By the end of the civil war in 2002, Angola faced severe challenges with over one million deaths, 4.5 million internally displaced individuals, and 450,000 fleeing the country. The destruction of infrastructure and public services during the war has led to persistent issues, particularly in public health. Today, Angola struggles with high child and maternal mortality —nearly one in five children dies before their fifth birthday, and the maternal mortality ratio stands at 199 maternal deaths per 100,000 live births. The country also has a high fertility rate of 5.8 births per woman, which places additional pressure on an already strained healthcare system. Malaria is the country's primary health burden and the principal cause of morbidity and mortality. While Angola´s entire +35.5 million population is at risk for malaria, the HIV/AIDS estimated prevalence is around 2%, presenting an opportunity to avoid the severe health impacts seen in other southern African nations.
The Angolan National Health Development Plan (2012-2025) outlines strategic health goals, including reducing malaria morbidity from 21% to 12%, maintaining HIV/AIDS prevalence at 2%, tripling the number of doctors per 10,000 citizens, improving skilled birth attendance from 49% to 70%, and increasing family planning services from 6% to 45%.
U.S. assistance focuses on sustainable health improvements and increasing Angolan ownership of health initiatives. Through partnerships with the Government of Angola (GRA) and other stakeholders, USAID aims to develop an integrated health system and a robust workforce capable of delivering quality health services. Key initiatives include the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI), which support the Ministry of Health in combating malaria, HIV/AIDS, and other communicable diseases. These efforts align with the Angolan government's priorities as outlined in the National Strategic Plan for the Health Sector 2023-2027.
USAID’s funding plays a critical role in capacity building and technical assistance, helping to implement the government’s health and development strategies. Current programs aim to ensure equitable access to quality health services, reduce maternal and child mortality, and halve malaria-related diseases and deaths.
Additionally, U.S. support in water and sanitation complements health initiatives by promoting access to clean drinking water and reducing the spread of diseases. The U.S. was also a key donor for COVID-19 vaccines in Angola, collaborating with partners to facilitate effective vaccination efforts. Ongoing support also includes strengthening laboratory systems and training healthcare workers to improve overall health outcomes in the country.
Malaria
Since 2006, the Presidential Malaria Initiative (PMI) has invested over $415 million to combat malaria and enhance Angola's health systems. The initiative has provided financial and technical assistance to the Government of the Republic of Angola (GRA) to implement effective interventions against malaria across more than 1,000 health facilities in six provinces, reaching approximately 19 percent of the total population. PMI focuses on delivering insecticide-treated nets, malaria diagnosis and treatment, and training health workers in various aspects of malaria management, including pharmaceutical and supply chain management. Additionally, PMI supports activities related to epidemiologic surveillance, entomological monitoring, and social behavior change.
In recent years, PMI has played a vital role in improving malaria treatment capabilities and health outcomes, contributing to a notable decline in malaria-related mortality in targeted provinces.
HIV/AIDS
As part of the PEPFAR Interagency Program, USAID supports the GRA to meet the UNAIDS’s 95-95-95 targets by 2030: 95 percent of all people living with HIV know their HIV status, 95 percent of all people with diagnosed HIV infection receive sustained antiretroviral therapy, and 95 percent of all people receiving antiretroviral therapy obtain viral suppression through technical assistance at the national, provincial, health facility, and community levels. In 2019, the PEPFAR program in Angola shifted its HIV programming focus to the prevention of mother-to-child transmission (PMTCT) in four provinces. With gains aligned with the country’s First Lady Born Free to Shine Initiative and ensuring no one is left behind, PEPFAR Angola currently looks beyond PMTCT to a family-centered care and treatment program for the general population including men, women, and children.
USAID provides technical assistance on improving the supply chain and procuring health commodities to improve HIV diagnosis, treatment and retention in care through right-size contributions to programmatic needs coverage. USAID also implements a community-based model that trains HIV positive women (and community HIV counselors) to test, identify pregnant and breastfeeding women living with HIV, obtain consent to test partners and their children, as well as the general population, including men, while referring HIV positive cases to specialized PEPFAR supported treatment facilities.
Maternal and Child Health - Polio Surveillance
USAID partners with Angola’s Ministry of Health (MoH) to improve maternal and child health through targeted polio surveillance. Since 2007, the U.S. Government, through USAID, has played a key role in supporting Angola’s polio eradication efforts. While Angola remained polio-free from 2011 to 2019, a vaccine-derived polio outbreak occurred from May 2019 to February 2020, with the last case detected in December 2023. In 2024, USAID provided over $800,000 in operational support for outbreak response through WHO/Angola. USAID will continue to provide technical and financial assistance to enhance routine immunization efforts and strengthen epidemiological surveillance for rapid detection and response.
Family Planning and Reproductive Health
USAID supports MoH primary goal of reducing maternal and child mortality by increasing access to high-quality family planning (FP) information, reproductive health services, and commodities. This includes expanding access to modern contraceptive methods, strengthening health provider capacity, and raising community awareness about reproductive health. USAID also works to integrate FP/RH services into broader health initiatives, such as maternal and child health programs, to ensure women and couples can make informed decisions about their reproductive health, contributing to better health outcomes for families and communities.
USAID initially launched Family Planning activities in two provinces, Huambo and Luanda, and has since expanded the program to six provinces, now including Malanje, Lunda Sul, Lunda Norte, and Cuanza Norte. A total of 156 USAID-supported health units across these provinces now offer integrated Family Planning and HIV counseling and testing services. This expansion aims to increase access to comprehensive reproductive health services and improve overall health outcomes in Angola.
USAID works closely with UNFPA to support Angola’s Ministry of Health in its commitment to the FP2030 global initiative, advocating for increased domestic financial resources to implement sustainable Family Planning programs. In collaboration with the Government of Angola and other stakeholders, USAID helped procure and distribute over 5.8 million FP/RH products to USAID-supported facilities between 2017 and 2022. Since 2017, USAID has been a key donor, providing approximately $28 million for family planning programs and commodities in Angola, fostering long-term reproductive health improvements.
COVID-19
USAID’s COVID-19 program in Angola supports the government in implementing key prevention, control, and response strategies. The program facilitates mobile vaccination teams across 14 provinces to increase vaccine access and works with the Ministry of Health to execute the National Deployment and Vaccination Plan. Additionally, USAID is enhancing Angola’s vaccine storage capacity by installing ultra-cold chain freezers in eight provinces and conducting communication campaigns to boost vaccine uptake.
In 2021, U.S. President Joe Biden committed $4 billion to COVAX to aid in vaccinating 70% of the population in over 100 low- and middle-income countries. The U.S., as the largest donor to COVAX, has pledged to provide more than 1.2 billion COVID-19 vaccine doses globally. Through USAID, over $33.6 million has been provided to Angola for COVID-19 response since 2020.