-PSM) program is supporting the procurement of over 1 million insecticide-treated nets (ITNs), which will be distributed to the general population during a 2026 mass campaign to help Togo achieve universal coverage as recommended by WHO. GHSC-PSM will continue supporting the procurement of essential antimalarial commodities in the coming years.

Nutrition

In coordination with the Regional Economic Growth Office and WAHO, RHO supports activities that also aim to increase access to safe and nutritious foods through strengthened food safety systems, like improved nutrition monitoring and surveillance systems, coordinate with and scale-up regional food fortification and biofortification policies and technologies. 

USAID and WAHO also jointly established a Regional Food Fortification Alliance and Regional Health Observatory that monitors progress on nutrition in the region. With USAID’s support, WAHO organized the 17th ECOWAS Nutrition Forum in Nigeria to strengthen private and public nutrition partnerships. Key partners including UNICEF and the International Food Policy Research Institute, collaborated with WAHO to develop a guide to translate the recommendations from the 16th Nutrition Forum into concrete activities at the national level. The guide, which WAHO has disseminated to member states, serves as a basis to assess the level of implementation and ownership of key nutrition actions identified by West African stakeholders. USAID also provided technical and financial support for the launch of the Regional Health Observatory, aimed at ensuring universal access to nutrition data and strengthening country ownership of nutrition data management in ECOWAS member states. Additionally, WAHO organized the 17th ECOWAS Nutrition Forum in Nigeria to strengthen public-private nutrition partnerships. With USAID/WA’s support, WAHO developed and plans to pilot a nutrition training curriculum for university students in 5 countries across West Africa starting with a training of trainers in the first quarter of 2025. 

Global Health Security

USAID engages in global health security through a One Health framework, a multi-sectoral approach that recognizes the interconnection between people, animals (wild and livestock), plants, and our shared environment. An integrated One Health approach to public, animal, and environmental health is vital to preventing, detecting, and responding to pandemics. 

RHO collaborates with WAHO through the Regional Centre for Surveillance and Disease Control in Nigeria and the Regional Animal Health Center in Mali, to advance the global health security agenda and One Health. 

Learn More:

• West African Health Organization (WAHO)
• Economic Community of West African States (ECOWAS)
• Ouagadougou Partnership